💓 Can Atrial Fibrillation Come and Go? Yes – and the way it behaves tells us what type of atrial fibrillation you have.

🫀 What Is Atrial Fibrillation?

Atrial fibrillation (AF) is a chaotic rhythm that starts in the heart’s upper chambers; the atria. Instead of beating in a steady rhythm, the heart fires off many small, irregular electrical signals that make it “fibrillate.”

Typical symptoms include:

💢 Palpitations (a fast or fluttering heartbeat)

😮‍💨 Shortness of breath

🪫 Fatigue or reduced exercise tolerance

The pulse can vary greatly, often around 150 beats per minute, but it’s different for everyone. What makes atrial fibrillation unique is that the rhythm is “irregularly irregular” – completely without pattern or timing.

👩‍🦳 Anna’s Story – The Heart That Wouldn’t Calm Down

Anna, 66, is an active retiree who enjoys walking and staying fit.From time to time, she notices her heart “jumping” a little, especially at night when she’s about to fall asleep. These episodes only last a few minutes, so she doesn’t think much of it.

But one day, she suddenly feels her heart racing and pounding hard for several hours. At the emergency clinic, her ECG looks normal again, the episode has stopped. The doctor suspects atrial fibrillation, but without documentation, it’s hard to say for sure.

Three months later, it happens again, this time lasting for several days. Her heartbeat feels fast and irregular, she becomes short of breath and tired. Now the ECG clearly shows atrial fibrillation, and the rhythm doesn’t return to normal on its own. After medications and an electrical cardioversion, her heart returns to normal rhythm. She is discharged on blood thinners and medicines to help maintain a steady rhythm.

For a while, things go well, but occasionally she feels short episodes again, lasting only a few hours and resolving spontaneously.

Three years later, Anna is admitted to hospital once more.This time, the fibrillation doesn’t stop. Even after several cardioversion attempts, her rhythm remains irregular. The doctors decide to let the AF remain, but they control her heart rate with medication so it doesn’t beat too fast.

🔄 The Three Types of Atrial Fibrillation

Anna’s story perfectly illustrates how atrial fibrillation can change over time.

1️⃣ Paroxysmal Atrial Fibrillation

Appears suddenly and often stops on its own within 48 hours (sometimes up to a week). ➡️ Anna’s first episode was like this – her heart restored normal rhythm on its own.

2️⃣ Persistent Atrial Fibrillation

Lasts longer and does not return to normal without treatment, such as medication or electrical cardioversion. ➡️ This was the case during Anna’s second hospital stay.

3️⃣ Permanent Atrial Fibrillation

When the rhythm can no longer be restored and both the patient and doctor decide to accept the fibrillation and focus on controlling the heart rate and preventing blood clots. ➡️ This is where Anna eventually ended up.

📊 How AF Evolves Over Time

Many people start with paroxysmal AF, but over time, the condition can become more persistent. Studies show that about one in three people with paroxysmal AF develop permanent AF within ten years.

This happens because the atria gradually change in structure and function.Risk factors that accelerate this process include:

• Older age 👵

• High blood pressure 💥

• Diabetes 🍬

• Kidney disease

• Obesity and sleep apnea

  
  

❤️ Why It Matters to Recognize AF

Atrial fibrillation isn’t dangerous by itself, but it can lead to serious complications, especially blood clots and stroke 🧠.Rapidly conducted AF can lead to heart failure 💔 That’s why early diagnosis and proper follow-up are essential.

Treatment focuses on two main goals:

1️⃣ Keeping the heart rate under control and reducing symptoms

2️⃣ Preventing blood clots with anticoagulant (blood-thinning) medication

💬 In Short

• Atrial fibrillation can come and go, or become a lasting condition

• The three types are paroxysmal, persistent, and permanent

• Early detection and treatment protect the heart and prevent stroke

  
  

🩺 Final Thought

Atrial fibrillation isn’t just one single rhythm disorder, it’s a condition that evolves over time. The earlier you discover it, the better you can protect your heart and live well with it. 💓