We wish to thank Martignani et al. 1 for their critical Letter to the Editor according to our article recently published in Europace 2 where they question our proposal that propafenone should not be generally excluded from cardioversion of paroxysmal atrial fibrillation in patients with structural heart disease. Recent 2016 European Society of Cardiology Guidelines for the Management of Atrial Fibrillation 3 support the use of propafenone for acute pharmacological cardioversion in patients with new onset of atrial fibrillation. However, their restriction that propafenone should only be given to patients without structural heart disease3 particularly bases on CAST (the Cardiac Arrhythmias Suppression Trial ), …