Atrial fibrillation classification
Isolated (ie, idiopathic) atrial fibrillation (AF), which occurs in patients younger than 60 years of age, is very common. Although the prognosis is good and the risk of systemic embolism is low (approximately 1.3% over a 15-year period), idiopathic AF can cause very serious symptoms and patient anxiety. Like a “secondary” OP, an isolated OP can be paroxysmal or persistent.
Paroxysmal isolated atrial fibrillation
Only one or several very rare episodes of arrhythmia are possible, but in some cases atrial fibrillation (AF) often recurs, sometimes several times a day.
Paroxysms can last for many hours or end in a few seconds. Over time, some patients (but not all) of AF become persistent.
Studies show that an episode of atrial fibrillation (AF) can lead to changes in the electrical properties of the atria that help to maintain arrhythmias — this process is referred to as “electrical remodeling.”
Often, patients have very serious symptoms. In other cases, including frequent relapses occurring with a high frequency of ventricular contractions, arrhythmia may be asymptomatic or accompanied only by the sensation of arrhythmia, without any discomfort due to high heart rate.
Only some patients can name the factors immediately preceding the arrhythmia and, possibly, provoking it (such as physical exertion, vomiting, alcohol intake or fatigue). One of the forms of paroxysmal idiopathic AF is caused by an increase in the tone of the vagus nerve: an arrhythmia always begins during rest or sleep.