This case discussion activity was recorded at a live meeting in Short Hills, NJ on October 17, 2019. The meeting included renown electrophysiologists Drs. Suneet Mittal (Valley Health System), Jagmeet P. Singh (Massachusetts General Hospital), John M. Miller (Krannert Institute of Cardiology), and Andrew E. Epstein (University of Pennsylvania). Join Dr. Miller as he presents a case focused on managing atrial fibrillation that highlights critical management challenges and therapeutic options for rhythm control and stroke prevention. Dr. Mittal moderates the panel discussion that provides insights and pearls for clinicians who manage patients with this disorder. Slides by the other faculty are provided in the Resources section.