Background It is unclear whether a history of paroxysmal atrial fibrillation (PAF) would impact the effect of catheter ablation on persistent atrial fibrillation (AF).This study aimed to compare the effect of catheter ablation on persistent AF with and without a history of PAF.Methods One hundred and eighty-three patients underwent catheter ablation of persistent AF lasting for ＞1 month and were reviewed.Patients were divided into two groups according to whether they had a history of PAF or not.Group Ⅰ consisted of persistent AF patients with a history of PAF,and group Ⅱ consisted of persistent AF patients without such a history.All patients received catheter ablation focused on pulmonary vein isolation and were observed for arrhythmia recurrences,which were defined as documented episodes of AF or atrial tachycardia after a blanking period of 3 months.Results One hundred and three patients (60.9％) in group Ⅰ and sixty-six patients (39.1％) in group Ⅱ were successfully followed and included in analysis.There were no significant differences in clinical and echocardiographic characteristics between both groups except for a younger age and more male patients in group Ⅱ.After (15.5±10.7) months of follow-up,59 (57.3％) patients in group Ⅰ and 49 (74.2％) patients in group Ⅱ maintained sinus rhythm free of anti-arrhythmia drugs (P=0.025).Multivariate analyses found left atrial anteroposterior diameter (P=0.006) and persistent AF with a history of PAF (OR 1.792,95％ CI 1.019-3.152; P=0.043) as the only independent statistical predictors of arrhythmia recurrences.Conclusion The arrhythmia recurrence rate of catheter ablation based on pulmonary vein isolation in persistent AF with a history of PAF was higher than those without a history of PAF