paroxysmal AF

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Paroxysmal atrial fibrillation is often more symptomatic than stable fibrillation, and it is often difficult to distinguish from frequent atrial ectopics.

It is a common cause of palpitations in middle age and the elderly. It may cause stroke.

Classification of AF (5):

  • atrial fibrillation is classified as "paroxysmal" if episodes terminate spontaneously or after targeted intervention within seven days, whereas atrial fibrillation lasting more than seven days without termination is considered "persistent" and often requires electrical or pharmacological cardioversion for termination
  • atrial fibrillation that persists continuously for longer than a year is termed "longstanding persistent atrial fibrillation"
  • when the patient and clinician decide not to pursue anyany attempt to restore normal rhythm, atrial fibrillation is considered "permanent"


  • Ponamgi SP et al. Screening and management of atrial fibrillation in primary care. BMJ 2021;372:mn379

Last edited 04/2021 and last reviewed 05/2021