I was on ADT for eight years, So I can relate. I had to quit taking zytiga because Of how it treated my heart (Afib).

Did your doctor consider putting you on Darolutamide? It has few problems with the heart, For me, it is worked quite well and not caused any more heart issues.

I was on ADT (Eligard, Lupron, Orgovyx) alone for Almost 3 years before my PSA started rising, and I became castrate resistant. So staying on Eligard May work OK as long as your PSA stays undetectable. At that point, you need to consider a second drug an ARSI like Darolutamide.