"After all that you have endured, and BIG congrats on that, is there anything you can share as to the secrets of proper diagnosis? It is costing me my small fortune to get it figured out."
by the secrets of proper diagnosis, do you mean how the diagnosis of afib was finally achieved?
assuming this is the case - if you search for posts by me (JAM) you can dig up pretty much my whole history of heart issues.
The short answer is have your girlfriend leave you, go on a multi-week angst-fueled orgy of excessive endurance exercise and sleep deprivation, wait until you're in afib, then go to the emergency room complaining of heart problems and be hooked up to an ECG faster than you can think. Then you finally have an ECG trace you can show your disbelieving cardiologist demonstrating that there is, in fact, a problem, even though their various tests over the last few years didn't find anything.
In a bit more detail-
I developed a heart arrhythmia at a very early age (like 7 or so) that was mostly controlled via medication until my early 20s. At that point it was frequent enough that I underwent an ablation for what was later called 'Wolfe-Parkinson-White type II syndrome' (spelling might be off). My understanding is this was a single-point ablation to fry a node in my left atrium, a much less complicated procedure than what is used to treat afib. The side effect of this is I was highly sensitized to heart issues, and had confidence in what did and did not feel right with my heart beat.
At this point I was symptom-free and had the best ~6 years of my athletic life filled with excessive ironman racing, getting faster that I ever believed possible. At some point I started getting weird fatigue symptoms and occasional highly elevated 'jumpy' heart rates with excessive intensive endurance exercise. With my history of heart problems I of course went to see a cardiologist and got hooked up to the treadmill stress test, the 24 hour holter monitor, and the month-long event recorder. None of these showed an issue.
After a few more years, a few different cardiologists, and a bunch more testing the afib episodes got a little more frequent (every few months, rather than once a year) and a bit longer duration (10s of minutes, rather than a few minutes). It was during this time that I had an episode trigger after a hard swim on little sleep, and it lasted long enough that I was able to get to an emergency room to get that 'proof' that there was a problem.
I waited another couple of years for things to get worse before I decided the risk of surgery was worth it due to the impact the (now almost daily and hours-long) afib episodes were having on my life.
I'm afraid I'm not much help in how to diagnosis the problem cheaply. The best I can offer there is stress yourself out as much as possible and make sure an emergency room is handy (disclaimer- i am not a medical professional and I don't actually recommend this as a method of diagnosing heart problems!). But I can at least offer some sympathy and my experience - It can take a long time for modern medical science to track down and diagnose intermittent medical problems. In my experience, how I felt was a much more sensitive test than anything the doctors were able to do.
I have heard of a small, implantable monitor that can be used to diagnose heart issues with more confidence. if you're really having issues this might be something that you could discuss with you cardiologist. The one I've heard about is the Medtronic Reveal:
http://www.medtronic.com/...ing/device/index.htm)
(Disclaimer: I work for Medtronic, but in an unrelated business unit. I don't know anything about this device other than seeing it at a product fair once)
Best of luck, and know that you're not alone.
Jeff