For young (<60), asymptomatic, paroxysmal atrial fibrillation patients on noacs with lvh, should the patient seek out catheter ablation for treatment?

Depends: on left atrial size and function, frequency. Ablation is a big deal and frequently unsuccessful. I would try to suppress with a beta blocker like Bystolic, get magnesium level to 2.1-2.4, potassium to 4.1-4.5, stay off stimulants/alcohol, use hawthorne berry, avoid many other supplements, get general labs checked. Why the LVH? HRS, MD, FACC. www.thepmc.org