Types of Atrial Fibrillation: What You Need to Know
AFib is classified into four types based on how long the irregular heartbeat lasts: paroxysmal, persistent, long-standing persistent, and permanent.
Paroxysmal AFib comes and goes on its own, while persistent AFib lasts longer and may require medical intervention. Long-standing persistent AFib lasts for at least a year, and permanent AFib is continuous.
Treatment options vary depending on the type of AFib, but the goals are to restore normal heart rhythm, manage heart rate, and prevent blood clots.
Overview
Atrial fibrillation (AFib) is a type of arrhythmia, or irregular heartbeat. It causes the upper and lower chambers of your heart to beat out of sync, fast, and erratically.
AFib used to be classified as either chronic or acute. But in 2014, new guidelines from the American College of Cardiology and American Heart Association changed the classification of atrial fibrillation from two types to four:
paroxysmal AFib
persistent AFib
long-standing persistent AFib
permanent AFib
You can start with one type of AFib that eventually becomes another type as the condition progresses. Keep reading to learn more about each type.
1. Paroxysmal atrial fibrillation
Paroxysmal AFib comes and goes. It begins and ends spontaneously. The irregular heartbeat may last anywhere from several seconds to a week. However, most episodes of paroxysmal AFib resolve themselves within 24 hours.
Paroxysmal AFib may be asymptomatic, which means that you experience no apparent symptoms. The first line of treatment for asymptomatic paroxysmal AFib may be lifestyle changes, such as reducing daily caffeine consumption and reducing stress, in addition to medications as preventative measures.
2. Persistent atrial fibrillation
Persistent AFib also begins spontaneously. It lasts at least seven days and may or may not end on its own. Medical intervention such as cardioversion, in which your doctor shocks your heart into rhythm, may be needed to stop an acute, persistent AFib episode. Lifestyle changes and medications may be used as preventive measures.
3. Long-standing persistent atrial fibrillation
Long-standing persistent AFib lasts at least a year without interruption. It's often associated with structural heart damage.
This type of AFib can be the most challenging to treat. Medications to maintain a normal heart rate or rhythm are often ineffective. More invasive treatments may be needed. These can include:
electrical cardioversion
catheter ablation
pacemaker implantation
4. Permanent atrial fibrillation
Long-standing persistent AFib can become permanent when treatment doesn't restore normal heart rate or rhythm. As a result, you and your doctor make a decision to stop further treatment efforts. This means your heart is in a state of AFib all the time. According to research, this type of AFib may result in more severe symptoms, lower quality of life, and an increased risk of a major cardiac event.
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