@aard I needed two, and I know at least two people who needed 11 between them. One of them, a grandma, has a truly wonky heart with lots of problems, and she eventually agreed to have a pacemaker installed and to have them nuke her AV node at the same time. Yes, it's draconian, but she is in a much better place ever since.

I also had RVR, but I don't think it was so problematic for me in terms of symptoms. But the chaotic upper chamber made me feel terrible. I couldn't wait for that second ablation, and am now 42 months with normal sinus rhythm. Our friend at the top does not have RVR, and he/she is inclined to leave well enough alone. I can't disagree, especially if the heart is already on squishy ground health-wise. On the other hand, it might help a squishy heart a great deal to NOT BE in arrhythmia of any kind. That would mean a second attempt at an ablation.

It would be interesting to understand what was missed, what was incomplete, or what was done that ought not to have been, on the first attempt. If it's simple paroxysmal AF, and it sounds like it might have been, then a simple pulmonary vein isolation (PVI) was almost certainly all that was attempted. My first was that, but so was my second. The second has worked because the electrophysiologist found a small gap he had missed the first time and made a lesion there to close the 'dam' of scar tissue. It worked immediately! He didn't even bother cardioverting my heart before sending me out to recovery, something he told me he does routinely.

I don't envy our OP. Heart is squishy, but also in AF. AF by itself is almost never a problem, and certainly is not a lethal disorder. But, left going on a long time CAN bring on harmful conditions such as valve prolapse, atrial enlargement, and even heart failure. If it were my heart, I would ask for one last crack at the AF, but I would want to know what the EP intends to look for that he may have missed.