It has indeed been a long and winding road from cryptogenic stroke to occult AF (AF) with many intervening detours. AF associated with mitral valve disease was identified in 1930 by Harvey as increasing the risk of stroke by 17-fold. In 1991 Wolfe identified a 5-fold increase in stroke risk for AF without mitral valvular disease. In the following year’s warfarin was shown effective in stroke reduction in such patients. In 1998 Haissaguerre suggested that AF was a primary arrhythmia with focal origin within the pulmonary vein. At that time AF management usually involved the doubly noxious regimen of amiodarone and warfarin. CABANA trial results and the observation that ablative procedures do not mitigate stroke risk, regardless of their perceived success, have forced a return to chronic anticoagulation for AF stroke prevention.