@callmekate A t-score of -4.8 is serious business. I would not rule out Evenity (the most powerful and fastest bone builder) because of AFIB. As to stroke risk and cardiovascular events if you look at the research you see a slight elevation in events in one study and none in the other major study. Certainly if there is an elevated risk it is not great as too many people are taking Evenity now and those CV events do not appear to be happening.
Try to balance the risk of fractures with a -4.8 vs the very slight maybe potential increase in risk (and maybe no increase of risk) with Evenity.
I am biased - I chose Evenity and had great results and no side effects worth even mentioning.

I would investigate the CV and AFIB issues and discuss with doctors but I wouldn't reject it out of hand. With quick searches I don't see any mentions of AFIB with Evenity. There is some concern about AFIB with bisphosphonates which you would likely need after Evenity. Not sure about Prolia. You definitely need a good doctors guidance with these issues.

I would suggest you see a Functional Medicine type doctor for BHRT. My wife starting BHRT in her seventies working with our integrative cardiologist. It is definitely doable and it would probably still help your bones but not work as a powerful bone builder like Evenity.
Good luck to you