@woodside these are fantastic, thank you! I have saved them in my Google docs.

My stroke risk and bleeding risk are still pretty equal so the decision on anticoagulation depends on other factors so far. The calculator was reassuring.

I will share the two takeaways from the guidelines that apply to me (and my posts on Mayo), based on my experience and my more recent reading ("The Afib Cure", Day and Bunch). I can see that my EP is using the more flexible guidelines.

Others can read the whole list of takeaways on more aggressive treatments and the article as a whole in detail but I am just posting excerpts.

2.
AF risk factor modification and prevention: This guideline recognizes lifestyle and risk factor modification as a pillar of AF management to prevent onset, progression, and adverse outcomes. The guideline emphasizes risk factor management throughout the disease continuum and offers more prescriptive recommendations, accordingly, including management of obesity, weight loss, physical activity, smoking cessation, alcohol moderation, hypertension, and other comorbidities.
3.
Flexibility in using clinical risk scores and expanding beyond CHA2DS2-VASc for prediction of stroke and systemic embolism: Recommendations for anticoagulation are now made based on yearly thromboembolic event risk using a validated clinical risk score, such as CHA2DS2-VASc. However, patients at an intermediate annual risk score who remain uncertain about the benefit of anticoagulation can benefit from consideration of other risk variables to help inform the decision, or the use of other clinical risk scores to improve prediction, facilitate shared decision making, and incorporate into the electronic medical record.