A 60-year-old man has been recently diagnosed with paroxysmal atrial fibrillation and comes to you for further evaluation. Five years ago, he underwent dual-chamber pacemaker implantation for intermittent high-grade atrioventricular (AV) block. His other past history includes hypertension and hyperlipidemia. His medications at present include lisinopril 10 mg daily, metoprolol 50 mg twice daily, and simvastatin 40 mg nightly. He underwent stress echocardiography last year, which reveals no evidence of ischemia, LVEF 65%, and without any significant valvular abnormalities. Upon routine interrogation of his pacemaker, he is found to be in atrial fibrillation by the detection of mode switching about 10% of the time. The average ventricular rate in atrial fibrillation is 80-90 bpm. He is unaware of these events.

With regard to management of atrial fibrillation, which of the following would you advise?

1. Flecainide
2. Amiodarone
3. Catheter Ablation for AF
4. Upgrade to CRT
5. Continue current treatment