From the Guidelines
Approximately 25-30% of atrial fibrillation (AFib) cases are paroxysmal. Paroxysmal AFib is characterized by episodes that start and stop spontaneously, typically lasting less than 7 days and often resolving within 24-48 hours without intervention 1. This form of AFib can be challenging to diagnose because patients may be in normal sinus rhythm during medical evaluation. Patients with paroxysmal AFib often require monitoring with Holter monitors, event recorders, or implantable loop recorders to capture these intermittent episodes. Some key points to consider in the management of paroxysmal AFib include:
- The importance of early intervention with rhythm control strategies to prevent progression to more sustained forms of AFib 1
- The need for appropriate anticoagulation therapy based on the patient's CHA₂DS₂-VASc score, regardless of how frequently episodes occur 1
- The potential for paroxysmal AFib to progress to persistent or permanent forms over time, with about 5-10% of patients progressing each year 1 It's also important to note that paroxysmal AFib carries similar stroke risks as other AFib types, making anticoagulation therapy a crucial consideration in management 1. Overall, paroxysmal AFib is a significant subtype of AFib that requires careful diagnosis and management to prevent complications and improve patient outcomes.
From the Research
Prevalence of Paroxysmal Atrial Fibrillation
- The prevalence of paroxysmal atrial fibrillation (AFib) is estimated to be around 40% of all AFib cases 2.
- Another study suggests that paroxysmal AFib constitutes approximately half of all AFib cases 3.
- The exact percentage of paroxysmal AFib may vary depending on the population studied and the criteria used to define paroxysmal AFib.
Definition and Classification of Paroxysmal Atrial Fibrillation
- Paroxysmal AFib is defined as attacks of arrhythmia lasting < 7 days separated by prolonged periods of sinus rhythm 4.
- Chronic AFib is defined as AFib established for > 7 days 4.
- The differentiation of paroxysmal from chronic or established AFib is based on the history of recurrent episodes and the duration of the current episode of AFib 4.
Risk Factors and Progression of Paroxysmal Atrial Fibrillation
- Risk factors for paroxysmal AFib include age, prior valvular heart disease, ischemic heart disease, heart failure, and hyperthyroidism 5.
- The progression of paroxysmal AFib to chronic AFib is estimated to occur in 15-30% of patients over a period of 1-3 years 5.
- A study found that 24% of patients with paroxysmal AFib progressed to persistent AFib during a follow-up period of approximately 1 year 6.