So, yes you'll need medicine.
Yes if the medicine is unsuccessful, you may need a cardioversion (electric shock)
If the afib cant be controlled then yes, you will need anti coagulants.
Ablation will be your last line of therapy.
All of these things are important to your long term health. There are some doctors who take a 'rate control' type of approach and eont do much to treat you. However in my opinion, given your age and many years ahead of you i think this could have serious consequences in the long term.
Heart block is inevitable, cardiomyopathy likely, and as has been explained theres a small chance for a stroke. You should accept whatever treatment the doctor feels is best for you.