Eighty one elderly patients with paroxysmal atrial fibrillation were studied with respect to clinical features, effect of antiarrhythmic drugs and prognosis. 35 (43.2%) patients were associated with coronary artery disease and/or hypertension, while 23 (28.4%) patients had no other cardiovascular diseases. The latter condition was significantly less in patients over 60 years old when they had the first paroxysmal attack. Atrial fibrillation became permanent in 18 (22.2%) patients. Left atrial enlargement and abnormal cardiac function were significant independent factors affecting the type of atrial fibrillation. During an observation period of 12-84 months, the incidence of cerebral embolism and cardiac death were 6.1% and 4.9% respectively in all cases. We did not find that the prognosis of patients was affected by the types of atrial fibrillation.