@clayart Any episode of Afib, or atrial fibrillation increases your risk of heart attack and stroke. Early management and intervention can stop progression. The recommended treatment depends on your specific diagnosis, but a single episode is all that is needed to tell the cardiologist you are at risk - and once your heart begins having faulty electrical pulses, it doesn't just go away. I also note that you are already on Eliquis -is this new, or have you had blood clots in the past? If so, afib increases your stroke risk even higher.

What testing has been done to determine the source of your afib? Have they done a complete risk assessment?

Here is the current American Heart Association information about Afib:
https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af
Why do you amiodarone should be a medication of "last resort"? As far as I know, it is typically prescribed for medically-managed afib.

It sounds like you are little like me - last September, at Urgent Care, the treating Advanced Nurse Practitioner didn't like the explanation that my shortness of breath was from Covid & Asthma, so she ordered a new ECG on the spot - it showed an irregular heartbeat that was not on my previous tests and she sent me right to the ER, where they found a significant heart blockage. I had been ignoring my symptoms for over a year, and the cardiologist got me right in for testing and treatment. After much discussion, he agreed to watch and wait for a year before surgical intervention -IF I added 3 medications and agreed to monitoring by the cardiology lipid clinic where they cover lifestyle issues. So far, so good - I will see him in May for a follow-up.

Did your cardiologist explain their reasoning for the ablation? Can you compromise on a watch-and-wait period if you take the additional medication?