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Classification and clinical types of atrial fibrillation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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classification of atrial fibrillation

A simple classification scheme has been proposed based on presentation and duration of the arrhythmia (1,2).

  • recent onset or first diagnosed
    • patients who presents with AF for the first time regardless of the duration of arrhythmia or the presence and severity of AF-related symptoms (2)
    • may or may not reoccur (3)

  • paroxysmal
    • is self terminating (usually within 48 hours)
    • although episodes may generally last up to 7 days, the 48 hour time point is clinically important since probability of spontaneous conversion is low after this time and anticoagulation must be considered (2)
    • recurrent (3)

  • persistent
    • does not self terminate and last for more than 7 days or cardioversion (either with drugs or by direct current cardioversion (DCC)) is needed to restore sinus rhythm (2)
    • recurrent (3)

  • long standing persistent
    • continuous AF for more than 1 year duration

  • permanent AF
    • rhythm control interventions have been abandoned and the arrhythmia is accepted by the patient (and physician) (2)


  • first diagnosed AF may be either paroxysmal or persistent or already be deemed permanent (2)
  • after 2 or more episodes AF is considered as recurrent and both paroxysmal and persistent AF may be recurrent (1)
  • arrhythmia tends to progress from paroxysmal to persistent long-standing persistent and eventually to permanent. (2)



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