What are the different types of atrial fibrillation (AFib)?

Theodore Chow, MD
Cardiology (Cardiovascular Disease)
Rapid AFib can lead to a rapid pulse rate, chronic AFib has occurred for a long time, and paroxysmal AFib refers to short bursts of atrial fibrillation. Watch Theodore Chow, MD, of Regional Medical Center, discuss their differences.
Senthil K. Thambidorai, MD
Internal Medicine
There are two types of atrial fibrillation, which are defined by the cause of the atrial fibrillation.
  • Valvular: This is caused by a valve problem, such as a leaky or tight valve.
  • Non-valvular: This is where the structure of the heart and the valves are otherwise okay but you do have atrial fibrillation.
Both types of atrial fibrillation have an equal risk for stroke. If you have had atrial fibrillation, you should talk to your doctor about your stroke risk, and he or she may recommend you take blood thinners to lower your risk. 
Matthew T. Levy, MD
Clinical Cardiac Electrophysiology
The different types of atrial fibrillation (AFib) are paroxysmal (the most common), persistent and permanent. In this video, Matt Levy, MD, a cardiologist at Good Samaritan Hospital, discusses the difference between them.
Andrew J. Brenyo, MD
Cardiology (Cardiovascular Disease)
In reality there is a spectrum of atrial fibrillation, and not different types. The analogy I use with patients is that atrial fibrillation is a weed in your yard. At first there are only a few weeds (representing paroxysmal atrial fibrillation; that which comes and goes) but without treatment, these few weeds grow to represent a significant portion of your yard (persistent atrial fibrillation). Completely untreated the weed will grow to overtake your entire yard (longstanding persistent atrial fibrillation). As with treatment of this weed, atrial fibrillation is much more successfully treated when it is in the paroxysmal stage than when it has reached the longstanding persistent stage. That it is why it needs to be addressed with your doctor even if it is very infrequent and mild. There are not necessarily different types of atrial fibrillation but more of a spectrum of paroxysmal to persistent to longstanding persistent dependent upon the amount of time that the patient spends in normal rhythm vs. atrial fibrillation.

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There are three types of atrial fibrillation.

Paroxysmal Atrial Fibrillation

In paroxysmal atrial fibrillation (AF), the faulty electrical signals and rapid heart rate begin suddenly and then stop on their own. Symptoms can be mild or severe. They stop within about a week but usually in less than 24 hours.

Persistent Atrial Fibrillation

Persistent AF is a condition in which the abnormal heart rhythm continues for more than a week. It may stop on its own, or it can be stopped with treatment.

Permanent Atrial Fibrillation

Permanent AF is a condition in which a normal heart rhythm can't be restored with treatment. Both paroxysmal and persistent AF may become more frequent and, over time, result in permanent AF.

Dr. Michael Roizen, MD
Internal Medicine
You can think of the different types of atrial fibrillation (AF) as The Three Ps. They are:
    • Paroxysmal atrial fibrillation where you experience a sudden and rapid spike in your heart rate that lasts for as short as a few seconds or as long as a few days and resolves itself on its own.
      • Persistent atrial fibrillation where your heart rhythm is out of whack and it stays that way until you get treatment.
        • Permanent atrial fibrillation where the usual treatments aren’t doing the trick. It is possible for paroxysmal and persistent AF to eventually morph into permanent AF.

          There are three different kinds of atrial fibrillation: paroxysmal, persistent, and permanent. Paroxysmal atrial fibrillation is a condition where the episodes of atrial fibrillation come and go suddenly, lasting anywhere from seconds to hours, with mild-to-severe symptoms. The heart will go back to its normal rhythm on its own.

          In persistent atrial fibrillation, the heartbeat will be rapid and irregular until you see a doctor and have it treated.

          The heart rhythms of people with permanent atrial fibrillation cannot become normal even with treatment, but they can be treated to slow their heart rates down. Permanent atrial fibrillation can develop from paroxysmal and persistent atrial fibrillation.

          Douglas E. Severance, MD
          Family Medicine
          Atrial fibrillation, which is a racing, irregular heartbeat, is categorized into three types: paroxysmal, persistent, and permanent atrial fibrillation. The first kind, paroxysmal atrial fibrillation, comes and goes; you may have symptoms off and on, and your doctor may have you to wear a portable heart monitor for 24 to 48 hours to detect and diagnose the abnormal heart rate. Persistent atrial fibrillation is a second type of the heart rhythm disorder that only stops when you take treatment with medications and/or electrical cardioversion to convert your heart's irregular rhythm into a normal rhythm. Permanent atrial fibrillation is the diagnosis given in cases where the patient's normal heart rhythm can't be restored even after trying different medications and/or cardioversion.

          There are three different types of atrial fibrillation, characterized by their duration and response to treatment. They are:

          • Paroxysmal, where atrial fibrillation occurs periodically and ends spontaneously;
          • Persistent or chronic, where an irregular heart rhythm will not return to normal on its own but does respond to treatment;
          • Permanent, where an irregular heart rhythm can’t be corrected with treatment and continues indefinitely.
          Piedmont Heart Institute

          Types of atrial fibrillation are as follows:

          Paroxysmal atrial fibrillation

          In paroxysmal atrial fibrillation (AF), the abnormal electrical signals and rapid heart rate begin suddenly and then stop on their own. Symptoms can be mild or severe and last for seconds, minutes, hours, or days.

          Persistent atrial fibrillation

          Persistent AF is a condition in which the abnormal heart rhythm continues until it's stopped with treatment.

          Permanent atrial fibrillation

          Permanent AF is a condition in which a normal heart rhythm can't be restored with the usual treatments. Both paroxysmal and persistent AF may become more frequent and, over time, result in permanent AF.

          This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

          Continue Learning about Atrial Fibrillation

          Atrial Fibrillation

          Atrial Fibrillation

          Atrial fibrillation -- the most common type of cardiac arrhythmia -- causes an irregular heartbeat that can increase your risk for stroke and heart failure. Atrial fibrillation (AF or AFib) results from faulty signals produced by ...

          the heart's electrical system, causing the upper portion of the heart to fibrillate, or contract rapidly and irregularly. AFib doesn't cause noticeable symptoms for everyone. For those who do experience symptoms, heart palpitations are common along with feeling weak, dizzy and tired. Learn more about atrial fibrillation with expert advice from Sharecare.

          Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.