Paroxysmal atrial fibrillation
- Philip J Podrid, MD, FACC
Philip J Podrid, MD, FACC
- Professor of Medicine, Professor of Pharmacology and Experimental Therapeutics
- Boston University School of Medicine
- Lecturer, Harvard Medical School
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 AF (PAF), also termed intermittent AF, is defined as an episode of AF that terminates spontaneously or with intervention in less than seven days . “Persistent,” “longstanding persistent,” and “permanent” are clinical labels used for 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, 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".)
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.
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- SIGNS AND SYMPTOMS OF AF
- Atrial premature beats
- Autonomic dysfunction
- NATURAL HISTORY
- Recurrence of AF
- Progression to permanent AF
- Risk of embolization
- MANAGEMENT OF THE ARRHYTHMIA
- Acute therapy
- Prevention of recurrence
- Rate control