@californiazebra I am in Canada, so a different system. However, people routinely shop around for various kinds of expert care in the USA, including traveling to the Texas Cardiac Arrhythmia Institute where the vaunted, and wildly popular, Dr. Andrea Natale does his magic. He provides instructions to the at-home care team about checkup imaging and tests, like a TEE (trans-esophageal echocardiogram) that he asks his patients to undergo if he has inserted a Watchman into their left atrial appendage (LAA) while he's ablating them. I haven't heard of any cardiologists bristling and getting huffy that they don't want to help a patient who has undergone a tricky and highly technical procedure out of state and just wants their thumb up to Dr. Natale, or to send him imagery on their behalf....which most also will do if requested (with payment, of course).

So, the usual protocol, leaving aside a Watchman done at the same time, is for you to see a local physician within 10 days of the ablation to ensure you're in NSR and that the incision has healed or at least isn't open or infected. Try for six days to a week if you can. Then, at about the ten to twelve week mark, you get issued a Holter monitor to wear over night, and you're asked to do a normal day, including any sports or exercise. You have to remember to note down on a record they supply of any key activities like meals, lifting, moving something, going for a long walk or run, climbing stairs that require you to get a bit out of breath....that kind of thing so they can remark on your heart's response at that time and hopefully NOT see any blips....just a quickened NSR in response to the higher demand. If the Watchman were installed, then you'd normally get a TEE at the six month mark to ensure it isn't leaking or displaced. If that checks out, you may be asked for one more TEE at the full year mark. If there's still no leaking, and you have no other issues that raise your risk for bleeds or stroke, no other comorbidities that might require anti-coagulation, then you would be invited to cease taking the DOAC like Eliquis or Xarelto...your choice, but they would likely say it's not necessary due to your apparently sealed LAA where the bulk of the risk of clot formation during AF lies.

@californiazebra I had to go out of my local area for my ablation. I live in SW Colorado and there are no facilities that do the ablation procedure. I flew to Denver and had my PFA done at UC Health in Aurora, CO in May of this year. I have a local cardiologist, but I do telehealth with UC Health. I actually prefer the contact with UC Health and my primary care provider over the local cardiologist. With today's technology and information sharing doing telehealth is not much different from in-person visits. I do daily monitoring of the pulse rate and BP and upload a trend file, so it is available when I do my telehealth visits. I will return to UC Health next May for an in-person in-depth assessment.