We suggest that after conversion to sinus rhythm has been achieved, whether antiarrhythmic drug therapy is indicated should be based on the estimated probability of recurrence and the symptoms during AF. Long-term therapy will need to be determined by an appropriate outpatient consultation. (Recommendation Conditional, Quality Low)

Values and preferences: This recommendation places a high value on minimizing the risk of infrequent but serious side effects associated with long-term antiarrhythmic drugs. A high value is also placed on the appropriate use of specialty care to make patient-specific decisions to minimize these risks. A lower value is placed on the avoidance of symptoms associated with subsequent episodes of AF/AFL if antiarrhythmic drugs cannot be avoided.