Routine biopsies will tell you if the heart is doing well or rejecting in some way. The patient would be having symptoms such as shortness of breath and congestive heart failure if the heart started being rejected. All of a sudden can happen if the patient has a heart attack. Hope this helps!
Depending on the cause and the symptoms, then the decision to manage medically or surgically can be made. Until all of the diagnostic testing is done to rule out certain things and actually find the cause of this enlarged heart, no assumptions should be made. Hope this helps!
Maybe a second ablation will be necessary based on symptoms. I would ask your cardiologist. Hope this helps!