[Paroxysmal atrial fibrillation: which anti-arrhythmic treatment?].

Only symptomatic patients with paroxysmal AF will be prescribed anti-arrhythmic drugs in order to prevent recurrences. Anti-arrhythmic drugs' efficacy in maintaining sinus rhythm is around 50 to 70 % at one year. Anti-arrhythmic drug prescription is associated with potentially life-threatening pro-arrhythmic effects. Anti-arrhythmic drug prescription should be tailored to each patient after carefully evaluating the risk/benefit ratio. Pulmonary veins isolation might be proposed in case of symptomatic paroxysmal AF after failure of anti-arrhythmic drug therapy.