@mhutch527 I can only write about my own experience, I have declined anticoagulation for 10 years. I have had episodes roughly once/year lasting 45 minutes to 7 hours (usually less than 2 hours). In 2015 my cardiologist wanted me on an anticoagulant. He later told me he thought I was right in declining. He said he believed they were "overmedicating" people.

My other cardiologist came into my hospital room after a bad episode and told me to "go home and forget it happened." This past year I finally found a doctor who is in the middle of these two approaches!

My current CHADS score is also 2. I finally got "pill in the pocket" Eliquis but have not had to use it.

Doctors have protocols and a score of 2 means anticoagulation is suggested. I believe they may feel more liable if they don't prescribe.

I did a month of a monitor and had a few moments of afib, atrial flutter, tachycardia and bradycardia. I still don't take any meds daily and have taken diltiazem maybe 3 times in 10 years. With afib my heart rate goes up to 190+ so I do feel it.

I often suggest the book "The Afib Cure" by cardiologists Day and Bunch. It has info on avoiding or stopping meds, but also on various med regiments and ablations. I take magnesium, drink low sodium V-8 for potassium, never eat late, and never recline after eating.

It might be helpful if your dad has a way to monitor- a Kardia or Smart Watch. So far he is not having any hidden afib other than that 11 seconds, in a month's time. If he has high blood pressure, weight issue, or diabetes they can be concerns but with his CHADS at 2 it sounds unlikely.

I am just another patient with an individual situation. We are all different. It has helped me to get more than one opinion, read and learn, and go to the cardiologist with notes!