Brief Answer:
Be reassured, vitals mentioned are normal at present, consider medication

Detailed Answer:
Hello mam, I do understand your concern because of frequent occurrence of A fib

Presently the vitals mentioned are perfectly ok, even if it's a fib it's with control ventricular rate and you should not worry.
Important points I would like to know

Are you hypertensive and which meds are you on?
Is it the first time you ever had a. Fib?
What are other Co morbidity and medication?

Now it's for the first time rule out all reversible causes like your medication history, electrolytes, thyroid status.
If all negative get preferably a trans esophageal echo.
My first choice to treat and prevent if no contraindication, will be small dose of beta blocker like metoprolol
Also consider anti coagulation based on your cha2ds2vas score.
If a fib is well controlled with medication, ablation will not be the first option as recurrence rate are high in Non specialist centers

A more detailed, history and relevant investigation would help me guide you better

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Brief Answer:
Continue the meds, monitor vitals and it should all be good till ablation

Detailed Answer:
I am happy that you chose me for answering your concern s, I will do so at the best of my abilities.

Now why did I ask you for history of hypertension?
Hypertension per say is the most common reason a person may have a. Fib and as you rightly suggested If was looking to suggest a medicine I would like to know your blood pressure range.

Now, if your a. Fib was under control for so many years, as a doctor I would have love to find what went wrong in the recent past, what are the precipitating cause.
Any recent infection, increased physical or mental stress, is your potassium and magnesium in the normal range.
If all the above are normal, I will peek into the medication you are taking.
Now levothyroxine dose of 275 means the needs are higher. So are we over treating. For that it's best is to get free t3 and free t4 hormones along with s. Tsh so that we may know their level as higher thyroid hormone levels are one of the common reasons for precipitating a . fib
Other drugs which has effects on cardiac rhythm is rhythmol , which should be monitored on regular basis, it may increase the PR and qrs interval and is pro-arrythogenic. Similarly zoloft can interact in cardiac conduction by slowing it.
A baseline ecg in sinus rhythm will help me measure the heart intervals

Now diltiazem is a drug similar to beta blocker in all ways and at dose prescribed should take care of a.fib, so temporarily till you meet your doctor it should be ok to take the drug. Just monitor the pulse and blood pressure during the time.
It should be enough to control afib I'd all precipitating cause nullified and increase in doe will push your blood pressure further down.

Now why ablation? As I said drugs will be first choice for a fib control because the dosage is mild with minimum side effects, however in your case because the chads score if less so with ablation you will not require anticoagulation which is good for better quality of life. So you may go ahead with ablation as per the discretion of your cardiologist.
Hoping this would help, any further doubt, you may ping me anytime.

Regards Dr. Priyank Mody

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