The morbidity and mortality associated with AF provide a rationale to maintain sinus rhythm. Given the anticipated enormous public health impact of AF, proven interventions to reduce the risk of stroke, HF, cognitive impairment, and mortality are direly needed. Large, prospective, multicenter, randomized clinical trials will help address whether sinus rhythm achieved with ablation techniques lowers morbidity and mortality compared with rate control alone or treatment with antiarrhythmic therapy. These studies will also best define the patient population that will derive the most benefit. Until the results of these types of clinical trials are available, it must be recognized that the only proven benefit of AF ablation remains the reduction of symptoms and an improvement in QOL.