The management of atrial fibrillation (AF) is plagued by, among other things, limitations in the efficacy, tolerance, and safety of currently available agents for the conversion of AF to sinus rhythm and for the maintenance of sinus rhythm. This review describes some of the most promising approaches to new therapies that may overcome some of the limitations of our current therapies. The agents we have chosen to review are representative of these new approaches and have completed their phase III trials and have submitted an application for approval for release by regulatory agencies or have almost completed their phase III trials and appear likely to submit for approval in the not to distant future.