Hello all. I have been "lurking" here for a while now. Here is my story. I am a 68 year old male in pretty good health. I lift weights, ride my bike, and walk daily. In the summer of 2020, I started experiencing "thumping" in my chest and felt tired all of the time. In October 2020, I was diagnosed with persistent atrial fibrillation. I got an EP and he put me on flecainide for rhythm control and did a cardioversion. I went into NSR, but it only lasted for about a week. Since I was not too symptomatic at that time, my EP dc'd the flecainide and started metoprolol for rate control. He later added diltiazem. I did OK for a while, but I hated the meds. They made me feel almost as bad as the afib. In May of 2021 I went to the hospital to start dofetilide (Tikosyn). I went into NSR after the second dose. I remained in NSR for about a year, but then I started having increasingly frequent break through afib episodes. These episodes were pretty intense, and I was very symptomatic (strong palpitations, shortness of breath, anxiety, etc). So, I had a radio frequency ablation done in June of 2022. The ablation really helped the afib a lot, although I had some SVEs and frequent PVCs afterwards. The SVEs started calming down over the summer until I had abdominal surgery in October for a hernia repair with general anesthesia. Two days after the surgery, I started having frequent PACs along with the PVCs. I started magnesium taurate in December and it has almost totally eliminated the PVCs, and the PACs eventually went away. In January, I met with my EP and complained about feeling generally spacey and low energy with a persistent, mild headachy feeling. I had experienced this for some time, but always attributed it to the afib. But since this feeling persisted after my rhythms were relatively OK, I was thinking it was medication side effects. My EP agreed and had me hold 2 doses of dofetilide to see it that helped. After holding the second dose, I went into afib, but converted to NSR after resuming the dofetilide. Next, I tried holding the diltiazem and after 2 days, I felt better, but then the PACs and SVEs came back with a vengeance (I have a Kardia). So now I remain on dofetilide, metoprolol, and diltiazem. I am doing well rhythmically, but still have the spacey, crappy feeling that I think is medication related. My EP said that he would do a second ablation if I want to get off of the meds. I don't want to do anything this summer, because I want to enjoy the season. He said he could do another radio frequency ablation this fall or if I wanted to wait, the pulse field ablation would be available this spring. I have some decisions to make. Sorry for the lengthy diatribe. I appreciate this site.