Diane said:
'...It was either a great placebo, it worked, or I was going to go into sinus anyway...."
The latter. When one is paroxysmal, it comes and goes on its own, sometimes with the help of meds, sometimes only with a coupla decent belches. Seriously. For me, going to bed at night, having that first twitch about six minutes later, and when I aroused for a minute and 'listened', my heart was in NSR without fail. 100% reliably. It took a couple of months, but eventually I came to rely on that first-jerk reliability and was so grateful. My sis-in-law goes to bed and that's when her AF starts. And her story is shared by probably 20% of all AF sufferers (admittedly a guess).

When I relapsed about six months after my first ablation, I had two 220mg amio left from a previous scrip...my first ablation failed inside of six days and I was admitted. Between the ER internist and my EP, they elected to give me 'the big hammer'. I went on 400mg BID for a week as a loading regimen, then 200 BID for four weeks, then a two week taper at half that rate. It worked, and I was good until the two month mark, had more AF, told to go on 25 mg metoprolol BID, which was good until the event just two months later that I started out describing. I took the 400 mg total, and it didn't touch the rate or rhythm. Told to go home and hope it would revert with metoprolol, which I had also. I was back in NSR inside of four hours, albeit with about 75 mg in me from a drip while in ER. So, yes, a drug will help to tip you, but you go home in VTac or AF after they shrug and invite you back if it won't subside inside of 24 hrs, and while you're watching TV or on the computer three hours later, it reverts. Happened to me several times. I had four cardioversions, none of which lasted for more than 16 hours, last one was a whole 20 minutes. The heart has a mind of its own, lemme tell ya. 😀

I do find it very encouraging that your atrial enlargement reversed somewhat when you went for long periods free of ectopy. The literature is mixed on that, and the very wonderful AF clinic outreach nurse who held my hand several times when I was in ectopy, this over the phone, told me that my LA would probably not reduce in size over time. Others, like you, insist that theirs has, or did. So, thank you for including that important information. I have been in NSR for 20 months after the second ablation, and have felt my heart improving slowly every since. Just recent went on a hike with my wife which included 250 steps on a bluff overlooking the ocean nearby, and I haven't felt the strength like that in over two years. It's marvelous. Slow...for me...but marvelous to have it back (used to be a competitive runner.

About amiodarone. It's a big hammer, but comes with glaring caveats. I have never read, nor been told, that it is to be used for only certain arrhythmias, and certainly not just for ventricular arrhythmia, windy. I was in AF and it took me, with one single loading dose of 400mg, out of my AF inside of about 10 hours. I awakened, after some melatonin and some zopiclone, and about five hours of sleep (I was a mess sleep-wise by then), to find my heart back in NSR, and it never went out again until about three months later, a month after stopping the amio.

This is long, but sometimes anecdotal information is transferrable...amiodarone never impeded my normal range of BP. Only metoprolol did that, and it does for a good many users with ectopy when their incidence rises and the order is to increase the dosage. In my case, when I went to the ER six days out in family-doctor-discovered AF, my HR was 30, and one time when I was talking to my wife, the nurse came running to find me alert and conversing. She couldn't believe it. She held out her forefingers yay far apart and said they had watched me flatline for that long on their desk monitor. That was six days post-cath, with 50mg metoprolol prescribed BID. It was far too much, but....who knew!

Diane said: "...From my readings in this archive, vagal afib is far more common than the literature would suggest. Or the vagal afib people are so outraged by it they go looking hard for answers!..."

Maybe, yes, probably, but I think there is likely more of a dual nature to most cases of AF, not that most of us have one 'type' and not the other. I think the heart reacts to changes in Vagus tonality, but it also reacts to rushes of epinephrine by changing its substrate electrical properties. I mean, if the pulmonary vein ostia, say, are infiltrated with atrial endothelium, the atrium WILL respond when electrical impulses emanate from the veins because of that intimate incursion. Well, why are we not in ectopy constantly then? Why paroxysmally? The answer must lie in changes to the heart's state or condition, and that means what's happening around it and to it. So, I think that too much stress, poor sleep, finding out your sister was badly hurt, or that your bank account if overdrawn, may put you into AF as readily as awakening with a start and having to leap out of bed will when an alarm signals an important event is pending. Or, that belching to relieve stomach distension (one of my triggers was distension, I believe) changes Vagal tonality and boom...yer in AF inside of five seconds.