In order for the safety of the out-of-hospital “pill-in-the-pocket” approach, several factors must be taken into consideration. Even if this treatment has been proven safe with a precedent in-hospital observation, the association of “pill-in-the-pocket” treatment with clinical conditions or with food and other antiarrhythmic and non-antiarrhythmic drugs must be kept in great consideration. Thus the outcome of the patients receiving this new therapeutic approach should be closely monitored. The “pill-in-the-pocket” approach is a recently innovative pharmacological scenario. However, we believe that an observation in the hospital is required after the “pill-in-the-pocket” approach.