My understanding is that AF is an evolving, or a progressive, disorder of the heart. Some tolerate it and are largely unknowing, or asymptomatic, or simply don't want to do anything about it. Many know when they are in AF and it greatly interferes with their peace of mind and with their quality of life. Sleep is impacted, loved ones are nervous because you are agitated and pacing or have that 1000 yard stare, and there's often a feeling of lack of control and of dread. Some are breathless, feel the thumping in the chest wall, and have to belch all the time. It simply sucks for them.

You are fortunate to not have a 'racing heart.' What is your HR during the worst of AF? Most of us have AF between 90 and 140 BPM, and if it's higher it's probably flutter. My information, both orally given by an electrophysiologist and in written form on a precis given to me for recovery at home following a catheter ablation, was that an HR above 100 should not be left untreated after 24 continuous hours. The reason is the heart muscle can become fatigued, but it can also compromise the mitral valve eventually, and it forces the atrium to enlarge...and this causes it to stiffen.

Did they not offer a rationale for letting you remain in AF? Perhaps its because yours is self-controlled and stable, at least for now, and doesn't present a risk to you. AF doesn't kill us, but it can cause problems later that will make our health a challenge. An enlarged left atrium is one of them, as is a prolapsed mitral valve. If it progresses to supraventricular tachycardia, or you develop what is called 'rapid ventricular response', this is a potentially dangerous situation that needs to be addressed right away. But, I take it that it is only your atrium that is contracting chaotically, and there is no apparent ventricular response...it still beats on cue from the SA node.

Again, AF won't kill us. It makes us miserable, anxious, and feeling unwell. But it won't kill us. What your care team SHOULD BE doing is treating you on the basis of quality of life, how it impacts you, how much you'd like to have an ablation or be cardioverted (was that not offered?), your current level of AF (paroxysmal, persistent, or permanent), and on your prognosis. Maybe you need to go further afield and find another more sympathetic EP, hopefully one who is highly sought, very busy, highly experience, and in high demand. Two I am aware of (do not know them) are Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin (he travels to hospitals all over), and Dr. Santangeli at Cleveland Clinic.

Good luck.