〔Abstract〕 Objective In the present study, the changes of left atrial matrix characteristics and the effect of catheter ablation on cardiac function in elderly patients with persistent atrial fibrillation were observed. Furthermore, the application of two catheter ablation methods including circular pulmonary vein isolation combined with left atrial matrix modification or left atrial posterior wall isolation were compared by researchers in order to explore effectiveness and safety of the two methods in elderly persistent atrial fibrillation patients. Methods A total of 86 elderly patients with persistent atrial fibrillation were selected and divided into two groups using randomization principle; the pulmonary vein isolation combined with left atrial matrix modified catheter ablation method was named matrix modified group(43 cases); the pulmonary vein isolation combined with left atrial posterior wall isolation catheter ablation method was named posterior wall isolation group(43 cases). During ablation left atrial electro matrix mapping were analyzed by multipole catheter for all patients. After ablation all patients were follow-up in 12 months by cardiac color doppler ultrasound examination, ECG and Holter. The incidence of arrhythmia, serious adverse event and complications were compared between two groups. Successful rate of single ablation and blank period recurrence after ablation were observed in 12 months follow-up time. Results Through electrogram mapping of left atrium low-voltage areas or scar areas were founded in 72 cases among the 86 cases after ablation, After a 12-month follow-up, the incidence of arrhythmia in the blank period between the two groups was 41.9%(matrix modified group) and 23.3%(posterior wall isolation group), independently,P<0.01, successful rates of single ablation in the two groups were 83.7%(matrix modified group), 60.5%(posterior wall isolation group), independently,P<0.01. No adverse event occurred in the two groups. After AF ablation LVEF increased, LVEDD and LVAD significantly decreased in all of the cases. There was no significant difference between the two groups in patients' characters ablation time and complications rate. Conclusion Circular pulmonary vein isolation combined with left atrial matrix modification is as safe as left atrial posterior wall isolation, and it is a simplified, personalized, and more effective ablation strategy in elderly patients with persistent atrial fibrillation.