"I have Persistent or Chronic (all-the-time) Atrial Fibrillation but no symptoms ('silent' A-Fib). What should I do?"
You may want to consider just learning to live with it. You will have to be on blood thinners or have a Watchman device installed to keep from having an A-Fib stroke. You will probably have to take rate control meds to keep your heart from beating too fast. Your heart isn't pumping out properly, but you can compensate to some extent by exercise. You may be able to lead a close to normal life in silent Chronic A-Fib. It's hard to justify the effort and risk necessary to fix Chronic A-Fib if you have no A-Fib symptoms.
Chronic A-Fib is harder to fix and often requires at least two catheter ablations. An unintended consequence of a successful ablation is your A-Fib may be improved so that you are only Paroxysmal (occasional). But Paroxysmal A-Fib may be more debilitating and troublesome. At least in Chronic A-Fib you don't have to worry about an A-Fib attack.
A Cox Radial Maze to fix Chronic silent A-Fib is open heart surgery which is very traumatic and risky. It's hard to justify open heart surgery if you're feeling OK.
Another factor to consider is your age. If you're 40 years old, it's probably worth the effort to get your Chronic silent A-Fib fixed. Over time it will probably damage your heart, brain, and other organs. But if you're in your 70s, you can probably live the rest of your life in a satisfactory, fulfilling manner even with silent Chronic A-Fib.
However, having had A-Fib, the author knows how wonderful it is to be in normal sinus rhythm. Even though you have Chronic silent A-Fib and in general feel OK, you may want and need to get rid of your Chronic A-Fib. Most doctors understand this need to have a heart that beats normally and will work with you, as long as you understand the risks and challenges.
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