Atrial Fibrillation: Understanding Paroxysmal to Permanent AFib

By: Dr. Saumil R. Shah

What does Atrial Fibrillation Mean?

Atrial fibrillation (AFib) is a condition whereby the upper chambers of the heart (atria) lose their normal rhythm. The result is inefficient blood flow, which can cause blood to pool inside the chamber and result in an increased likelihood of blood clots forming.

Atrial Fibrillation may be classified as Paroxysmal, Persistent, or Permanent. Below, we’ll take a brief look at each of the classifications and what the implications may be for an affected person.

Paroxysmal AFib

In cases of Paroxysmal AFib, a person’s heart operates normally for the majority of time, but can occasionally beat very rapidly.  Episodes may last for seconds, minutes, or hours.

The symptoms of paroxysmal AFib may differ on a case-by-case basis. A racing heart, lightheadedness, and dizziness are some of the common symptoms.  Cases of paroxysmal AFib typically resolve themselves within seven days without any intervention.

Persistent AFib

Those affected by Persistent AFib are experiencing episodes of AFib for a period of more than seven days. The symptoms of persistent AFib include fatigue, lethargy and shortness of breath.  When an episode lasts longer than 7 days, the person is unlikely to come out of AFib without treatment.  In order for a person to “get out” of persistent AFib, either a shock treatment (cardioversion) or medication must be administered.

Permanent AFib

In cases of Permanent, or Long-Standing Persistent AFib, a person is experiencing minimal or no symptoms.  With permanent AFib, a conscious decision has been made that no additional action is going to occur at the moment. In other words, there is no attempt to remove the person from being in a state of Permanent AFib.

If a patient, previously felt to be in permanent AFib, develops symptoms, attempts can be made to convert patients out of AFib.  This pattern of AFib is referred to as Long Standing Persistent AFib, and typically AFib has been present for over a year.

For a deeper look into the different types of Atrial Fibrillation, check out this video of Dr. Gilligan explaining each type and risk factors of AFib.


What If I Have No AFib Symptoms?

There is a significant portion of patients afflicted with AFib who experience no symptoms at all. Within this group, there is a subgroup of patients who have subconsciously changed their lifestyles to adjust to being in AFib. For example, someone with no overt symptoms might notice that they tire more easily after their usual workout. After they change their workout schedule or intensity, they return to feeling more like themselves, possibly never having known that they were in AFib during that time. If you have noticed shifts in your energy level that impact your day-to-day activities, it is important for you to let your doctor know of this change.

If you have any further questions concerning AFib, we encourage you to schedule an appointment today.

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