We suggest catheter ablation to maintain sinus rhythm as first-line therapy for relief of symptoms in highly selected patients with symptomatic, paroxysmal atrial fibrillation. (Recommendation Conditional, Quality Low)<br /><br /><b>Values and preferences: </b>This recommendation recognizes that individual patients may have a strong intolerance or aversion to antiarrhythmic drugs such that the risk of ablation is deemed warranted.