There are two major forms of AF.
- persistent AF – where AF is persistent lasting for many days or weeks. In this form of AF, it is unlikely that normal rhythm will be restored without medical intervention such as cardioversion or ablation.
- paroxysmal AF -where AF is intermittent, coming and going frequently. In this form of AF, it is possible that there are clear triggers for AF. AF often starts and stops spontaneously, and can last from several minutes to several hours. Some drugs, such as flecainide, can be useful in converting AF to the normal rhythm when taken during an episode of AF. This type of treatment is termed a “pill-in-the-pocket” strategy – meaning a pill is taken as and when needed to stop an attack of AF.
Atrial fibrillation doesn’t have to remain persistent, and the decision to treat AF with either drugs, cardioversion or ablation will need to be discussed with your doctor in order to decide on the best management strategy to help with your AF symptoms. One reasonable management strategy, however, particularly if you don’t appear to have any symptoms whilst in AF, maybe to leave you in a state of AF permanently. In this case, your doctors will explain why this may make sense for you and what drugs you may need to take life-long to maintain a decent heart rate profile throughout.