They are correct that you typically do not need a pacemaker for a-fib. There is always a possibility that you might need one after the ablation. It is not often, but when you have a-fib it is like a bunch of extra power sources firing off sending the electrical impulses that the heart doesn't need. When the cardiologist goes in, they attempt to find the extra sources and cauterize them and stop them from doing that. I have seen atrium be so sensitive that it is hard to pin point the source(s) of the problem.

This is probably the biggest and major drawback to an ablation. It can cause you to have bradycardia (slow heart beat) and require a pacemaker. This is certainly not the norm, but indeed a possibility. No surgery/procedure is without risk. As you age, get as much info about it as possible and make the best decision you can for you and your health.

Like any other profession there are folks that are good at their job and folks that are bad at their job. Cardiologist are a lot like any other physician that does procedures. They would rather be in the room working on you, than in the office talking to you. It is their element and what they like to do. To the man with the hammer in his hand, everything looks like a nail.