Ablation Verses Anti-arrhythmic Therapy for Reducing All Hospital Episodes From Recurrent Atrial Fibrillation

Inclusion Criteria: 1. Documented paroxysmal atrial fibrillation 2. Modification or initiation of anti-arrhythmic agent required for symptom control 3. Males or females eighteen (18) to eighty (80) years of age 4. Suitable candidate for catheter ablation 5. Signed informed consent Exclusion Criteria: 1. Contraindication to catheter ablation 2. No carer to enable daycase discharge 3. Arrhythmias other than AF documented unless they have had curative ablation (eg. for atrial flutter) 4. No documentation of sinus rhythm within 3 months 5. Valvular or coronary heart disease needing regular follow up 6. EF \<45% or moderate/severe LV dysfunction 7. Active gastrointestinal disease 8. Renal failure with creatinine \>200 μmol/L or on dialysis 9. Active fever or infection 10. Life expectancy shorter than the trial 11. Allergy to contrast 12. Severe cerebrovascular disease 13. Bleeding or clotting disorders or inability to receive heparin 14. Uncontrolled diabetes (HbA1c ≥73 mmol/mol or HbA1c ≤64 mmol/mol and Fasting Blood Glucose ≥9.2 mmol/L) 15. Serum Potassium \[K+\] \<3.5 mmol/L or \>5.0 mmol/L 16. Malignancy needing surgery, chemotherapy or radiotherapy 17. Pregnancy or women of child-bearing potential not using a highly effective method of contraception 18. Must not have previous (4 weeks prior to screening) or current participation in another clinical trial with an investigational drug or investigational device 19. Unable to give informed consent 20. Uncontrolled thyroid disease defined as abnormal thyroid function tests causing cardiac manifestations within the last 6mths 21. Unable to attend follow up visits