Pulmonary Vein Isolation With Versus Without Continued Antiarrhythmic Drug Treatment in Subjects With Recurrent Atrial Fibrillation

Inclusion Criteria: * patient has continued (IC or III) ADT throughout the 3-month blanking * patient is free of symptomatic and asymptomatic AF (as evidenced by 1-day Holter) at the 3-month visit * drug-resistant (at least one class IC or III) symptomatic AF was the primary indication for prior PV isolation * in the three months prior to PVI, at least one episode of symptomatic or asymptomatic AF * PV isolation was performed according to the standards set forward by the Task Force Document (sedation or general anesthesia) * PV isolation was the only target for ablation (except for cavotricuspid (CTI) ablation if documented AFL) * PV isolation was performed by point-by-point irrigated radio frequency (RF) guided by contact-force (Biosense) (10-30gr-continuous lesion) * PV isolation (i.e. entry block) was verified in each vein after a waiting time and adenosine (with continued RF if acute reconnection) * Signed Patient Informed Consent Form. * Age 18 years or older. * Able and willing to comply with all follow-up testing and requirements. Exclusion Criteria: * Longstanding persistent atrial fibrillation (\>12 months of continuous AF) * Previous ablation for AF * left atrium (LA) size \> 55 mm * left ventricular ejection fraction (LVEF) \< 40% * AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause * coronary artery bypass graft (CABG) procedure within the last six months * Awaiting cardiac transplantation or other cardiac surgery * Documented left atrial thrombus on imaging * Diagnosed atrial myxoma * Women who are pregnant (by history of menstrual period or pregnancy test if the history is considered unreliable) or breastfeeding * Acute illness or active systemic infection or sepsis * Unstable angina * Uncontrolled heart failure * Myocardial infarction within the previous two (2) months * History of blood clotting or bleeding abnormalities * Contraindication to anticoagulation therapy (ie, heparin or warfarin) * Life expectancy less than 12 months * Enrollment in any other study evaluating another device or drug * Presence of intramural thrombus, tumor or other abnormality that precludes catheter introduction * Patients not taking any class IC or III ADT at 3 months after PV isolation * No documentation of entry block at initial PV isolation - no waiting time or adenosine. * Additional linear ablation or defractionation during the initial procedure (except for CTI ablation for documented or induced cavo-tricuspid isthmus dependent flutter).