@shoshin I read that whole article that you linked. The lone afib forum is excellent.

I really think the question of whether afib inevitably gets worse depends.

My first episode happened after I flew across the country to help one of my kids in a pretty dire health crisis. I was stressed, dehydrated, and took a half Klonopin (relaxation after stress can be a trigger), then lay on my right side and felt large fish flopping in my chest, was short of breath, and had chest and jaw pain. I got up and walked (my poor kid following me) to a nearby street and a fire truck was at a red light. I had never been to this city before and went up to the fire truck window to ask where the nearest hospital was. I had never called an ambulance in my life and didn't know what was happening. I told the fire fighter that there seemed to be something wrong with my heart. He and his partner jumped out and put me on a bench and did an IV and treated me then took me to the hospital. A couple of hours later it stopped. I took aspirin for a month and my heart felt pretty unstable for quite awhile.

Since then, this has happened once/year until these past two years, there has been a longer two year interval. I had one very brief episode last month that I was able to stop.

My theory is that the cancer medication that I was taking was the main culprit. It eliminates all the estrogen produced by the adrenals and I doubt that it has no other effect on those glands or other glands. It cannot be a coincidence that my first episode was a few months after starting and that the interval got longer after I finished the meds.

So along the way I also learned a few things, and that may also be a factor in the longer interval. @shoshin you are right, with experience we can tell something might be coming. I do not have PVC's or PAC's but get a full feeling in my chest. I take a simethicone for GI gas and part of a Klonopin to relax my muscles and this has helped. I never lie on my right side. I never eat after 5 or 6 pm. I never recline after eating and if I have GERD I try to sleep upright. I drink low sodium V-8 which is loaded with potassium and take 600mg magnesium at night. I walk and tai chi and qui gong with deep breathing have helped I think.

Twice, once last year and once last month, I had a brief episode (minutes) that I aborted by sitting up straight. Five of the other times I was in the ER and even the ICU (my blood pressure is low so diltiazem makes them nervous) but not since 2021.

There is very slight thickening of my atrial wall. I have had a very high CRP. I have had a lupus diagnosis for a long time and a recent high antibody for scleroderma. Obviously inflammation is an issue for me.

I don't want to jinx myself. So far I have avoided blood thinners. I don't know what the future holds but hope this post is helpful. It is possible that it is inevitable that things will worsen or maybe not. I have no opinion. We are all individuals. I do know there are things we can do that can help ourselves for a time, even if the result isn't perfect.