@aard Most EPs who aren't hungry for money would refuse a patient unless they had/have other comorbidities and cardiac defects either corrected or well under control. Since mitral valve prolapse can cause AF, there's little point in attempting an ablation until and unless the mitral valve is repaired. Remember, each intervention requiring invasion of the body is risky. Surgeons are loath to enter a body unless the risk is manageable and small, and unless the benefits greatly outweigh the risks. So, attempting to perform a 'successful' ablation when the cause of the AF is still present seems wasteful of resources, the surgeon's time, and adds to the risk burden for the patient already slipping in health.

These are general rules understood by most everyone, patient and physician. However, each case presents as a unique one and all relevant factors have to be considered. The conscientious physician will only intervene surgically if to not do so presents an even greater hazard.