I am a 59-year-old female with atrial fibrillation who just had a CAC score of 815! I have an electrophysiologist for my a-fib and saw a second cardiologist for the high CAC score yesterday. The a-fib has been present for 7 years and is currently fairly well controlled, but the high CAC score has me extremely scared! The cardiologist did not offer much in the way of information and just said I had to have a Lexiscan and then possible catheterization based on those results. Researching the Lexiscan makes this test sound horrific and full of risks. Should I proceed straight to heart catheterization? Incidentally, I have already been placed on a statin and aspirin and I am asymptomatic, having never had any angina. My cholesterol was also totally normal prior to being placed on the statin at 163, and I had a normal coronary CT scan and Myoview stress test 3 1/2 years ago prior to having cardiac ablation for my a-fib. I am very over overweight (although have lost 28 pounds in the last few weeks) and not very physically active, having always had sedentary jobs most of my life. I also have type 2 DM, but my A1c has never been over 7, I do not require insulin, and my blood pressure is well controlled. I have also never smoked and there is no history of heart disease in either of my parents or my sibling. I have a medical background, but I find all of this quite confusing and don’t know how best to proceed.