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Paroxysmal vs. permanent atrial fibrillation
Atrial fibrillation describes an irregular heartbeat, also known as an arrhythmia, which can lead to HF, blood clots, stroke and other cardiac-related complications. It is estimated that nearly 3 million U.S. adults are living with atrial fibrillation, according to the American Heart Association.
The AHA/American College of Cardiology/Heart Rhythm Society Guideline for the Management of Patients with Atrial Fibrillation defines AF as:
Paroxysmal: symptoms that are sporadic and stop spontaneously or with intervention within 7 days. Recurrent episodes may occur. Although the self-limiting episodes are not sustained with paroxysmal AF, these patients are at risk for progressing to a more sustained arrhythmia.
Persistent: sustained episodes for more than 7 days.
Longstanding persistent: continuous episodes for more than 12 months.
Permanent: normal heart rhythm cannot be restored. “Permanent AF is used when there has been a joint decision by the patient and clinician to cease further attempts to restore and/or maintain sinus rhythm.”
AF is a progressive condition. What may begin as paroxysmal or persistent AF may develop into longstanding persistent or permanent AF.
Patients with symptoms of AF may experience palpitations, weakness, a reduced ability to exercise, fatigue, lightheadedness, dizziness, confusion, shortness of breath and/or chest pain, according to information from the Mayo Clinic. Other conditions such as HF, hypertension and sleep apnea have been associated in studies with progression to permanent AF.
Treatment options for AF vary, but may include blood clot prevention with drugs such as warfarin, aspirin or novel oral anticoagulants; rate control, with medication such as beta-blockers or calcium channel blockers; rhythm control; other therapies such as amiodarone; electrical cardioversion; catheter ablation; and maze surgery, according to the NHLBI.
Additional information may be found at these websites:
http://www.nhlbi.nih.gov/health/health-topics/topics/af/types
http://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/basics/symptoms/con-20027014
http://www.ncbi.nlm.nih.gov/pubmed/26115137
http://circ.ahajournals.org/content/early/2014/04/10/CIR.0000000000000041.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/26130952
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872084/
http://www.stopafib.org/progresses.cfm