Purpose of review: To address the changing definition of atrial fibrillation as it reflects the major paradigm shift in the comprehension of mechanisms underlying atrial fibrillation and the possible treatment options targeting persistent atrial fibrillation.
Recent findings: Persistent atrial fibrillation exists in a spectrum that is linked to paroxysmal atrial fibrillation. The mechanism underlying persistent atrial fibrillation has evolved significantly but requires further understanding in order to improve its management. The role of external factors, such as blood pressure, on the development of persistent atrial fibrillation and its underlying substrate require further exploration. Catheter ablation has evolved significantly but controversy remains regarding the optimal approach for persistent atrial fibrillation.
Summary: The definition of atrial fibrillation has evolved significantly as a result of knowledge gathered from therapy with catheter ablation for atrial fibrillation. Further trials are required to investigate the causes, mechanisms and optimal therapies for persistent atrial fibrillation.