@m245837 The ablation may not be necessary if he is so seldom in AF. Yes, it's a progressive disorder, but in your hubby's case it seems to be very slow. But more, if his heart echos don't show any enlargement of the left atrium, and if we know he has no ischemia due to blockages, then he could afford to wait for an ablation. That is my inexpert opinion (no medical training whatsoever, although I have done a ton of reading as an AF sufferer (yes, I did suffer, as many patients do). The idea is to nip AF early, but it's best if it's a bit more active than just two isolated bouts of it. In most cases, the person is in and out of AF once or twice a week, or a month, and it is at this point that the electrophysiologist stands a better chance of finding AF and where to ablate. There's more to this, but this will suffice for the moment.

The Watchman only reduces the risk of a clot emerging from the left atrial appendage (LAA). When in fibrillation, that small grotto doesn't get good blood flow and clots can form. If the heart resumes normal sinus rhythm, it can dislodge the clot(s) which can then travel up the aorta and out the the heart, itself, to the brain, or to the lungs....all very bad. The Watchman seals off the appendage so that no clots can emerge. From there, with a very seldom fibrillating heart, and almost no risk due to LAA leakage, your husband might be able to forego anti-coagulation drugs like Eliquis or Xarelto. If he has other comorbidities, his risk still might be too high for your doctor's liking, at which he may be encouraged to take a DOAC like Eliquis or Xarelto (DOAC is 'direct-acting oral anti-coagulant;).

@m245837 he has Afib episode only twice? Hard to believe. Afib comes and go. I strongly doubt any doctor would recommend ablation for only 2 episodes of Afib

@m245837 I’m on this site because I had an ablation 1-1/2 years ago at Mayo. I read your question to a heart rhythm expert and this was their response:
A key foundational principle in preventing the progression of atrial fibrillation episodes—beyond procedural treatments—is the modification of risk factors. If you are overweight, weight loss may be helpful. Exercise has also been shown to reduce recurrences, based on a landmark series of studies conducted in Australia. In addition, blood pressure should be well controlled. If your heart’s pumping function is even slightly reduced, medications that help the heart recover strength are critical, because overall heart health is a major determinant of outcomes.

If you proceed with a Watchman device to minimize the risk of stroke—which is determined in part by the CHA₂DS₂-VASc score, a system that considers factors such as congestive heart failure, hypertension, advanced age, diabetes, prior stroke, and vascular disease—then many clinicians will also consider treating the arrhythmia with an ablation, since the catheters are already in the left atrium during the procedure. These are complex decisions that are best made in close consultation with an expert who knows your specific situation. It sounds like you’re on the right path.