How Atrial Fibrillation Progresses
While atrial fibrillation may start out somewhat benign, over time it may progress.
During early episodes, atrial fibrillation may go away by itself within a few minutes, though over time, it may require medicine to go away. Some of the afib patients that we have spoken with said that in the early stages their atrial fibrillation symptoms were infrequent and often were well-controlled by medication, which usually included rate control or rhythm control drugs in combination with anticoagulants like warfarin (Coumadin®).
But over time, however, their atrial fibrillation episodes became more frequent, or lasted longer, and medication became less effective or even stopped working altogether.
For some patients, the occasional episodes transformed over time and became constant.
As their afib grew worse, they felt increasingly tired, weak, and lifeless, and were concerned about the potential of even more serious health effects from afib like congestive heart failure and stroke.
Categories of Atrial Fibrillation
Your atrial fibrillation will fall into one of three categories used by cardiologists and electrophysiologists:
- Paroxysmal, or intermittent — episodes that come and go, but generally resolve themselves or resolve with minimal medication
- Persistent — longer episodes that require intervention to terminate, such as intense medication or electrical cardioversion
- Permanent — long-standing atrial fibrillation that doesn't resolve, even with intervention
You may also see afib categorized by surgeons as either intermittent, which stops by itself or medically, or continuous, which cannot be stopped. Only surgical ablation will cure continuous afib.
You may start out with intermittent (paroxysmal) afib and over time migrate to persistent afib as your episodes last longer and don't resolve by themselves. Or you may start out with persistent afib, or even permanent afib if your episode cannot be resolved. The longer you have atrial fibrillation, or the more persistent or permanent it is, the harder it becomes to treat or cure.
Many patients respond well to medication or electrical cardioversion, and never need anything more. However, some patients do not, and some that we spoke with felt that afib never gets better — it only gets worse. The good news is that now there are solutions that can cure afib.
