@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;).