When my EP suggested an AV node ablation, I researched it. As you say, it requires that you have a pacemaker, which I do. In order for the heart to beat, the pacemaker takes over after an AV node ablation. In my simplistic reasoning, I equate it to turning off the electricity in a house and having the generator control the electricity. I don't want to do that. I can't help but wonder if his reasoning is because I am "old", and this is a quick fix. In addition, I have other medical issues (CLL, CKD, etc) which might be part of his reasoning. I also read that AV node ablation does not stop AFib; in fact, many people go into chronic AFib without the accompanying side effects because the heart is beating normally (due to the pacemaker). Another concern I have is that AFib is causing some atrial enlargement and diastolic dysfunction. If I have chronic AFib, what about those concerns. I am hoping for a PFA. I have tried to get a second opinion with a doctor highly recommended in his group. However, they will not let me make an appointment with a different doctor in the same group! So, I am looking at a different medical team. If only I could prevent this AFib - but while doing everything recommended, it keeps coming back! It helps to hear from others with this condition.