24
Introduction
Table 4. Definitions (cont'd)
Term Definition
Long-standing
persistent AF
AF that is continuous for >12 months in duration
Permanent AF A term that is used when the patient and clinician make a joint
decision to stop further attempts to restore and/or maintain sinus
rhythm
Acceptance of AF represents a therapeutic decision and does not
represent an inherent pathophysiological attribute of AF
Terms considered obsolete
Chronic AF This historical term has had variable definitions and should be
abandoned. It has been replaced by the "paroxysmal, persistent,
long-standing persistent and permanent" terminolog y.
Valvular and
Nonvalvular AF
The distinction between "valvular" and "non-valvular" AF
remains a matter of debate. Their definitions may be confusing.
Recent trials comparing vitamin K antagonists with non-vitamin
K antagonist oral anticoagulants (OACs) in AF were performed
among patients with so-called "non-valvular'' AF. These trials
have all allowed native valvular heart disease other than mitral
stenosis (mostly moderate and severe) and prosthetic heart valves
to be included. We should no longer consider the classification of
AF as ''valvular'' or "non-valvular" for the purpose of defining the
etiolog y of AF, since the term was specific for eligibility of stroke
risk reduction therapies. Valvular and nonvalvular terminolog y
should be abandoned.
Lone AF This term has been used in the past to identify AF in younger
patients without structural heart disease who are at a lower risk for
thromboembolism. This term does not enhance patient care, is not
currently used and should be abandoned.
