Atrial fibrillation (AF) is the most common arrhythmia lasting for more than 30 seconds. Its prevalence in the population increases with age, and it is estimated to affect over 4 percent of the population above the age of 60 [1-3]. (See "Epidemiology of and risk factors for atrial fibrillation", section on 'Epidemiology'.)
Paroxysmal atrial fibrillation (PAF), also termed intermittent AF, is defined as recurrent (two or more) episodes of AF that terminate spontaneously in less than seven days, usually less than 24 hours [4-6]. “Persistent” (AF that continues until reverted chemically or electrically), “longstanding persistent”, and “permanent” (AF continued as the underlying rhythm of choice) are the other types of AF. (See "Overview of atrial fibrillation".)
This definition applies to recurrent intermittent episodes of AF that are unrelated to a reversible cause. If the AF is secondary to cardiac surgery, pericarditis, myocardial infarction (MI), hyperthyroidism, pulmonary embolism, pulmonary disease, or other reversible causes, therapy is directed toward the underlying disease as well as the AF.(See "Epidemiology of and risk factors for atrial fibrillation".)
The frequency of paroxysmal AF (PAF) is uncertain, because up to 90 percent of episodes are asymptomatic [7,8], including some that last more than 48 hours .
This topic will address the ways in which patients with PAF differ from the broad population of patients with AF. However, in many instances, patients with PAF are managed in a manner similar to those with more sustained forms of AF.