Persistent atrial fibrillation (PersAfib or AF) is the most common type of abnormal heartbeat. Common symptoms include feeling that your heart is racing (heart palpitations), quivering or skipping a beat. The condition requires treatment to restore regular heart function and prevent stroke. Nonsurgical and surgical treatment options are available.
Persistent atrial fibrillation (PersAfib or AF) is the most common type of abnormal, rapid heartbeat (arrhythmia). When you have this condition, your heart beats in an irregular pattern and often beats faster than usual. It cannot get back to its regular rhythm on its own. Common symptoms include feeling that your heart is:
Persistent Afib occurs when your heart's two upper chambers (atria) don't beat at a regular rhythm or rate. The chaotic pulse causes the lower chambers (ventricles) to pump too quickly. When that happens, they can't properly deliver oxygen-rich blood to your body.
This type of atrial fibrillation lasts for at least seven days in a row. You may experience daily symptoms for several minutes or hours. Some people experience no symptoms at all. Persistent Afib is progressive, which means it worsens and may become permanent.
Persistent Afib has no cure. But treatment can restore the heart’s normal rhythm and reduce symptoms. Early detection and management can also help prevent complications such as:
Persistent means continuously. Persistent atrial fibrillation means that an abnormal heartbeat continues for at least seven days straight.
Persistent Afib differs from other types of atrial fibrillation, including:
Persistent atrial fibrillation often develops in people who have paroxysmal Afib. When paroxysmal atrial fibrillation becomes persistent, your heart cannot get back to a regular rhythm without treatment.
At least 2.7 million Americans live with atrial fibrillation. Researchers believe an estimated 70% of those cases are persistent or long-standing persistent Afib.
Children rarely develop atrial fibrillation. When they do, their symptoms, diagnosis and treatment are usually similar to adults.
Some children with Afib may have difficulty describing symptoms. Talk to your healthcare provider if your child experiences:
Risk factors may also involve genetic changes (mutations) in families.
Other factors include heart damage or defects linked to:
Lung conditions that can lead to persistent Afib include:
You may also be at higher risk due to:
Lifestyle factors can raise your risk as well if you:
The cause of persistent atrial fibrillation is an abnormal signal that interferes with the heart’s electrical system.
The heart is a muscular organ that pumps blood through your body at a steady rhythm. Two upper chambers (atria) pump blood into two lower chambers (ventricles), which send blood to the lungs and throughout the body.
Your heartbeat is part of a complex electrical system. Cells in a part of the atria called the sinus node (SA node) produce electrical signals to squeeze your heart (make it contract). Abnormal signals interfere with this electrical process. It then becomes more difficult for the heart to pump at a steady pace, affecting blood flow to the rest of the body.
When this occurs, blood can collect in the heart and lead to blood clots which can cause a stroke. You’ll need treatment to restore normal blood flow. If normal heart rhythm and blood flow cannot be restored, you might need treatment with blood thinners.
Some people have no symptoms, while others feel fluttering or pounding in the chest. Other common symptoms include:
If you have any of these symptoms, see your healthcare provider. Early detection and treatment can help avoid complications. People with atrial fibrillation are five times more likely to have a stroke than those without the condition.
And if you have chest pain or pressure, call 911 immediately. You may be having a heart attack.
Healthcare providers diagnose persistent atrial fibrillation with a physical exam and questions about your symptoms. Your provider may already be checking you regularly for paroxysmal Afib, which often develops into persistent Afib.
If no Afib is present at the time of your exam, your provider may ask you to wear a portable device, such as a Holter monitor or ambulatory monitor. These devices track your heart rhythms for 24 hours or longer. Fitness tracker data can also help detect arrhythmia.
Electrocardiogram (EKG) is a painless test that helps healthcare providers diagnose all types of atrial fibrillation. Your provider attaches electrodes (sensors) to your chest using tape (adhesive). The electrodes record your heart’s electrical activity over several minutes.
Providers may also perform tests such as:
There is no cure for persistent atrial fibrillation. But treatment can slow or prevent symptoms, making it easier for you to manage the condition. Lifestyle changes such as quitting smoking and drinking less alcohol can also help reduce abnormal heart rhythms and prevent complications.
The goal of treatment for persistent atrial fibrillation is to:
Your treatment plan may depend on:
Healthcare providers often use nonsurgical techniques to treat persistent Afib, including:
If your provider recommends surgery, procedures include:
You can also ask your provider if you’re eligible to participate in any clinical trials. These studies test promising new therapies not widely available.
Persistent atrial fibrillation requires a team of specialists for accurate diagnosis and effective treatment. Your care team may include:
Along with treatment, lifestyle changes can help control persistent atrial fibrillation. Your healthcare provider may recommend that you avoid or adjust activities that trigger a rapid, irregular heart rate.
You may also be advised to:
With the right treatment and regular management, most people with persistent atrial fibrillation can live active, healthy lives. The longer persistent Afib goes without treatment, however, the harder it is to manage. It may become permanent or lead to severe complications such as blood clots or stroke.
Make an appointment with your healthcare provider if you have any signs of persistent atrial fibrillation. These signs include heart palpitations or shortness of breath. If you experience chest pain or pressure, call 911 or seek immediate medical help.
Extreme temperatures and high altitudes may affect the heart. You may also be concerned about whether you can drive safely or participate in competitive sports. Talk to your healthcare provider so that you are prepared and can continue to do the activities you enjoy.
Follow your healthcare provider’s recommendations to manage complications and treat symptoms of persistent Afib. Your provider can work with you to develop a personalized care plan to optimize your health.
A note from Cleveland Clinic
Persistent atrial fibrillation is one of the most common heart conditions in the U.S. Early diagnosis and treatment can help restore regular heart function. With the right treatment, you can reduce symptoms and avoid complications. Talk to your healthcare provider about the steps you can take to stay active and manage symptoms.
Last reviewed by a Cleveland Clinic medical professional on 07/01/2022.
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