My posts get lengthy and have become burdensome to me about atrial fibrillation, arrhythmias, their progressive nature, and that the real risk lies in either stroke or heart failure, with the latter term an unfortunately doom-laden one that sounds worse than it really is. However, as I just stated, most disordered hearts electrically tend to progress toward worse states or levels, and eventually all that's left is a pacemaker if nothing else is done to control the arrythmia...whichever one it is. The problem really is that the one chamber must bulk up its mass of myocytes in order to keep up. In the case of atrial fibrillation, the left atrium enlarges and thickens its muscular wall. This has the effect of causing stretching inside which causes fibrosis, or scarring. This encourages yet more fibrillation. Or, the stretching causes the mitral valve between the left atrium and ventricle to prolapse, which also tends to encourage arrythmia and wall-thickening. The point of all this is that the wall-thickening is only helpful to an upper limit after which the muscle thickness actually begins to hinder itself, and the heart loses efficiency in pumping. This insufficiency is called 'heart failure'.

Please note that people can live many years with either condition, the heart failure and/or arrythmias....except for ventricular tachycardia...you do not want that...at all...at all. It's just that there will be a gradual decline, and that is what all of us would want to avoid if possible. So, you take a DOAC (Direct Oral Anti-Coagulant) daily to minimize the risk of stroke from improper circulation in the heart (chiefly the left atrial appendage), you take a beta or a calcium channel blocker to reduce heart output (don't make the heart beat so strenuously, even at rest), but the blockers also slow the heart rate when you are in arrhythmia, and you may need an anti-arrhythmic drug like Multaq, Flecainide, Sotolol, propafenone, Diltiazem, or others...several others...and whatever you tolerate that helps you at the same time.

Unfortunately, there seems to be a wide disparity between the quality of training, and also in the experience, of all the electrophysiologists out there. The top tier ones are very busy, highly sought, and are exceptional with an exceptional record of success. However, even they frankly tell their first-time ablatees that they will probably be back for more work. And they do come back, whether in months or years. I had two ablations months apart because the index failed inside of six days.

To conclude, and to answer your question, yes, left unmanaged, or left improperly treated by drugs or by surgery, the tendency over time is for arrythmias to become persistent and then permanent. I strongly suggest you consider looking further afield for another, better, electrophysiologist. Find the best two days' drive away if necessary.