Atrial Fibrillation Paroxysmal Information

It is now well established that patients with recurrent paroxysmal atrial fibrillation are at similar stroke risk as those who are in atrial fibrillation chronically. Although these episodes may be apparent to the patient, many are not recognized and may be totally asymptomatic. Thus, ambulatory electrocardiographic monitoring or event recorders are indicated in those in whom paroxysmal atrial fibrillation is suspected. Antiarrhythmic agents are usually not successful in preventing paroxysmal atrial fibrillation episodes. However, immediate self-administered treatment with an antiarrhythmic agent (experience is perhaps greatest with propafenone, 300 mg orally, repeated once after 2–3 hours if necessary) may interrupt symptomatic episodes, and chronic use of a -blocker or rate-slowing calcium channel blocker may reduce the severity of symptoms. In any case, chronic anticoagulation is indicated except in those who are under 60–65 years of age and have no additional stroke risk factors (see above).

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