The review presents data from recent clinical recommendations for preventive medical treatment of atrial fibrillation. All available up-to-date data on trials results are summarized and analyzed. The issues of long-term treatment strategy and prevention of atrial fibrillation recurrences are discussed. Different up-to-date classes of antiarrhythmic drugs, registered in various countries of Europe and America, are reviewed. The article deals with preventive antiarrhythmic efficacy, pro-arrhythmogenic and other side effects of these antiarrhythmic drugs. The results of studies on short-term antiarrhythmic treatment, along with its advantages and disadvantages, are presented. These trials are designed to help the physician to choose the optimal treatment strategy, given its potential impact on outcomes, as well as the benefit-risk ratio. According to the up-to-date data, sinus rhythm restoration should be a preferable treatment strategy, especially in younger people.