Atrial fibrillation may be paroxysmal or persistent. Paroxysmal atrial fibrillation refers to atrial fibrillation that comes and goes on its own. The episodes may last anywhere from a few minutes to several hours, and sometimes several days. Persistent or chronic atrial fibrillation lasts for more than seven days. In patients with persistent atrial fibrillation, a normal heart rhythm is restored by treatment.

Because of the sluggish movement of blood through the atria during atrial fibrillation, there is a tendency for blood clots to form in some patients. This can lead to complications such as stroke. For this reason, medications that thin the blood, such as aspirin or warfarin, are necessary for some patients with atrial fibrillation.

Atrial flutter

Some patients with paroxysmal atrial fibrillation (the type that comes and goes, as compared to persistent atrial fibrillation, which can stay for more than a week) also have right atrial flutter. Right atrial flutter results from a “short circuit” in the right atrium and causes symptoms that are very similar to the symptoms of atrial fibrillation. Most patients cannot tell the difference between atrial fibrillation and atrial flutter.

Some individuals feel fine when they are in atrial fibrillation. This is more often the case in older patients who are not very active than in younger, more active patients. If the atrial fibrillation is not causing any symptoms, sometimes the best course of action is to simply live with it instead of receiving medications or other treatments in an attempt to restore a normal heart rhythm. For those patients, medications may still be needed to prevent a rapid heart rate and to prevent blood clots.

Many people can be treated by medication alone, and a number of treatments for afib are outpatient-based. We offer a variety of treatment options, depending on the condition of the patient, including:

• Drug therapy, such as anticoagulants
• Electrical cardioversion
• Pacemaker
• Catheter ablation
• Implantable cardiac defibrillator (ICD)
• Pulsed field ablation (PFA), a nonthermal ablation with minimal risk of collateral tissue injury that specifically targets abnormal heart cells
• Vein of Marshall ethanol ablation, a targeted approach to persistent and recurrent conditions that eliminates residual mechanisms of afib
• Maze procedure (see below)
• Thoracoscopic surgical ablation (see below)

Call us at 888-287-1082 to schedule an appointment with a U-M Cardiovascular Center physician, get a prescription refill, or request to speak with your nurse, or visit the Make a Cardiovascular Appointment page.

• Heart Rhythm Disorders Information Guide (PDF)
• Donate a Pacemaker