There are strategies that work for some people besides cardioversion (I know two who have been CV'd over 40 times!!) or drugs. These people find out what their triggers are and avoid them. They also lose weight if they could stand to shed a few pounds, avoid alcohol and caffeine, and some find that limiting calcium intake works well. Others take L-Taurine and Magnesium. I know that high levels of potassium is not good for one's kidneys over time, but the first time I ended up in the ER for post-ablation arrythmia, they fed me two large horse pills of potassium once they had my blood assay results. I eat lots of foods rich in potassium most days, so I ought not to have been light on that element. Their numbers said I was indeed light, so now I eat pistachios, potatoes most days, drink coconut water, grow beets each summer, and I have at least 1/4 cup of peanut butter on w/w bread for breakfast. You'd think I would be good, but.....apparently I dump potassium.

Don't forget those statistics about ablations though: index ablations fail at the rate of about 25% across all surgeons. The ratio improves for second ablations meant to correct what was missed the first time. And almost all other forumites across various fora I attend where AF is discussed end up needing other measures in time, including subsequent ablations, because the disorder progresses. If the index caught it properly, and just a PVI was done, the heart looks for other re-entrant foci over the next months and years, and then the arrhythmia returns. The re-entrants are typically out from the pulmonary vein ostia where the antrum is. Or the Vein of Marshall, or the superior vena cava, or the coronary sinus, or it moves to the atrial appendage. It can take place near the SA node in a loop.

The good news is that, if one anti-arrhythmic drug fails to control it, whether from being the wrong drug or from the heart overcoming its effects in time (losing its potency), there are others. I have been on amiodarone. There are worse things, but some would argue with me. It's a harsh drug, and must be closely monitored. But it got my heart under control, and looking back, I am grateful for that three month interlude. And, there is usually room for one more ablation if the numbers total six or seven and less. After larger counts, the EP might suggest a pacemaker.