Paroxysmal Atrial Fibrillation: What It Is and How It Is Treated

Written by Medicover Team and Medically Reviewed by Dr Jagadeesh Chandra Bose Y , Cardiologists

Causes
Find a Doctor
Diagnosis
Treatment
FAQs
Book an Appointment

1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Paroxysmal Atrial Fibrillation (PAF) is a type of atrial fibrillation characterized by episodes of rapid and irregular heart rhythm that begin suddenly and stop on their own or with treatment. These episodes can last from minutes to several days and may recur over time.

PAF can cause palpitations, shortness of breath, fatigue, dizziness, or chest discomfort. Although some people have no noticeable symptoms, appropriate diagnosis and management are important because atrial fibrillation can increase the risk of complications such as stroke.

What are the Types of Paroxysmal Atrial Fibrillation?

Paroxysmal atrial fibrillation is itself a form of atrial fibrillation in which episodes start and stop intermittently. Atrial fibrillation can also be classified according to how long the abnormal rhythm persists and whether it stops without intervention.

Paroxysmal Atrial Fibrillation: Episodes begin suddenly and usually stop on their own within seven days, often within 24 hours.
Persistent Atrial Fibrillation: The abnormal rhythm continues for more than seven days and generally requires medical treatment to restore normal rhythm.
Long-standing Persistent Atrial Fibrillation: A continuous abnormal rhythm that has lasted for at least 12 months.
Permanent Atrial Fibrillation: A decision has been made with the healthcare team to accept the abnormal rhythm rather than attempt to restore normal heart rhythm.

What are the Symptoms of Paroxysmal Atrial Fibrillation?

Symptoms of PAF can vary in frequency and severity. Some people may have no symptoms, while others notice symptoms during an episode because the heart is beating rapidly and irregularly.

Palpitations: A sensation of a fast, fluttering, pounding, or irregular heartbeat.
Shortness of Breath: Difficulty breathing or feeling breathless, particularly during physical activity.
Fatigue: Unusual tiredness or weakness during or after an episode.
Chest Discomfort: Pain, pressure, or discomfort in the chest.
Dizziness or Lightheadedness: Feeling faint or unsteady during an abnormal heart rhythm.
Reduced Exercise Tolerance: Difficulty performing usual physical activities without becoming tired or breathless.
Sweating: Unexplained sweating may occur during an episode.

What are the Causes of Paroxysmal Atrial Fibrillation?

Paroxysmal atrial fibrillation can develop when abnormal electrical signals disrupt the normal rhythm of the heart. Several heart conditions, medical disorders, lifestyle factors, and inherited factors can increase the likelihood of developing PAF.

Heart Conditions: Coronary artery disease, heart valve disorders, heart failure, and other structural heart problems can increase the risk.
High Blood Pressure: Long-term hypertension can place additional strain on the heart and contribute to atrial fibrillation.
Thyroid Disorders: Abnormal thyroid function, particularly an overactive thyroid, can trigger irregular heart rhythms.
Sleep Apnea: Obstructive sleep apnea is associated with an increased risk of atrial fibrillation.
Alcohol: Heavy alcohol consumption can trigger episodes of atrial fibrillation.
Stimulants: Nicotine, excessive caffeine, and certain medications or recreational substances may trigger episodes in susceptible individuals.
Genetic Factors: A family history of atrial fibrillation may increase the likelihood of developing the condition.
Age and Other Medical Conditions: Increasing age and conditions such as obesity, diabetes, and chronic lung disease may increase the risk.

When to See a Doctor?

See a cardiologist if you experience repeated episodes of palpitations, an irregular heartbeat, unexplained fatigue, or shortness of breath. Early evaluation can help confirm PAF and assess the risk of complications such as stroke.

Repeated episodes of a fast, fluttering, or irregular heartbeat
Shortness of breath or reduced ability to exercise
Unexplained dizziness, fatigue, or lightheadedness
Chest discomfort associated with an irregular heartbeat

Get medical help immediately if:

Severe or persistent chest pain or pressure
Severe difficulty breathing or fainting
Sudden weakness or numbness, facial drooping, difficulty speaking, or other signs of stroke

These symptoms may indicate a serious heart or stroke-related complication and require urgent medical attention.

Find Cardiologists for Paroxysmal Atrial Fibrillation Treatment Near You

How Is Paroxysmal Atrial Fibrillation Diagnosed?

Diagnosing PAF can be challenging because episodes may stop before a person reaches a healthcare facility. Diagnosis usually involves documenting the abnormal heart rhythm and evaluating the heart for possible underlying causes.

Electrocardiogram (ECG)

An ECG records the electrical activity of the heart and can confirm atrial fibrillation when an episode is occurring. Because PAF is intermittent, a routine ECG may not detect an episode if the heart rhythm is normal during the test.

Holter Monitor

A Holter monitor continuously records the heart rhythm, usually for 24 to 48 hours, and may help detect episodes that occur during the monitoring period.

Event or Patch Monitor

Longer-term ambulatory monitoring can be used when episodes occur less frequently. These devices can record the heart rhythm over several days or weeks and increase the likelihood of detecting intermittent AF.

Implantable Loop Recorder

For people with very infrequent but concerning episodes, an implantable loop recorder can continuously monitor heart rhythm for an extended period.

Echocardiogram

An echocardiogram uses ultrasound to assess the heart's structure and function and can identify conditions that may contribute to atrial fibrillation.

Blood Tests

Blood tests may be performed to assess thyroid function, electrolyte levels, and other conditions that could contribute to an abnormal heart rhythm.

What are the Treatment Options for Paroxysmal Atrial Fibrillation?

Treatment for PAF aims to control the heart rate or restore normal rhythm, reduce symptoms, and lower the risk of complications such as stroke. The appropriate treatment depends on the frequency and severity of episodes, underlying heart conditions, and the individual's risk factors.

Medications

Antiarrhythmic Medicines: Certain medicines may help restore or maintain a normal heart rhythm in appropriate patients.
Rate-Control Medicines: Beta-blockers and certain calcium channel blockers may help slow the heart rate during episodes.
Anticoagulants: Blood-thinning medicines may be recommended for people with sufficient stroke risk to reduce the chance of blood-clot-related complications.

Lifestyle Changes

Heart-Healthy Diet: Eating a balanced diet rich in vegetables, fruits, whole grains, and other nutritious foods supports cardiovascular health.
Regular Physical Activity: Appropriate exercise can support heart health, although people with symptomatic PAF should discuss suitable activity levels with their doctor.
Weight Management: Maintaining a healthy weight can reduce cardiovascular risk and may reduce the burden of atrial fibrillation.
Limit Alcohol: Reducing or avoiding alcohol may help prevent AF episodes in susceptible individuals.
Manage Stress: Relaxation techniques, adequate sleep, and stress management may help reduce potential triggers.
Stop Smoking: Avoiding tobacco and nicotine can support overall cardiovascular health.

Medical Procedures

Electrical Cardioversion: A controlled electrical shock may be used to restore a normal heart rhythm in selected patients.
Catheter Ablation: A minimally invasive procedure that targets areas of abnormal electrical activity responsible for atrial fibrillation. It may be considered when medications are ineffective, not tolerated, or in selected patients as an early rhythm-control treatment.
Pacemaker: A pacemaker is not a routine treatment for PAF but may be needed in selected patients with significant slow heart rhythms or other specific rhythm disorders.

Your health is everything - prioritize your well-being today.

Consult Paroxysmal Atrial Fibrillation Doctors Today

Frequently Asked Questions

1. What are the symptoms of paroxysmal atrial fibrillation?

Symptoms may include irregular heartbeat, palpitations, dizziness, fatigue, chest discomfort, and shortness of breath. Some people have no symptoms.

2. What causes paroxysmal atrial fibrillation?

Common risk factors include high blood pressure, coronary artery disease, heart valve problems, heart failure, thyroid disorders, obesity, sleep apnea, and excessive alcohol use.

3. How is paroxysmal atrial fibrillation treated?

Treatment may include medicines to control heart rate or rhythm, blood thinners to reduce stroke risk, lifestyle changes, cardioversion, or catheter ablation when appropriate.

4. How is paroxysmal atrial fibrillation diagnosed?

Diagnosis is usually made with an ECG (electrocardiogram). Because episodes can come and go, a Holter monitor, event recorder, or other portable heart monitor may be needed.

5. What medications are used for paroxysmal atrial fibrillation?

Medicines may include beta-blockers or calcium channel blockers for heart-rate control, antiarrhythmic drugs for rhythm control, and anticoagulants to reduce the risk of blood clots and stroke.

6. Is paroxysmal atrial fibrillation serious?

It can be serious because atrial fibrillation increases the risk of blood clots and stroke. Proper treatment and regular monitoring can help reduce these risks.

7. Can paroxysmal atrial fibrillation go away on its own?

Yes. Paroxysmal atrial fibrillation starts and stops on its own, usually lasting less than seven days. However, episodes can recur and should still be evaluated by a doctor.

8. When should I seek emergency care for atrial fibrillation?

Seek emergency medical care if an irregular heartbeat occurs with severe chest pain, fainting, severe shortness of breath, or symptoms of a stroke, such as sudden weakness, facial drooping, or difficulty speaking.