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It is hard to know what may have caused your atrial fibrillation. Sometimes it is inherited just like other conditions. You are quite young to have this, but it is certainly possible. Without knowing if you have a gene or other predisposing factors, it is hard to know whether it will happen again. The chances are good that it will not, but there are certainly no guarantees. The best thing that you can do is keep in close touch with your physicians. If you are going in and out of atrial fibrillation, it will be important to be on an anticoagulant to prevent stroke, but I am sure that your cardiologist at home is mindful of that. If the atrial fibrillation continues to be a problem, there are procedures that can be done in the interventional cardiology laboratory and there is a surgical procedure that can be done which corrects atrial fibrillation in 80-95% of cases.
Atrial fibrillation can occur in young people without any known heart disease. It is hard to predict the recurrence. Most likely it will recur again. Atrial fibrillation can recur on sotalol therapy in 50% patients. In that case another drug can be tried. If that fails, then another drug or catheter ablation can be tried.

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Mike, sounds like you have frequent episodes of atrial fibrillation. You should avoid provoking factors, you mentioned. You need another antiarrhythmic drug to control atrial fibrillation. If the medicines fail then you will benefit from ablation therapy.

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There is ongoing interest in the use of fish oils to prevent atrial fibrillation, however, it is a bit too early to know. Fish oils are generally good for your heart and it is probably a general effect on the blood vessels and the heart muscle itself that benefit patients who take fish oils.
Fish oil has some benefit in atrial fibrillation. However, it is not a wonder drug for the disease. Patients need to be standard medications to control the heart rate and prevent stroke.

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Atrial Fibrillation may complicate acute illness such as pneumonia. While you are more likely to have another bout down the road under similar circumstances, provided that you have no other risk factors for stroke such as diabetes, hypertension or structural heart disease, you could indeed stop warfarin and bisoprolol and see how you do. You can cautiously resume alcohol and caffeine intake - there is no firm association between intake of these substances and atrial fibrillaioin in most patients.

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Atrial Fibrillation may complicate acute illness such as pneumonia. While you are more likely to have another bout down the road under similar circumstances, provided that you have no other risk factors for stroke such as diabetes, hypertension or structural heart disease, you could indeed stop warfarin and bisoprolol and see how you do. You can cautiously resume alcohol and caffeine intake - there is no firm association between intake of these substances and atrial fibrillaioin in most patients.

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Atrial fibrillation is typically triggered by ectopic beats that arise in the pulmonary veins, although some of the time ectopic beats that arise elsewhere in the heart may trigger it as well. The ablation strategy first and foremost targets electrical disconnection / isolation of the veins to prevent such ectopy from triggering the arrhythmia. Many ablated patients however do go on to having frequent ectopic beats without fibrillation. This is likely the function of the atrial muscle substrate, action of the autonomic nervous system and the coupling interval between the extra beats and the normal beats.

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while individual cardioversions are fairly benign, given the frequency of cardioversions recently and the total number, this patient should consider an alternate strategy to control his atrial fibrillation such as initiation or a change of antiarrhythmic drugs or ablation. There is some data that blood tests which are typically used to document a heart attack may be somewhat abnormal after an electric cardioversion. At the same time there is little evidence that repeat cardioversions even at high energy result in lasting detectable heart damage

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Well, ablation may be a technically feasible procedure despite the fact that your atrial fibrillation is now permanent. There are some issues, however. Data suggests that success of ablation may be lower in those with permanent AF, particularly when they have failed multiple antiarrhythmic medications. You are probably looking at about 60% freedom from symptomatic AF off antiarrhythmic drugs at 1-2 years following a single ablation procedure and 75-80% after up to 2 ablation procedures. Most of our current evidence supports ablation in patients with symptomatic AF or with evidence of tachycardia mediated cardiomyopathy - demonstrable worsening of heart function while out of rhythm. In patients with normal heart function, no significant symptoms from AF who are well rate controlled - that is their heart rate at rest is around 80 bpm or less and with moderate exertion it is 100-120 bpm - there may be less benefit to ablation vs medical management. Coumadin is a decent way to prevent stroke. At the moment there is no solid data on stroke prevention with ablation, so patients over 75 years of age, or with history of stroke, abnormal heart function, diabetes and high blood pressure typically stay on coumadin even after a clinically successful ablation.

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Staying in atrial fibrillation at a high rate may be deleterious to the function of your heart. The longer you stay in AF the less is the chance of it converting back to sinus rhythm by itself. Given that with a history of ablation you seem to have chosen the path of sinus rhythm it would be reasonable to go for cardioversion and given recurrences five months following ablation, seek a second procedure, try an antiarrhythmic drug or accept AF and target aggressive rate control with the intent of getting your heart rate below 100 beats per minute.