Reducing AF burden (AFB), eliminating long episodes of AF (LEAF), and restoring normal sinus rhythm have been shown to markedly improve symptoms and lessen heart failure progression.  With the widespread use of FDA-approved wearable AF monitoring devices for arrhythmia detection, it is now possible to identify subjects with high AFB, LEAF and symptoms; these patients are at high risk of complications, including stroke, heart failure, and progression to permanent AF.  Budiodarone has been shown to markedly reduce the number and duration of AF episodes, restoring atrial contraction and normal sinus rhythm.  In another study, it does not depress ventricular function and is well tolerated in AF subjects with heart failure.  Dose adjusted budiodarone may provide a new safe and effective treatment option in AF patients to inhibit development of or treat heart failure in a personalized manner with patient monitoring.