Atrial fibrillation (AFib) is a type of heart disorder marked by an irregular or rapid heartbeat. Persistent AFib is one of three main types of the condition. In persistent AFib, your symptoms last longer than seven days, and your heart’s rhythm isn’t able to regulate itself anymore.
The other two main types of AFib are:
- paroxysmal AFib, in which your symptoms come and go
- permanent AFib, in which your symptoms last for more than a year
AFib is a progressive disease. This means that many people first develop paroxysmal AFib, with symptoms that come and go. If it’s left untreated, the condition can progress to the persistent or permanent types. Permanent AFib means that your condition is chronic despite treatment and management.
The persistent stage of AFib is serious, but it’s treatable. Learn what you can do about persistent AFib to help prevent further complications.
Symptoms of AFib include:
- heart palpitations
- racing heartbeat
- dizziness or lightheadedness
- overall weakness
- shortness of breath
As your condition becomes more chronic, you may start noticing symptoms on a daily basis. Persistent AFib is diagnosed in people who have any of these symptoms for at least seven days straight. But AFib can also be asymptomatic, which means there are no symptoms.
It’s not always known what causes AFib, but common risk factors include:
- a family history of AFib
- advanced age
- high blood pressure, also called hypertension
- a history of heart attacks
- sleep apnea
- alcohol consumption, especially binge drinking
- overuse of stimulants, such as caffeine
- thyroid disorders
- lung disease
- severe infections
Managing chronic illnesses and lifestyle habits may decrease your risk. The Heart Rhythm Society provides a calculator that evaluates your risk for developing AFib.
Your chances of developing persistent AFib are also greater if you have a pre-existing heart valve disorder. People who’ve had heart surgery are also at an increased risk of getting AFib as a related complication.
Persistent AFib is diagnosed with a combination of tests and physical exams. If you’ve already been diagnosed with paroxysmal AFib, your doctor may see how your condition has progressed.
While an electrocardiogram can be used as an initial diagnostic tool for earlier AFib stages, other tests are used for more advanced or persistent AFib. Your doctor might recommend the following:
- blood tests to look for underlying causes of AFib progression, such as thyroid disease
- chest X-rays to look at the chambers and valves within your heart, and to monitor its overall condition
- echocardiogram to detect heart damage through sound waves
- use of an event recorder, a portable device such as a Holter monitor that you take home to measure your symptoms over a period of time
- exercise stress test to measure your heart rate and rhythm after physical activity
With persistent AFib, your heart rhythm is so disrupted that your heart isn’t able to normalize it without medical intervention. There’s also a risk for blood clots that can lead to heart attack or stroke.
Treatment may include medications to control your heart rate and rhythm or clotting of your blood, as well as methods not involving medications.
Medications to control heart rate
One goal in persistent AFib treatment is to slow down a rapid heart rate. Your doctor may prescribe medications like:
- calcium channel blockers
- digoxin (Lanoxin)
These work by reducing electrical activities within the upper chamber of your heart to the lower chamber.
Your condition will be monitored carefully to look for side effects, such as low blood pressure and worsening heart failure.
Medications to control heart rhythm
Other medications may be used alongside heart rate drugs to help stabilize your heart’s rhythm. These come in the form of antiarrhythmic drugs, such as:
Side effects of these medications can include:
- upset stomach
Blood clot medications
To lower the risk of stroke and heart attack, your doctor may prescribe a blood clotting medication. Blood thinners, known as anticoagulants, can help. Anticoagulants your doctor may prescribe include rivaroxaban (Xarelto) or warfarin (Coumadin). You may need to be monitored while taking these medications.
Surgical procedures, such as catheter ablation, may also help stabilize heart rhythm in persistent AFib. These involve incisions in your heart to target overactive areas.
Your doctor will also probably recommend lifestyle changes to help complement your medications or any surgical procedures. These may include:
- diet changes
- stress management
- the management of chronic illnesses
The longer persistent AFib goes without detection, the more difficult it can be to treat. Untreated persistent AFib can lead to permanent AFib. Having any form of AFib, including persistent AFib, increases your risk for stroke, heart attack, and death.
The best way to prevent complications from AFib is to carefully manage and treat it. If you’re diagnosed with persistent AFib, talk to your doctor about all your options. The key outcome for this stage is to make sure it doesn’t progress further into a long-standing or permanent stage.