Atrial Fibrillation: Ablation or Surgical Treatment II: FAST II

Inclusion Criteria: * Recurrent symptomatic paroxysmal atrial fibrillation * Previously failed one or more antiarrhythmic or beta-blocker medication (treatment \> 30 days) or if any contraindications against treatment with these drug. * Patient is willing and able to attend the scheduled follow-up visits * Signed informed consent Exclusion Criteria: * Persistent or permanent atrial fibrillation * Previously atrial fibrillation ablation procedure * Atrial fibrillation secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause * Severe underlying heart disease (congenital heart disease, significant valvular disease, cardiomyopathy with LVEF \< 35 %, angina pectoris/ ischemic heart disease). * Severe enlargement of left atrium (\> 45mm) * Patient with pacemaker * Failure to obtain informed consent * Pregnant or breastfeeding women. * Patient unable to undergo TEE or with documented left atrial thrombus * Patients with co-morbid conditions who, in the opinion of the investigator, constitute increased risk of general anesthesia or port access, e.g. pleural fibrosis, chronic obstructive pulmonary disease (FEV1 \< 1.5 L/s). * Known internal carotid artery stenosis (\> 80 %). * Patients, who are enrolled in another clinical trial * Life expectancy less than one year * Previously TIA/stroke