Today I saw my EP, unfortunately the Myasthenia played up so very difficult to talk or think so wasn't able to say everything I wanted but he could see I was struggling and was very patient.
From his side the options were Amiodarone - I feel that is last resort and I am not there yet, Flecainide which I am not keen on but will consider but want to be observed for first dose in hospital in case of Myasthnic crisis - which he agreed was essential. Another PVI ablation - a possibility if things don't improve or Pace and ablate not there yet I hope!
He agreed that the AF is vagal and can see from the ECGs that it starts with Atrial Tachycardia, then flips into AF. We agreed that working with diet etc with the nutritionist could improve or at least manage the episodes, as long as they were not too frequent and didn't impact the Myasthenia too much, which is my major concern. If they do so then I can return for review and consider another PVI ablation.
So I have a free pass to go on holiday in a few weeks - hurrah!
Hoping tomorrow will be a better day.