Inclusion Criteria:

* Have documented AF, which warrants active drug or ablative treatment
* Be eligible for both catheter ablation and at least 2 sequential anti-arrhythmic drugs and/or 3 sequential rate control drugs
* Be >65 yrs of age, or <65 yrs with one or more of the following risk factors for stroke: Hypertension, Diabetes, Congestive heart failure (including systolic or diastolic heart failure), Prior stroke or transient ischemic attack, Left atrium >4.5 cm, ejection fraction <35% by echocardiogram, radionuclide evaluation or contrast ventriculography

Exclusion Criteria:

* Previously failed 2 or more membrane active anti-arrhythmic drugs
* Efficacy failure of a full dose Amiodarone trial of >12 weeks duration
* Any amiodarone therapy in the past three months
* Reversible causes of AF including thyroid disorders, acute alcohol intoxication, recent major surgical procedures, or trauma
* Lone atrial fibrillation in the absence of risk factors for stroke in patients <65 years of age
* Recent cardiac events including myocardial infarction, percutaneous intervention, or valve or coronary bypass surgery in the preceding 3 months
* Hypertrophic obstructive cardiomyopathy
* Class IV angina or congestive heart failure
* Planned heart transplantation
* Other mandated anti-arrhythmic drug therapy
* Heritable arrhythmias or increased risk for "torsade de pointes" (a specific, rare variety of ventricular tachycardia) with class I or III drugs
* Prior left atrial catheter ablation with the intention to treat AF
* Patients with other arrhythmias requiring ablative therapy
* Prior surgical interventions for AF such as the MAZE procedure
* Prior atrioventricular nodal ablation
* Medical conditions limiting expected survival to <1 year
* Contraindication to warfarin anti-coagulation
* Women of childbearing potential
* Participation in any other clinical mortality trial
* Unable to give informed consent