AF is a progressive disorder for all but the very rarest of cases. It can be controlled well by lifestyle changes, sometimes quite drastic changes, while for others just losing weight, going off four cups of coffee each day, or foregoing alcohol are all it takes. Sometimes supplementing with elemental magnesium helps if one doesn't get enough of it in their diet.

Cardioversions are a literal crapshoot. They work well, one-and-done, for a lot of first time AF patients. Others, like me, get four of them over three years and they don't work for more than 20 minutes to 16 hours (yes, that's true). So, I got two ablations because the first failed. I'm in my 31st month free of AF after my second ablation.

This is exceedingly important: you do NOT want to submit your heart to an electrophysiologist (EP) who feels that he/she can only guesstimate a 50% probability of the ablation working. That's a TERRIBLE statistic. Across the field of electrophysiology, the standard claim is 75% probability of success, and the very best EPs get 80% on their first crack at you. So, about 25% of all index ablations fail across the field of electrophysiology. Gentleman doctors like Andrea Natale at Texas Cardiac Arrhythmia Institute in Austin and Dr. Pasquale Santangeli at Cleveland Clinic routinely get above 80% because they're well-trained and do 10-15 ablations each week. In Natale's case he travels to about six different hospitals in the western USA.

Please do get an ablation, but get it as early as you can while your heart can be treated the easiest....early in the AF game. Please shop around for a highly regarded EP, even if you have to travel, and even if you have to wait 4-6 months. You will be much further ahead to submit to the better experience of the best doctors.