This study aimed to evaluate the long-term efficacy and clinical outcomes of catheter ablation performed with cryoballoon (CRYO) in comparison with robotic magnetic navigation (RMN) in patients with persistent atrial fibrillation (PersAF). A total of 200 patients with symptomatic PersAF were prospectively enrolled and non-randomly assigned (1:1) to the CRYO or RMN guided-ablation group undergoing pulmonary vein isolation (PVI) and additional linear ablation if necessary and then followed up over 5 years. The primary endpoint was freedom from atrial tachyarrhythmias (ATs) recurrence following a 3-month blanking period after the initial procedure. The secondary endpoints consisted of all-cause and cardiovascular rehospitalizations, rates of electrical cardioversion (EC) and re-do ablation, new-onset neurological event, major bleeding event and the difference in CHA