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Updated: Oct 12, 2025

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Is Progression From Paroxysmal to Sustained Atrial Fibrillation Bad News?
Hisashi Ogawa1, Masaharu Akao1
1Department of Cardiology, National Hospital Organization Kyoto Medical Center.
Abstract:
Atrial fibrillation (AF) is the most common sustained arrhythmia and associated with increased morbidity and mortality resulting from thromboembolism and heart failure. AF often presents initially as paroxysmal and may progress to a sustained form over time. Sustained forms of AF may be associated with increased symptoms and cardiovascular morbidity, and AF progression may be associated with increased risk of clinically adverse events and outcomes. The present review discusses the clinical factors of arrhythmia progression and risk stratification available to assess the probability of AF progression. Furthermore, currently available treatment options for preventing AF progression are explored and evaluated.
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