Atrial fibrillation is a type of arrhythmia, or irregular heartbeat, that often causes the heart to beat at an abnormally fast rate. Doctors need to determine which type of atrial fibrillation a person has to choose the best treatment option for them.
The three main types of atrial fibrillation (A-fib) are paroxysmal, persistent, and long-term persistent. Doctors also categorize A-fib as either valvular or nonvalvular.
In some cases, A-fib may not cause any symptoms, so a doctor might only discover it when testing for other conditions. In some people, it will present with symptoms. The presence of symptoms is not a factor in the classification of A-fib.
In this article, we discuss the different types of A-fib.
A paroxysm is a sudden episode of a disease or symptom.
In paroxysmal A-fib, the irregular rhythm starts suddenly and resolves without treatment within 7 days. The episode may only last a few seconds before it stops on its own.
A person with this type of A-fib will have no noticeable symptoms and may not require treatment to control their heart rhythm. However, a doctor will often prescribe anticoagulation medications to make it harder for the blood to form clots. These drugs may help prevent a stroke.
Episodes occur intermittently at irregular intervals in paroxysmal A-fib.
Approximately half of all cases of A-fib are paroxysmal.
The episodes in persistent A-fib are continuous and last for more than 7 days.
While these episodes may resolve without treatment, a person with persistent A-fib often needs to receive medication or undergo a procedure to restore their heart rhythm.
They may take medication to slow the heart rate. Usually, a doctor also issues anticoagulants to prevent blood clots.
In addition to antiarrhythmic medications, there are several procedures that a doctor may use to restore a regular heartbeat in people with persistent A-fib. These include cardioversion, which involves issuing a small electric shock, and catheter ablation, in which the surgeon destroys the heart tissue that is responsible for the irregular rhythm.
This type of A-fib was formerly called permanent A-fib.
When medications, cardioversion, catheter ablation, and other methods are unable to convert A-fib back to a normal rhythm, and it seems unlikely that this conversion will be possible, doctors refer to the condition as long-term persistent A-fib.
People with this diagnosis will have agreed with their doctor to stop attempting the conversion.
However, a doctor might still issue medication to control a person’s heart rate and prevent blood clots.
If A-fib is nonvalvular, this means that a heart valve issue, such as mitral stenosis or a replacement valve, is not the cause of the condition.
Conversely, in people with valvular A-fib, an issue with a heart valve is responsible for the arrhythmia.
Any of the three types of A-fib can be either valvular or nonvalvular.
It is vital that doctors determine whether or not the heart valves are responsible for a person’s A-fib before deciding on a treatment plan. Newer medications for preventing blood clots are available, but the United States Food and Drug Administration (FDA) has not approved them as a safe and effective treatment for nonvalvular A-fib.
Atrial fibrillation is an arrhythmia. There are several different types of A-fib, which vary in the length of arrhythmia episodes and in how they respond to treatment.
Paroxysmal A-fib lasts for between a few seconds and 7 days, while persistent A-fib lasts for more than 7 days. Long-term persistent A-fib is continuous and does not respond to treatment.
Doctors also classify A-fib as valvular or nonvalvular according to whether or not the heart valves are causing the arrhythmia.
How do I know which type of A-fib I have?
Doctors classify A-fib according to how long an episode lasts. Each type of A-fib may or may not cause symptoms, and you might not know that you have this condition if you do not experience any symptoms.
If your episodes last for only a few seconds or up to 7 days, the A-fib is paroxysmal. Episodes lasting longer than 7 days indicate persistent A-fib. When A-fib does not respond to attempts to convert it to a regular rhythm, it is called long-term persistent A-fib.