@californiazebra Thank you for sharing your history. I may think of other things to say later but wanted to reply quickly to some of your questions.

Yes, my ablation was PFA. At the time of my original consultation with electrophysiologists, only one of the two was using the PFA approach. By the time of my next consult after my breast cancer treatment, both were now using PFAs. I had done research about this approach when first considering an ablation and knew this was the approach I preferred.

Another thing you and I share, unfortunately, is a history of dysphagia. I've had mine since 2007 following some kind of upper respiratory infection (URI). The URI didn't seem complicated at the time, but in the aftermath I developed dysphagia and a tendency for largynospasms. I also developed chronic hives which gradually disappeared after a few months. My ENT doc who diagnosed my dysphagia compared it to an infection-induced cardiomyopathy but one affecting my swallowing muscles. He thought it probably followed the URI infection.

(As an aside, this experience gave me sympathy with people who have suffered long-term COVID. You just never know what side effects can come with certain infections.)

My dysphagia was so severe in the beginning, I lost considerable weight and went on disability. It has never disappeared but I've adapted to it over the years. I still cannot swallow a lot of pills so am glad both letrozole and kisqali are small enough for me to manage.

My dysphagia is a neurological issue. It followed a prior history of severe facial pain called geniculate neuralgia, initially diagnosed as trigeminal neuralgia. Ironically, that wicked, wicked pain which plagued me for decades has gradually improved but did so about the same time I developed the other neurological issue of dysphagia.

None of this has anything to do with afib and breast cancer, but may indicate how convoluted histories can get and how that complex history may affect our treatment choices. I also am always wary of anesthesia but have gone through 3 surgeries in a year. I always share my neurological history with my anesthesiologists in advance of surgery, mostly because of my fear of it triggering a largyngospasm. I give them a printed copy of that history.

Again, I remain hopeful your afib episodes will continue to diminish in number. I never had persistent afib episodes but rather paroxysmal afib. AFib is only one of the cardiac issues which we need to monitor. One of my cardiologists is aggressive in her approach to cardiac issues which is both good and bad. Good in that she recognizes cancer and chemotherapy drugs as both being what she would call cardiotoxic. But bad in my book in that she tends to overprescribe, adding more meds than I am comfortable taking.

You have an excellent handle on your history and issues. Once you speak with docs about your afib choices, you will have information you can think about and research. I think there is another afib option called Watchman but know nothing more than that.

Sending you my best wishes for better days ahead!

I