My first thought is try and get an electrophysiologist. There aren’t many of them and even when you get accepted as a patient it can be months to get an appointment. It is worth the effort and wait. Electrophysiologists are known in the trade as the electricians focused on heart rhythm. The two I’ve had was/is up on all the very latest advancements and treatment to afib.
A little personal bio at 75. I’ve been in permanent afib for over 20 years. That is I am never out of afib. Been through 3 cardioversions, 3 different anti-arrhythmic meds regiments culminating in a high dose of amiodarone, and 4 hours on the table during a cardiac-ablation - all failed. Despite all of the above I still ride my bike. In 2019 I rode 800 Km across northern Spain and hopefully post covid I’ll be back to long rides. Both my past and current electrophysiologists have emphatically said my bike riding is doing as much for my cardio health as any meds they have prescribed. For the last many years I’ve been taking metoprolol (Toprol) and Xarelto, which I seem to tolerate pretty well.
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On a trip you've got worry as a companion, for you're always concerned about what happens next and sticking to an itinerary. . . . on a journey you never have to worry. Something always happens next.
- Gordon Hempton: One Square inch of Silence