What long term effects if afib left untreated

Potentially, yes. All the low rate means, if it's 80-100, is that you don't (yet) have RVR syndrome or 'rapid ventricular response', where your left ventricle is trying to keep up with the chaotically beating atrium above it. If your rate is 120 and up, it probably means you do have RVR.

AF is generally and widely regarded as a progressive disorder. It isn't a lethal disorder, but if it isn't treated it can do lasting damage to your heart. The reason is that the chaotic rhythm of the left atrium imparts forces to the myocardial substrate and to the mitral valve that, over time, can lead to morphological changes that are damaging to heart function. Among them are wall-thickening of the left atrium (also known as 'enlargement'), and mitral valve regurgitation (MR) due to the repeated out-of-synch contractions between the two chambers. In time, the result is mitral valve prolapse and eventually heart failure.

Note that this CAN happen, and does in some patients...................................but not all. And many AF patients live for decades with the condition because they are asymptomatic and don't feel stressed as a result. They sleep well, eat well, are still reasonably active (but not as much if they were athletic because the pumps are less efficient now)...and they'll die in an accident or from cancer in 20 years. Not from the AF.

You almost certainly need do nothing at present except to accept the prescription of a cardiologist and take a direct-acting oral anti-coagulant like apixaban or rivaroxaban. They are NOT like aspirin. Aspirin is an anti-platelet which is not the same as the types of clots that might form in the left atrial appendage while the heart is fibrillating (LAA). While your are fibrillating, especially longer than five or six hours, you run a five-times higher risk of a clot forming in the LAA and then emerging when it gets flushed out and travels downstream into your heart's own vessels, the lungs, or to your brain. !!!!!!!!!!!

Later, in weeks/months/years ahead when your AF begins to come on more frequently and lasts longer each time, you would want to have already established a relationship with a skilled electrophysiologist (EP). So, if I were you, I'd get that process underway soon. They would perform an ablation on your left atrium to stop the rogue signals from emerging from your pulmonary vein ostia, their mouths, and spreading across the lining of the atrium. This is how the normal signals are propagated and how they make the LA beat. Except now you have other cells that are trying to take over that signalling and the two, those coming from the sino-atrial node (SA) and the new rogue cells compete.

When this all happened to me, I commenced a process of self-education. I read widely, watched videos on YouTube put on by qualified EPs, and learned a great deal, including my likely history and what I could do to change it. I learned in short order that I would want a catheter ablation, which is now widely accepted in the field of cardiology as the gold standard of care for treating AF.

I see the lengthy response from another patient so I won't add to that. My question is why you have these very reasonable questions that have not been answered by your cardiologist when you were diagnosed? How old are you; are you looking at the next 30 years like some people or just the next 5-10 like me? What quality of life do you expect; do you mind the "occasional A-fib episodes" or do they disrupt your life or cause anxiety? I have heard of people who are in A-fib almost all the time and claim "it doesn't bother them" or some of us who hate living with the sensation and the corresponding feelings of weakness, breathlessness and discomfort. My first reaction was to tell you that you need to have a in depth conversation with the cardiologist who treats you and if he/she doesn't give you clear answers, reasonable options, and informed risks, then you need a new doctor. As a retired nurse, I am shocked at how many patients don't ask or are afraid to ask what this diagnosis really means and what drugs do over time and what options are available to them. Just saying! Good luck.

@sjm46 In today's world many think of getting responses from social media as the equivalent of direct medical advice. Just read any posts in social media groups and it's loaded with advice and photos and links and personal experiences.
That horse left the barn many years ago and is definitely not coming back home.

@sjm46 Your post reads like I wrote it. I too wonder why someone asks a question here that should be answered by their health care providers. At this point in time I suffer from intermitent episodes of Afib that are usually brought on by execise of some kind. I get fatigued and somewhat breathless. It makes me more made than anything else that I cannot do the things around my place that need to be done without discomfort. I had a PFA last year and was AFib free for about 8 months. Then I had two episodes of RVR that have created the need to go back on 180mg of Diltiazem along with Eliquis have been on without a break since my first episode of Afib. I am in constant contact with my electrophysiologist team at UC Health in Aurora, CO and will probably have another PFA in the next 30 t0 60 days. Since I am about to turn 87 like you I am looking at the next 5 to 10 years. I want to do what I need to do without having to sit down and rest every 10 minutes.

I’m sorry you that you’re going through this. My sister had afib. She took medication and had an ablation. The doctors wanted to give her a pacemaker. She refused.
Six years ago she had a stroke and heart attack. She died just short of her 68th birthday 😢

@suerte I am so touched by your comments; I love that you see that age is not the biggest issue for treatment but rather quality of life! You sound like a "go-er" so why wouldn't you want to feel well, able to do what you want to do. I am 80 and work out at the gym for almost 2 hours daily, and I mean some serious exercise. My husband does the same. Whether it is 5 years or 15 to live, it doesn't matter; I want to do my own thing for as long as I can, just as you do. I hope your next ablation works; I have heard that it sometimes takes more than one. My ablation from November, 2025 is holding so far without any episodes of A-fib. I am hopeful; I have made every lifestyle change that I can in the hopes that it will give me success. I take Eliquis and a very small dose of Amlodipine for nightime B/P elevation. As a retired professional, I encourage everyone who is being treated for any condition to ask for (and get) explanations/treatment options and side effects of every med they are taking. I actually heard a woman at church talking about having a procedure that she had mistakenly thought was an "ablation" (heard us A-fib women talking about it) when in fact as we questioned her, we found she was having an angioplasty! Oh my goodness; how can a cardiologist not clarify a blockage clearance from an arrhythmia!? That is why I send my husband into his appointments with his list of questions --and I tell him not to come home without the answers! 🙂

@sjm46 I dropped my first cardiogist because his attitude of do no harm was really do nothing. His first comment to me was that some people just live with Afib. Well I am not one of those people. My attitude is that if you are not getting answers to your questions from a health care provider, then find a new one. So I went out and did a search for the best cardio care facility reasonably close to me for more input and for the ability to provide more "invasive" procedures like PFA. My primary care provider is great and has always given me all of the information on what can be done and has always recommended the correct medications. I am a proactive person and like to see actions that address issues and provide potential solutions. I always asks questions (from a prepared list) of all of my health care providers so I can be as well informed as possible as to what are my health issues and what are the potential ways to provide a cure or at the least some relief from the symptoms. I use the internet and some AI sites not for what I should do, but for knowledge and for interpretation of the "code" that doctors use in the clincal notes.

@suerte You're a person after my own heart! I totally agree with all that you decided! Good luck and keep us updated on how you are doing.