I hear you. So many mysteries, so few anchors, talks of 'triggers', positional, drugs suddenly, maybe for life...oy!

I take it that you're on a DOAC? You should be. ..at least that's indicated for anyone with AF. Anyone proffer a CHADS-VASC score for you? Most cardo/EP use that to determine medication.

Some respond very nicely to supplements of Mg, and I happen to take the '-ol' formulation of CoQ-10 (Costco) because I am told I have to be on a statin for life (MIBI X2, echo, Doppler, angio all said I was at very low risk, no ischemia, minor deposition, but...take the statins. GGrrrrr...!)

An EP will want some stability and will only want to treat you urgently if you have a very high burden and indications of valvular problem onset, englargement, unknown duration of flutter, etc. They'll want apnea controlled first, for example. Valves repaired first. As you would know, mitral prolapse is a distinct problem with AF and its generation of fibrosis.

I had only minor success with manual stimulation of the tragus. There's a video on youtube about doing this to increase tonality of the Vagus nerve. First, lightly grip the tragi with forefinger and thumb, and repeatedly tug upward, but letting your grip loosen and your finger slide off...so only moderate lifting. Do this 20 times. Then, invert thumbs, nails down, and insert them into the ear canal. Repeatedly lift 20 times. Not so comfortable, but not painful. This should help. It sometimes helped to settle my AF, but not often.

For me, eventually, and with a lot of reading, I realized that only an ablation was going to work for me. It did, but not the first instance. Seven months later, a second go did the trick.

As we tell each of our inquirers looking for answers over on afibbers.og, it's very much a unique and individual experience for each of us. About all that's really common is our commiseration and mutual support. Drugs work well, then they don't. Or they make people feel awful, and only a pacemaker or ablation will work....or they won't either. Some can't sleep, some can't eat, some can't walk, some can't stand...it's all over the place.

For those reading this, it's a journey we must all bear, hopefully not alone. It's hard on relationships, it's hard on sleep, on anxiety, and it's usually progressive. So, if you have palpitations that come and go, if you have a firm diagnosis of paroxysmal 'any arrhythmia', get it controlled ASAP to prevent your heart from remodeling itself, which it will do if you stay in arrhythmia too long. Find out what works, and do a lot of reading. In my case, I couldn't wait to have an ablation, and one of them ultimately put me back on my feet. It could work for you.