@harbeywj as I wrote, the first cardiologist, 10 years ago, wanted to put me on anticoagulants and I declined. It's not like I just said no; we discussed it and he agreed to wait. He did prescribe diltiazem as needed (low bp was a concern) and then went to digoxin, which I did not take and told him so.

The next episode, for which I was hospitalized, brought a cardiologist telling me to go home and forget it happened.

This wide divergence in advice was certainly a tip off.

The first cardiologist eventually agreed that I didn't need meds (after a few years) and said that "maybe we are overmedicating people." I have no idea. I am grateful and perhaps lucky to have avoided stroke or worsening afib so far (knock on wood, last one was April which came quicker than previous intervals).

The EP I recently saw said my CHADS2 technically means anticoagulation based on age and gender but all my other factors are negative so he didn't want to do anything but pill in a pocket. He briefly considered flecainide. I have taken diltiazem at home maybe three times. He said no ablation.

I am going to try to stay home next time, and medicate with diltizem with lots of hdyration. I have a bp cuff and if it is too low for diltiazem I will go to ER. EMT's always want me to call 911 but last time I drove myself.

After 9 years of magnesium, low sodium V-8, walking and tai chi, early dinner etc. etc. I bought "The AFib Cure: Get Off Your Medications, Take Control of Your Health, and Add Years to Your Life" by Day and Bunch. I was curious. They say that an increase in afib is not inevitable and that many (some?) can get off medications. I am not sure I trust anyone in this field but was glad to see some of my strategies affirmed.

That said, the cumulative physiology of this may actually be inevitable. I have some EKG abnormalities now when at rest and not in afib. I will go on anticoagulants when this new EP recommends them. I finally found a "just right" approach- not too aggressive and not too laissez-faire that I can trust.

My biggest concern is that ablation done early is more effective. My mother had permanent afib and I saw what that can do. The timing is just something I will rely on the MD for. As I said, he would consider my so far once annual episodes as success if he had done an ablation.
We'll see how long I go now!