Well, at least this condition is treatable with surgery. So many heart conditions lead to a heart attack before the person is treated, but with right atrial enlargement, at least a doctor can usually pick up on it and refer the person to a cardiologist for evaluation.
I don't know if open heart surgery is the usual treatment for this condition, or if the surgeon usually places a pacemaker. I know I would prefer just a pacemaker, if the outcomes were the same. I suppose it depends on the nature of the condition and the effects it is having on the heart.