Ablation plus Watchman to be successful???

@gloaming thanks for the good wishes…

Had first afib attack in 2018, and very minor ones since then --maybe 3-4 a year.--some lasting 2 hours. Haven't had any pocedures or meds (Only for first abib attack for two months) No in 2026 doctors want me to get ablation and Watchman since I am 80. I didn't want the invasive surgeries--takes me long to reover. Just started Eliquis: it is making me feel tired, achy, and the exisitng imbalance and dizziness I have (from nystagmus) is worse. The docs worry about fallin (which is have done--no injuries) g but Eliquis is making it worse.
On top of it, so many things are on restricted list with Eliquis, like some vitamins, many antacids, SSR, etc. I am a person who takes as little of possible of meds. So I am not sure w hat to do. No two doctors agree on all these things.
They tell me I am a stroke risk because of age and sex.
I have been reading everything I can but feel very stressed about deciding what to do. My docs are from one of the top hospitals but I can't get any suggestions that are not contradicted by many of doctors.
Adppreciate any help

@dprzybyl - I’ve only had two Afib episodes in my life, both that were caused by a preceding stressful event. But I found Dr. Mandrola, a cardiologist/electrophysiologist, and even bought his book although it was geared more to athletes who had Afib. I learned a lot from the book.

Dr. Mandrola is not a fan of the Watchman device. I hope this link will work to read his article about the Watchman device on Substack.
https://t.co/pqIGpdSehu

@dprzybyl This is where you have to decide what you are prepared to accept in the way of risk one way or another. There is a X5 increased risk of stroke when your heart is fibrillating in the left atrium due to the poor 'hygiene' in the left atrial appendage (LAA). But, your episodes are paroxysmal in nature, meaning they come and go on their own, no interventions necessary except for you telling yourself to keep calm and let it come to its own termination....which so far it has done.

But falling brings its own risks, including bleeds wherever tissues are disrupted due to the forces involved. So far, you're ahead of the game, and it worked that way for my then-93-year-old dad. He had falls, and was deeply anxious for them. Then came the one where he broke two vertebrae, and that meant major changes to his locomotion once he recovered....sort of. His last two years were a self-described 4/10 due to loss of autonomy and limited mobility....having to lean on a walker, still falling once a month....you get the picture. If you're taking a DOAC at the usual dose, twice a day, you do have a risk of serious bleeds, including intracranially. If your bone density is iffy or spotty, and you break a major bone that gashes an artery, you'll have maybe a minute of clear thinking left.

So, our EP friend says he'd like to ablate you when you're 'bout in the best place you'll ever be on this endless journey toward your natural end. Still in good shape, still young-ish, not wheezing and needing gas help, still cook for yourself and do your own toenails....you understand. It just goes downhill from here, and usually at an accelerating clip. He hopes you'll see that now or never is what he proposes.

I'm 77,

I underwent two medical procedures on November 18, 2025: a second ablation and a Watchman device implantation.

The ablation was performed by Dr. John D. Day, while the Watchman procedure was conducted by Dr. Vamsee Yaganti in Salt Lake City, Utah.

On December 29, 2025, I underwent my initial Transesophageal Echocardiogram (TEE) to evaluate the Watchman device, with all findings indicating satisfactory results to date.

Following my physician's instructions, I discontinued flecainide yesterday and will stop taking Eliquis on February 9, 2025. I will commence a regimen of 81 mg aspirin daily until further notice or instruction. I feel great!

Bob