"Discovering the potential cause of atrial fibrillation and treating it is recommended before initiating antiarrhythmic therapy." From Top Ten things to know. Rule number one. Remove the cause and thereby eliminate the threat. I noticed, however, that little or no mention of the causes of AF were addressed in this study but only intervention. Seems this is the definition of a semi-blind study where we treat the symptom and not the cause. Is this "Sam's" point that even in a focused study on the management of AF we ignore the elephant in the room how did we get here?