Paroxysmal atrial fibrillation is a type of arrhythmia (irregular heartbeat) known as atrial fibrillation. Episodes of this arrhythmia occur intermittently and may last less than seven days. It may increase your risk of having other episodes of irregular heartbeat.
Continue reading to learn more about paroxysmal atrial fibrillation, including how serious paroxysmal atrial fibrillation is, whether it’s reversible, and what to expect from it in the future.
Paroxysmal Atrial Fibrillation Definition
Paroxysmal atrial fibrillation is a short-term type of atrial fibrillation in which symptoms come and go.
Atrial fibrillation (AFib) is the most common type of irregular heart rhythm (or arrhythmia). It happens when the heart's upper chambers, called the atria, beat rapidly. They get out of sync with the lower chambers of the heart, known as ventricles, which can lead to blood pooling and serious complications, including blood clots, stroke, and heart failure.
AFib is categorized by how long the arrhythmia lasts. Some people with AFib will never experience symptoms. Paroxysmal atrial fibrillation symptoms last seven days or less. If AFib lasts longer than a week, it is persistent atrial fibrillation. If AFib lasts more than a year, it's called long-standing persistent AFib.
About one-quarter of people will experience AFib during their lives. The condition becomes more common with age.
Paroxysmal Atrial Fibrillation Symptoms
The symptoms of paroxysmal atrial fibrillation can vary, so you might have different symptoms each time you experience an AFib occurrence. The most frequent symptoms of AFib are:
- Palpitations
- Fatigue
- Shortness of breath
- Chest discomfort
- Lightheadedness
More rarely, some people can lose consciousness. In other cases, people with AFib have no symptoms at all.
Atrial Fibrillation: Deciding to Go to the Hospital
Causes and Risk Factors
Healthcare providers believe that the cause of AFib involves changes in the heart muscles. These changes affect how the muscle receives the electrical signals that control your heartbeat. Certain conditions and risk factors can increase your chances of having AFib, including:
- Age
- Obesity
- Lack of physical activity
- High blood pressure
- Diabetes
- Kidney disease
- Smoking
- Alcohol use
- Other cardiac disease
Diagnosis
To diagnose AFib, a healthcare provider must observe an irregular heart rhythm on an electrocardiogram (ECG). Paroxysmal atrial fibrillation can make this tricky because some people have symptoms that only last a few minutes or have stopped by the time they get to the healthcare provider’s office.
To help with your diagnosis, track when you experience symptoms and what they are. If an ECG in the healthcare provider’s office is normal, your provider may recommend ambulatory monitoring, a type of ECG you wear at home. You should wear the device until it has recorded an episode of the symptoms you have been experiencing.
Treatment
There are a few different treatment options for paroxysmal atrial fibrillation. It’s important to work with your healthcare team to weigh the benefits and risks of each. Your treatment plan should take into account any other serious health conditions you have, like diabetes or other cardiac concerns.
Treatments can include:
- Lifestyle changes, like decreasing alcohol use or increasing exercise, if that’s safe for you.
- Medicines to control heart rate and rhythm
- Cardiac ablation, a surgical procedure in which a catheter is inserted to scar the source of the arrhythmia
- Blood thinners to prevent clots that can cause complications
- Surgeries
Current treatment guidelines emphasize restoring normal heart rhythm as quickly as possible to prevent symptoms and complications and to keep the condition from worsening. In some people, this could mean that cardiac ablation is the first treatment used.
Prognosis
Paroxysmal atrial fibrillation is often progressive. Each episode of AFib increases the risk for subsequent episodes. Because of that, it’s important to work with your healthcare provider to treat paroxysmal atrial fibrillation, even if you only experience symptoms occasionally.
Telling yourself that paroxysmal atrial fibrillation is no big deal may comfort you. However, research shows 9% to 30% of people with paroxysmal atrial fibrillation will progress to persistent AFib within a year. So, staying proactive about treating this condition is important.
Coping
Getting an AFib diagnosis is stressful, but it’s important to remember that treatment is there to help. With treatment, you may experience no lingering symptoms. There are plenty of resources for coping, including a helpline from the Atrial Fibrillation Association.
Summary
Paroxysmal atrial fibrillation is an irregular heart rhythm that can cause symptoms including fatigue, lightheadedness, and—more rarely—stroke. Paroxysmal atrial fibrillation is a type of AFib that resolves within seven days, either on its own or with treatment. However, paroxysmal atrial fibrillation can increase your risk of developing persistent AFib. Because of that, it’s important to work closely with your healthcare provider to treat paroxysmal atrial fibrillation.
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National Heart, Lung, and Blood Institute. What is atrial fibrillation?
Heidt ST, Kratz A, Najarian K, et al.Symptoms in atrial fibrillation: a contemporary review and future directions.J Atr Fibrillation. 2016;9(1):1422. doi:10.4022/jafib.1422
Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193
Shukla A, Curtis AB. Avoiding permanent atrial fibrillation: treatment approaches to prevent disease progression. Vascular Health and Risk Management. 2013. doi: 10.2147/VHRM.S49334
Centers for Disease Control and Prevention. Atrial fibrillation.
By Kelly Burch
Burch is a New Hampshire-based freelance health writer with a bachelor's degree in communications from Boston University.
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