Introduction: Antiarrhythmic drugs are often administered after catheter ablation (CA) in patients with atrial fibrillation (AF); however, it is unclear for how long it should be continued. Methods: We administered hybrid therapy consisting of CA and bepridil to 130 patients with persistent AF and left atrial (LA) enlargement (volume index >48 ml/m 2). After a 2-month of hybrid therapy, bepridil discontinuation was attempted. All patients underwent echocardiography 6 months after CA. We investigated the relationship between the duration of bepridil administration and the recurrence of AF after bepridil discontinuation. Results: After excluding patients who were unable to maintain sinus rhythm during bepridil administration (n=18), and those who disagreed to bepridil discontinuation (n=17), 95 patients were divided into the short-term continuation (bepridil discontinued for <6 months [median 3.0 months] after CA [n=63]), and long-term continuation (bepridil discontinued for >6 months [median 11.4 months] after CA [n=32]) groups. During the mean follow-up period of 28±15 months, the groups showed a similar incidence of recurrent AF after bepridil discontinuation. In the long-term continuation group, 13 patients had recurrence, with 8 (62%) cases occurring within 4 months after discontinuation. A multivariate Cox regression analysis revealed that left atrial (LA) reverse remodeling (>15% decrease in LA volume index at 6 months) was an independent predictor of recurrent AF after CA (p<0.01). Conclusions: Long-term bepridil administration after CA did not affect the recurrence of AF after discontinuation. The assessment of LA reverse remodeling may be useful for decision-making regarding the discontinuation of antiarrhythmic drugs after CA.