OBJECTIVE： To observe the efficacy and safety of amiodarone combined with valsartan in the treatment of paroxysmal atrial fibrillation in elderly patients. METHODS：130 elderly patients with paroxysmal atrial fibrillation were randomly divided into observation and control group. Control group was orally given Amiodarone tablet 0.6 g in the first week， 3 times a day， 0.4 g in the second week， twice a day， 0.2 g in the third week， twice a day； observation group was additionally given valsartan capsule 0.4 g in the first 1-3 day（s）， once a day， the dose was increased to 0.8 g if patients showed no hypotension， once a day， and then decreased to 0.4 g if the pressure was lower than 100/60 mm Hg， once a day. The treatment course for both groups was 12 weeks. Clinical efficacy， and left atrium （LA）， left ventricular end-diastolic volume（LVEDV）， left ventricular systolic volume （LVESV）， left ventricular ejection fraction （LVEF）， heart rate， cardiothoracic ratio， systolic blood pressure， diastolic blood pressure before and after treatment， and incidence of adverse reactions in 2 groups were observed. RESULTS： Total effective rate in observation group was significantly higher than control group， the difference was statistically significant（P＜0.05）. After treatment， LA， LVEDV and LVESV， heart rate， cardiothoracic ratio， systolic blood pressure， diastolic blood pressure in 2 groups were significantly lower than before， and observation group was lower than control group， LVEF was significantly higher than before， and observation group was higher than control group， the differences were statistically significant（P＜0.05）. There was no significant difference in the incidence of adverse reactions（P＞0.05）. CONCLUSIONS：The efficacy of amiodarone combined with valsartan is more obvious than only amiodarone in the treatment of paroxysmal atrial fibrillation in elderly patients， with similar safety.