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European Heart Journal Advance Access originally published online on January 16, 2006
European Heart Journal 2006 27(5):621; doi:10.1093/eurheartj/ehi722
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Classification of atrial fibrillation

József Tenczer

St Emeritus Teaching Hospital
Budapest
Hungary

János Tomcsányi

St John of God Hospital
Budapest
Hungary
Tel: +36 14388560
E-mail address: tomcsanyi.janos{at}axelero.hu

In his editorial on the Euro Heart Survey on atrial fibrillation, Wyse1 rightly criticizes the current classification system of atrial fibrillation (AF).2 The most problematic issues of the current classification are the definitions of paroxysmal and persistent forms. The definition of persistent AF as an episode lasting more than 7 days is fundamentally flawed because persistent AF persists until it is terminated, be it 10 or even a 100 days later. In the case of paroxysmal AF, the problem is that episodes terminating spontaneously after more than 7 days cannot be properly classified. As we are unaware of any new recommendations that would solve these issues, although the current classification system causes several problems, we recommend the following changes.

These changes would make the classification somewhat more complicated, but the different forms of AF would be easier to distinguish, which would help in choosing the appropriate therapeutic approach, although epidemiologic studies would also give a clearer picture.


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  		Classification based on the current recommendations
 

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  		Classification based on our recommendation
 
References

  1. Wyse DG. The Euro Heart Survey on atrial fibrillation: a picture and a thousand words. Eur Heart J 2005;26:2356–2357.[Free Full Text]
  2. Fuster V, Ryden LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, Halperin JL, Kay GN, Klein WW, Levy S, McNamara RL, Prystowsky EN, Wann LS, Wyse DG. ACC/AHA/ESC Guidelines for the Management of Patients with Atrial Fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences developed in collaboration with the North American Society of Pacing and Electrophysiology. Eur Heart J 2001;22:1852–1923.[Free Full Text]

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This Article
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