Cardiologist Sanjiv M. Narayan, MD, PhD, serves as a professor of medicine at Stanford University. Prior to this position, he taught at the University of California, San Diego, and participated in dozens of studies on cardiovascular conditions. Several of Dr. Sanjiv M. Narayan’s more recent studies looked at persistent atrial fibrillation (AFib) and how it is affected by different treatments.
A type of irregular heartbeat, AFib can develop as one of three main forms. Each type lasts for varying amounts of time and calls for a specific treatment. It also affects whether the condition is an emergency or not. The three forms are:
- Paroxysmal AFib. Characterized by short, sudden episodes of irregular heart rhythm, this irregularity lasts from a few seconds to several days. In many cases, paroxysmal AFib is not treated although it is increasingly treated by catheter ablation. In general, physicians may consider prescribing anticoagulation medication to reduce the risk of blood clots.
- Persistent AFib. When irregular rhythm lasts for more than a week, it is often diagnosed as persistent AFib. In some situations, persistent AFib resolves on its own without medical intervention. However, some patients may need to take medication or undergo surgery to return their heart rate to normal. The standard surgical treatment for AFib is ablation. Other temporary measures include cardioversion, a procedure that sends electrical energy to the heart muscle to restore normal heart rate via paddles. Chemical cardioversion is also an option when patients have non-emergency AFib.
- Long-standing persistent AFib. Formerly known as permanent AFib, long-standing persistent AFib refers to irregular heart rhythm that lasts for more than one year. Catheter ablation, which makes small scars in the heart tissue so abnormal electrical signals cannot travel through the heart; medication; cardioversion; or any other form of treatment may be effective, but is often unable to stop this type of AFib, resulting in some doctors and patients halting treatment. In general, this condition should be managed with medications to prevent blood clots and control heart rate.
Since each form is separated by the amount of AFib that is detected, newer forms of monitoring are blurring the distinction between them. Techniques such as machine learning and computational methods may thus alter this separation in time, which may alter therapy.
A type of irregular heartbeat, AFib can develop as one of three main forms. Each type lasts for varying amounts of time and calls for a specific treatment. It also affects whether the condition is an emergency or not. The three forms are:
- Paroxysmal AFib. Characterized by short, sudden episodes of irregular heart rhythm, this irregularity lasts from a few seconds to several days. In many cases, paroxysmal AFib is not treated although it is increasingly treated by catheter ablation. In general, physicians may consider prescribing anticoagulation medication to reduce the risk of blood clots.
- Persistent AFib. When irregular rhythm lasts for more than a week, it is often diagnosed as persistent AFib. In some situations, persistent AFib resolves on its own without medical intervention. However, some patients may need to take medication or undergo surgery to return their heart rate to normal. The standard surgical treatment for AFib is ablation. Other temporary measures include cardioversion, a procedure that sends electrical energy to the heart muscle to restore normal heart rate via paddles. Chemical cardioversion is also an option when patients have non-emergency AFib.
- Long-standing persistent AFib. Formerly known as permanent AFib, long-standing persistent AFib refers to irregular heart rhythm that lasts for more than one year. Catheter ablation, which makes small scars in the heart tissue so abnormal electrical signals cannot travel through the heart; medication; cardioversion; or any other form of treatment may be effective, but is often unable to stop this type of AFib, resulting in some doctors and patients halting treatment. In general, this condition should be managed with medications to prevent blood clots and control heart rate.
Since each form is separated by the amount of AFib that is detected, newer forms of monitoring are blurring the distinction between them. Techniques such as machine learning and computational methods may thus alter this separation in time, which may alter therapy.
