Published: 12 April 2026
Author(s): Koohyar Ahmadzadeh, Amir Askarinejad, Gregory Y.H. Lip
Issue: April 2026
Section: Commentary

Atrial fibrillation (AF) remains the most common arrhythmia worldwide and a major contributor to mortality and morbidity from stroke and heart failure (HF). Despite growing recognition that AF behaves as a dynamic continuum, clinical practice and research continue to rely on the traditional (and perhaps, simplistic) classification into paroxysmal, persistent, and permanent AF. While these categories remain clinically useful and prognostically relevant, they do not fully capture the dynamic nature of AF, particularly the variability in arrhythmic burden within categories and disease progression over time [1].

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