Atrial fibrillation is a common arrhythmia associated with significant morbidity, including angina, heart failure, and stroke. Medical therapy remains suboptimal, with significant side effects and toxicities, and a high recurrence rate. Catheter ablation or modification of the atrioventricular node with pacemaker implantation provides rate-control but exposes patients to the hazards associated with implantable devices and does nothing to reduce the risk for stroke. Pulmonary vein antrum isolation offers a nonpharmacologic means of restoring sinus rhythm, thereby eliminating the morbidity of atrial fibrillation and the need for antiarrhythmic drugs.