2nd Afib Episode Since Ablation. Time For Another Op?

I had my Ablation in Bordeaux in June 2018. When a year passed and everything was calm I started to feel very confident.Then a month later I had a 7 hour episode. As the months passed I felt that might be a one-off but 2 nights ago (6mths after the first) I had another episode. This one 3.25 hours.

Much as I dread another op because of the cost, having to fly, and the great difficulty I had in coordinating the op, accommodation, TOE, flight and blood tests is it time think about another operation?

I don't think so, or at least not yet. It's time to modify your lifestyle factors and see if you can beat it.

Maximize dietary influences -- eat a high potassium, low salt diet (easy: the basic Mediterranean diet). Rule out or get treated for sleep apnea. Get your thyroid levels checked. Supplement magnesium. Exercise more. Do all that for another 12 months and see how it goes.

I concur with Carey, but also what about flec either on demand or at a low dose?

In my case, in addition to magnesium to bowel tolerance, at the beginning of the day, I put 2 tsps of potassium citrate and 1/2 tsp sodium salt (NaCl table salt) in a liter of water and drink it over the day. It is my version of "time release." The 2 tsps of potassium citrate is about 1 g potassium and the 1/2 tsp sodium salt is about 1 g of sodium. This is a 4:1 ratio. Then I don't eat processed (high sodium) food nor to I add it. The 4:1 ratio, from my reading is in the ballpark of what was available naturally to our prehistoric ancestors.

Sam, what time did this episode start and was it after excessive nocturnal nocturia like the episode before in July?

Thanks for the replies, folks

Carey. I'll take your advice and wait to see if I get another episode. I'm pretty much doing the things you recommend including ruling out Apnea some time ago and get my thyroid checked regularly.

George. I used Flec to convert. I never eat processed food and because my diet is so low in salt that my sodium levels are always borderline low I add a little salt with two of my glasses of water.

Mike. Yes nocturnal polyuria has been a long term problem made worse by a recent UTI which meant I could only empty my bladder with a catheter. (I've had to use a catheter 3 times a day for quite a few years due to urine retention). which I did 6/7 times per 24 hours during and for some time after the infection. I'm gradually able to pass some naturally and catheters are down to 5. This should gradually improve now. I've started using glycine in the evening to see if the condition improves. This was the most likely cause of the episode.