Background:AF is a common arrhythmia resulting in significant morbidity and mortality. AF can be classified into many subtypes depending on its characteristics and duration, paroxysmal AF is defined as intermittent episode that terminating spontaneously or within seven days of treatment. Paroxysmal AF estimated to constitute between 25% to 60% of all AF cases and its recurrences are associated with structural and electrical remodelling of the myocardium The pathophysiology of AF is complex and multifactorial, involving ageing and a structural remodelling whereby apoptosis, inflammation and fibrosis are the hallmarks.This study aimed to discuss role of using ultrasound in critical care of shock patients and how it helps intensive care doctors to take the right decision for management. METHODOLOGY: Relevant citations were extracted from Pubmed, Google scholar, Clinical key, Scopus, Med-line,Embase and Cochrane to identify role of understand paroxysmal atrial fibrillation burden, epidemiology and management of paroxysmal atrial fibrillation. Conclusion: Pathophysiology of AF is complex and multifactorial, involving ageing and a structural remodelling whereby apoptosis, inflammation and fibrosis are the hallmarks. Systemic inflammation is a strong predictor of atrial fibrillation. A key role for electrical remodeling is increasingly recognized, and experimental data suggest that inflammatory cytokines can directly affect connexins resulting in gap junction dysfunction

Paroxysmal atrial fibrillation burden- Epidemiology- Management