Clinical Research Directory

7.2 Inclusion criteria In order to be eligible to participate in this study, a subject must meet all of the following criteria: * Age ≥ 18 years old * ECG documented diagnosis of paroxysmal AF * Presence of symptomatic paroxysmal AF, defined as recurrent self-terminating AF (≥ 2 episodes in last 4 months) documented by typical symptoms, ECG or photoplethysmo-gram * Able and willing to sign informed consent. For SMART sub study only: \- Own a smartphone 7.3 Exclusion criteria A potential subject who meets any of the following criteria will be excluded from participation in this study: * A history of electrical cardioversion for persistent AF * History of AF episode \> 7 days * Previous or current chronic amiodaron use. * A history of pulmonary vein ablation * Taking part in another randomized trial * Reduced life-expectancy of \< 1 year * Presence of contra-indication for verapamil or metoprolol * Pregnant or breastfeeding women. Or women who are planning to become pregnant during the study period. * For substudy patients: already participating in an eHealth program Contraindications for verapamil or metoprolol: * Known hypersensitivity, intolerance or allergy to verapamil, metoprolol, or any excipi-ents. * Current use of verapamil, diltiazem, beta-blockers or digoxin, or \< 5 half-lives ago at the time of randomization. * Concomitant use of medications with absolute contraindications for verapamil or metoprolol (e.g., strong CYP3A4 inhibitors).\* * Resting heart rate \< 50 beats per minute at baseline. * Symptomatic hypotension (or systolic blood pressure \< 100 mmHg). * Second- or third-degree atrioventricular block. * Sick sinus syndrome or sinus node disease. * Wolff-Parkinson-White syndrome. * Severe heart failure (NYHA class III-IV or left ventricular ejection fraction \< 45%). * Clinically significant constipation requiring medical intervention. * Severe bronchial asthma or COPD with bronchial hyperreactivity. * Untreated pheochromocytoma (unless patient is concomitantly treated with an α-blocker). * Type 1 diabetes mellitus with frequent symptomatic hypoglycaemia where β-blocker use would pose unacceptable risk due to masking of symptoms. * Severe symptomatic peripheral arterial disease or disabling Raynaud's phenomenon. * Pacemaker therapy in place. An implanted loop recorder is not a contraindication. * Severe hepatic impairment (Child-Pugh class C). * Severe renal impairment (eGFR \< 30 ml/min/1.73m²). \*Patients using statins can be switched to an equivalent dose of rosuvastatin prior to ran-domization. Patients using oral anticoagulation need to be switched to apixaban or rivaroxa-ban.