Atrial fibrillation (AFib) is a condition characterized by an abnormal rhythm of the heart. There are several types of AFib and this condition can worsen and progress from a simple heart condition to a complicated, chronic, life-threatening pathology.
Paroxysmal atrial fibrillation
A paroxysm is a brief, transitory event, This type of AFib is transient, that is, it could be a one-time issue or last up to a week with no problems later. Its presentation varies. In some cases you may not even be aware of it happening or, you may feel it as fast, strong, distressing chest palpitations. The event usually resolves in less than a day, but may last up to a week. Paroxysmal atrial fibrillation can happen more than once. You may need treatment, or your symptoms may go away on their own.
In some instances the fast heartbeat (tachycardia) Paroxysmal AFib can alternate with slow, maintained heartbeats (bradycardia). In this case it is called a tachy-brady syndrome.
Persistent atrial fibrillation
Persistent AFib is defined as an AFib that lasts for more than a week. It may return to normal on its own, but it usually requires medical treatment to regulate the heartbeat.
In some cases electrical cardioversion may be needed. This is a case where the patient is placed under sedation or anesthesia to shock the heart under controlled conditions using a generator and electrodes that are attached to the chest. (Clear!)
If AFib requires cardioversion it is by definition a persistent AFib.
Long term persistent atrial fibrillation
In this case the AFib persists for more than a year despite the attempts to correct it with medication. Some patients who have had several electrophysiological (EP) ablations where the AFib still persists also fall in this category.
Permanent atrial fibrillation
Sometimes atrial fibrillation does not get better, even when attempts to restore a sinus rhythm with medicines or other surgical treatments have been tried. At this point, the AFib is considered to be permanent or chronic.
Often, especially without treatment, atrial fibrillation may progress from paroxysmal to persistent to long-term.
We have seen cases where the patient has had up to six EP ablations and the last case option that has been suggested is an atrioventricular node ablation. In these rare cases the Mini-Maze has been able to provide a solution.