@wews If you're not thoroughly dejected, and still hold out some hope of a successful ablation, and if you don't mind travel and have some resources at your disposal, I advise seeking the services of either Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute or Dr. Pasquale Santangeli at Cleveland Clinic. Four ablations that haven't worked suggest to me, a non-expert, that you weren't being ablated properly, either not with enough energy applied long enough or in the wrong places. You may be a 'complex' case where more than two or three walls of the six walls comprising the inner left atrium are beset by the rogue signalling cells. You might also wish to look toe AFib Education Centre channel on YouTube, Dr. Scot Lee. He claims a high success rate because he is willing to tackle complex cases.