Atrial fibrillation classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Although several clinical classification plans and protocols have been proposed, none of them fully account for all aspects of atrial fibrillation. The American Heart Association, American College of Cardiology, and the European Society of Cardiology have proposed the a classification system based on simplicity and clinical relevance.[1] It contains four main categories of atrial fibrillation; first detected, paroxysmal, persistent, and permanent.
Classification
| AF Category | Defining Characteristics |
|---|---|
| First detected | Only one diagnosed episode. |
| Paroxysmal | Recurrent episodes that self-terminate in less than 7 days (most episodes are brief and last < 24 hours). |
| Persistent | Recurrent episodes that last more than 7 days and may require pharmacologic or electrical intervention. |
| Permanent | An ongoing long-term episode that lasts for more than a year despite attempts at cardioversion. |
First Detected Atrial Fibrillation
Any patient with new diagnosed AF is in this category, as the exact onset and chronicity of the disease is often uncertain. The patient may have been symptomatic or asymptomatic.
Recurrent Atrial Fibrillation
Two or more identified episodes of atrial fibrillation are named as recurrent form of atrial fibrillation. This is further classified into paroxysmal and persistent based on when the episode terminates without therapy. Atrial fibrillation is said to be paroxysmal when it terminates spontaneously within 7 days, most commonly within 24 hours.
The term persistent or chronic is used if diagnosis of atrial fibrillation established for more than seven days. Differentiation of paroxysmal from chronic or established AF is based on the history of recurrent episodes and the duration of the current AF episode.[1][2][3]
Persistent Atrial Fibrillation
Persistent atrial fibrillation is defined as episodes of atrial fibrillation of more than seven days duration.
Permanent Atrial Fibrillation
Permanent atrial fibrillation is defined as atrial fibrillation that persists for more than a year. Cardioversion has either failed in these patients were has not yet been attempted.
Lone Atrial Fibrillation (LAF)
Lone atrial fibrillation is defined as atrial fibrillation in the absence of clinical or echocardiographic findings of cardiopulmonary disease including hypertension.[1] Patients in this group are young individuals (less than 60 years old).
References
- ↑ 1.0 1.1 1.2 Fuster V, Rydén LE, Cannom DS; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (7): e257–354. doi:10.1161/CIRCULATIONAHA.106.177292. PMID 16908781.
- ↑ Levy S (1998). "Epidemiology and classification of atrial fibrillation". J Cardiovasc Electrophysiol. 9 (8 Suppl): S78–82. PMID 9727680
- ↑ Levy S (2000). "Classification system of atrial fibrillation". Curr Opin Cardiol. 15 (1): 54–7. PMID 10666661