Paroxysmal AFib — Episodes That End Themselves
Short placeholder: episodes self-terminate within seven days, often within hours.
- <7 days: Episode duration (usually under 24 hours)
- Spontaneous: Conversion mode (no intervention needed)
- ~50%: Recurrence rate (placeholder estimate)
- Ectopic foci: Typical trigger (often pulmonary veins)
Definition and mechanism
Placeholder: brief self-limited bursts of irregular atrial activity.
Persistent AFib — Beyond Spontaneous Recovery
Short placeholder: sustained rhythm lasting over seven days, needing cardioversion.
- >7 days: Episode duration (does not self-terminate)
- Cardioversion: Intervention (electrical or pharmacologic)
- ~70%: Success rate (placeholder estimate)
- High: Recurrence risk (placeholder estimate)
Definition and management
Placeholder: requires active termination rather than watchful waiting.
Long-Standing Persistent AFib — Over 12 Months
Short placeholder: continuous rhythm disturbance lasting more than a year.
- >12 months: Duration (continuous arrhythmia)
- Advanced: Atrial remodeling (placeholder estimate)
- ~40%: Cardioversion success (placeholder estimate)
- Rate control: Strategy shift (placeholder note)
Definition and remodeling
Placeholder: prolonged duration drives structural atrial changes.
Permanent AFib — Rhythm Control Abandoned
Short placeholder: arrhythmia accepted, focus shifts to rate control.
- Abandoned: Rhythm control (joint decision)
- Rate control only: Strategy (placeholder note)
- Lifelong: Anticoagulation (stroke prevention)
- None accepted: Reversibility (placeholder estimate)
Definition and acceptance
Placeholder: a joint clinical decision, not a strict duration cutoff.
Progression Risk — From Paroxysmal Toward Permanent
Short placeholder: AFib often advances stepwise with time since diagnosis.
- ~15%/yr: Progression rate (placeholder estimate)
- ~25%: 5-yr permanent risk (placeholder estimate)
- Atrial fibrosis: Key driver (placeholder note)
- Early rhythm control: Prevention (placeholder note)
Why AFib progresses
Placeholder: fibrosis and remodeling entrench the arrhythmia over years.