Atrial fibrillation (AF) is a common cardiac arrhythmia associated with an increased risk of stroke, heart failure and mortality. While catheter ablation is increasingly used for early rhythm control, evidence on its cardiovascular outcomes in high-risk individuals with newly diagnosed AF remains limited. This study aimed to evaluate the association between catheter ablation and the risk of major adverse cardiovascular events (MACE) in high-risk patients with newly diagnosed AF using a target trial emulation design.