Objective To analysis the value of ECG f-Wave amplitude in predicting 1-year recurrence after catheter ablation(RFCA) in elderly patients with persistent atrial fibrillation (PsAF).Methods Patients aged ≥60 years who were diagnosed with PsAF and underwent RFCA in the First Affiliated Hospital of Nanjing Medical University from September 2014 to May 2022 were enrolled. Based on 1-year follow-up, patients were divided into two groups: the recurrence group and the non-recurrence group. The clinical characteristics of both groups were analyzed, and indicators showing significant differences were further examined using logistic regression analysis. Results A total of 369 patients were included. Of these, 88 patients (23.85%) experienced arrhythmic recurrence at 1-year follow-up. There were no significant differences between the two groups in terms of age, body mass index, comorbidities, left ventricular end diastolic dimension, left ventricular ejection fraction, pulmonary artery pressure, Pro-BNP, uric acid, and low-density lipoprotein cholesterol, antiarrhythmic drugs(all P＞0.05). The recurrence group had higher female ratio(39.77% vs. 26.69%,P=0.019), a longer duration of atrial fibrillation[17.00(6.00,60.00)month vs.8.00(3.00,24.00)month,P＜0.001], lower f-wave amplitude in lead III [0.07(0.06,0.08)mv vs. 0.09(0.08,0.11)mv,P＜0.001], lead avF [0.06(0.05,0.07)mv vs. 0.08(0.07,0.10)mv,P＜0.001], and lead V2 [0.07(0.06,0.09)mv vs. 0.10(0.08,0.12)mv,P＜0.001], larger LAD[44.00(41.00,47.00)mm vs.42.00(40.00,45.00)mm,P=0.039] and RAD[42.00(40.00,44.00)mm vs.40.00(39.00,43.00)mm,P=0.038]. Logistic regression analysis identified atrial fibrillation duration as a risk factor for recurrence in elderly patients, while f-wave amplitudes in lead V2 and aVF were protective factors. Conclusion The ECG f-wave amplitudes and atrial fibrillation duration may serve as predictors of the outcome of RFCA in elderly patients with PsAF.