Am I permanent or Paroxysmal

[steve60]

My consultant diagnosed me with Paroxysmal AF 3 years ago, I am on an Asprin a day and 300mg of Flecanide when I begin to have an episode. could I ask how long do others episodes last for, mine will last up to 72 hours, this is not intermittent but constant for 72 hrs, does that make me permanent or is this the norm ?.

[BStanding56]

I would imagine you are paroxamol, I am concerned that you are not on anticoagulaion medication to prevent strokes, apparently Asprin more or less does zilch in stroke prevention. I am not a medical person but a long time afibber who has been there and got the t shirtx I am sure someone will come along soon who can further inform you.

Beth

[SRMGrandma Volunteer]

Hi Steve,

Yes, even though your episodes last up to 72 hours, if it is resolves and you are back in normal rhythm, then it is paroxysmal, not permanent. That said, Beth is totally right. You need to be on a real anticoagulant, either warfarin or one of the newer ones to prevent the risk of stroke, which is very real, and the biggest thing we all fear with AF. I would talk to your health care provider about this immediately, and if they are not willing to change you from the aspirin, find someone who will. Be well.

[DrWarfarin]

Steve

I would not get too worried about the specific label as even us clinicians can be a little vague about what we. As a very simple rule of thumb, if you revert to sinus rhythm spontaneously or within 72 hours with medical intervention this is paroxysmal. If you can be returned to normal rhythm with various medical interventions, you are persistent and if you can never be returned to normal rhythm from AF then then this is permanent AF

The only reason this would be an issue would be if your are considering ablation therapy where theoretically NICE has only approved the intervention for those with paroxysmalAF(where there definition is very restrictive of a spontaneous reversion to sinus rhythm within 72 hours) , however this is usually overlooked in real life

The label of AF (paroxysmal, persistent, long term persistent or permanent) makes no difference to your stroke risk which is inherent is anyone suffering from AF in any of its forms.

I tend to agree with the zeal of the other posters about stroke risk assessment however before considering an anticoagulant you should assess your level of risk with the CHADSVASc schema (available at the AF Assoc web site).

If you are carrying any risk (a CHADSVASc score of 1 or greater) then I agree with the others that you should discuss an more effective intervention with clinician. This will be an anticoagulant

If you have a CHADSVASc score of zero then I would consider whether you wish to continue aspirin and I would refer you to the ESC guideline focussed update for AF of 2012(escardio.org/guidelines-sur...

MF