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Paroxysmal atrial fibrillation

David Spragg, MD, FHRS
Kapil Kumar, MD
Section Editor
Bradley P Knight, MD, FACC
Deputy Editor
Gordon M Saperia, MD, FACC


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 [4]. "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 pericarditis, hyperthyroidism, pulmonary embolism, 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 PAF is uncertain, because older studies have suggested that a majority of these episodes are asymptomatic [5,6], including some that may last more than 48 hours [5].

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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Literature review current through: Nov 2017. | This topic last updated: May 24, 2017.
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