Abstract: ob＜x＞jective To investigate the risk factors and the possible risk prediction methods of recurrence of persistent atrial fibrillation (AF) after radiofrequency catheter ablation. Methods This is a single-center prospective observational study and a total of 53 patients with persistent AF, undergoing RFCA for the first time from July 201 8 to August 2019 in Affiliated Hospital of Xuzhou Medical University, were prospectively enrolled. Relevant clinical data of these patients were recorded, left atrial voltage mapping was performed after circle pulmonary vein isolation under sinus rhythm , and COX multivariate analysis was conducted to explore the risk factors and predict the risk of the recurrence after a follow up for a mean of 16(12,21) months. Results 14 patients (26.42%) had atrial fibrillation recurrence. T he mean P wave duration (mPWD) was significantly longer (141.6±11.04 ms) vs (123.15±13.87 ms),P<0.001 and the mean left atrial voltage (mLAV) was significantly lower (0.66±0.36 mV) vs (1.14±0.49 mV),P =0.001of the recurrence group than that of the successful group. Cox multivariate regression analysis showed that both mPWD and mLAV were independent risk factors for atrial fibrillation recurrence(HR=1.10，95%CI 1.02~1.1 7，P =0.010; HR=0.14，95%CI 0.02~0. 84，P =0.033). ROC curve was ploted according to the predicted P value derive from the model constructed ba＜x＞sed on mPWD and mLAV indexes to predict the risk of atrial fibrillation recurrence, with AUC=0.90(95%CI 0.80~0.99,P<0.001). The cut-off point of predicted P value was 0.462, and the sensitivity and specificity of diagnosis were 78.60% and 94.90%, respectively. Conclusion The duration of P wave and the left atrial voltage can effectively predict the recurrence risk of persistent atrial fibrillation after single radiofrequency catheter ablation