Atrial fibrillation is one of the commonest palpitations that cardiologists see.
In many ways it can be one of the most difficult conditions to deal with. This is not because it is particularly dangerous to the patient (although there are significant clinical problems that might occur) but more because, despite the rhythm disturbance being the same, different patients are all very different.
Some patients are enormously troubled by an awareness of their irregular heart beat and this is called Symptomatic Atrial Fibrillation. Others are entirely unaware of their arrhythmia in which case they would be labelled as having Asymptomatic Atrial Fibrillation.
Some patients have occassional bouts of atrial fibrillation and the rest of the time their heart remains in a normal regular rhythm. This in known as Paroxysmal Atrial Fibrillation. Others remain in atrial fibrillation all the time - known as Sustained Atrial Fibrillation.
Some patients have an underlying cause of the rhythm disturance and then it is called Secondary Atrial Fibrillation whereas in others no other problem can be found in which case it is called Lone Atrial Fibrillation .
| No cause identified | Cause identified | |||
|---|---|---|---|---|
| Sustained | Intermittent | Sustained | Intermittent | |
| Not aware of palpitations | Sustained, asymptomatic, lone AF | Paroxysmal, asymptomatic, lone AF | Sustained, asymptomatic, secondary AF | Paroxysmal, asymptomatic, secondary AF |
| Aware of palpitations | Sustained, symptomatic, lone AF | Paroxysmal, symptomatic, lone AF | Sustained, symptomatic, secondary AF | Paroxysmal, symptomatic, secondary AF |
Further information from the National Institue for Clinical Excellence (NICE) can be found at: NICE guidance on AF