OBJECTIVE:　To　investigate　the　effect　of　pulmonary　vein　antrum　enlargement　combined　with　left　atrial　roof　cryoballoon　ablation　in　patients　with　persistent　atrial　fibrillation　(PeAF)　by　analyzing　the　relationship　between　left　atrial　isolation　area　surface　area　(ISA)　and　early　postoperative　recurrence.　METHODS:　93　patients　with　PeAF　were　classified　into　recurrence　and　non-recurrence　groups　according　to　the　results　of　the　1-year　follow-up.　Three-dimensional　electroanatomical　labeling　map　was　constructed　and　merged　with　that　of　the　left　atrial　pulmonary　vein　CTA,　and　the　ISA　and　the　left　atrial　surface　area　(LASA)　were　measured　and　analyzed　to　determine　the　relationship　between　ISA/LASA　in　relation　to　early　postoperative　recurrence.　RESULTS:　93　patients　were　included　and　followed　up　for　1 year　with　AF-free　recurrence　rate　of　75.3%.　The　ISA　of　the　recurrence　group　was　lower　than　that　of　the　non-recurrence　group.　Left　atrial　internal　diameter　(LAD),　left　common　pulmonary　vein,　the　ISA,　the　ISA/LASA　and　early-term　recurrence　had　statistical　significance　in　both　groups.　The　factors　that　significantly　predicted　early-term　recurrence　were　left　common　pulmonary　vein　and　the　ISA/LASA.　ISA/LASA　(HR　0,　95%　CI　0-0.005,　P = 0.008)　and　left　common　pulmonary　vein　trunk　(HR　7.754,　95%　CI　2.256-25.651,　P = 0.001)　were　the　independent　risk　factors　for　early　recurrence.　ROC　curve　analysis　showed　that　ISA/LASA　predicted　the　best　early　recurrence　after　operation　with　a　cut-off　value　of　15.2%.　CONCLUSION:　A　greater　ISA/LASA　reduces　early　recurrence　after　cryoablation　in　patients　with　PeAF.　An　ISA/LASA　of　15.2%　may　be　the　best　cut-off　value　for　predicting　early　recurrence　after　cryoablation　for　PeAF.　©　2024.　The　Author(s).