@dao that is a long time between AF episodes! For the last 10 years I have mainly had afib once a year with heart rate around 195. In 2023 I had it twice. I saw an electrophysiologist since my cardiologist thought things were getting worse, and the EP said that if he had done an ablation on me and saw two episodes a year, he would consider it a success!

I recommend the book The Afib Cure by Day and Bunch. two cardiologists. For some patients, they say that progression is not inevitable if triggers are identified and lifestyle changes are made. They even write about getting off meds. That said as responsible physicians, they write about meds in depth as well as cardioversion and ablation.

I declined blood thinners with my first dramatic episode in 2015 and am still not on any. I don't take any medications regularly knock on wood. I am humble and understand things may change. I take magnesium, drink low sodium V-8 for potassium, calcium and D3. I walk and do tai chi and try to keep stress down- not always successfully. I don't eat after 6pm and don't recline after eating, and never lie on my left side. Gas X relieves GI gas and can avert an episode. We are all different and over time these have been helpful things I have learned.

I have had "pill in a pocket" diltiazem for years and have taken it a couple of times but always end up in the ER because low blood pressure makes treatment difficult. Last fall I finally got permission to have Eliquis, a blood thinner, also as a "pill in the pocket," meaning when needed after an episode > 5 hours. This is a new protocol and avoids the side effects of daily blood thinners to cover afib that is so infrequent.

If I make it to April I will have gone a year again. Fingers crossed. But every year that goes by I am ready for a change!