I have sporadic "paroxysmal" afib and declined anticoagulation. One cardiologist pressured me to take one and 5 years later, when, at that point, I was having it once/year, he admitted that "we overmedicate." Another cardiologist told me, while I was in the hospital with afib, that I could "go home and forget it happened." Guess which doc I now use?
That said, for the most part, my afib has been a year apart (now two with one short episode last year) and the longest episode was 7 hours, and they did an echo to make sure I had no clots at the time. Some of my episodes are only an hour or two. I am always in the ER or even ICU because my heart rate goes up to 180+ and bp down. They use diltiazem in a drip.
The CHADS scores provide a sort of recipe for docs and I believe that they feel afraid of liability if they don't follow it. Your frequency is more than mine but it may be slowing down. And I don't know how long it lasts.
I read a great study on sort term anti-coagulation for one month after any episode lasting more than 5 (?) hours (sorry I forget the duration). I ask for short term anticoagulation every time I go in the hospital. I hope someday it goes into practice because anticoagulation has risks too.
Hard decision. Maybe, if you go 6 months without any afib, you can find a doc who will let you go off, or of course, you can decline the meds, but I cannot say anything pro or con, only what I do. I also don't know if you have to wean off of them because stroke risk might go up when you stop, if afib is going on. I don't know that but it is a question to ask.
My understanding is that
paroxysmal Afib can be very dangerous when unmedicated or unprotected a watchman device. See in my case unless it happens again my afib resolved itself because it was only related to the stress / anesthesia associated with total knee replacement.
Senator John Fettermanwas elected in 2022. You may remember he was guy who had a stroke. He has ignored doctors instructions to anticoagulate after having afib. I'm sure he isn't you since your Afib is so infrequent and you have already gone 5 years with no problem. Still I wanted to bring him to your attention