Indeed: There are a number of papers on the subject of sleeping position & cardiac function/risks vis-a-vis atrial fibrillation (AF). Of particular interest (to me) is the connection between left-side sleeping...& stimulation of the vagus nerve. which more often than not triggers the onset (for me) of AF.

Net-net: I assiduously avoid lying on my left side, whether while sleeping or even lying for brief periods on my chaise lounge (watching the horrid news of the world). In fact, I have aimed/worked to entrain myself...to sleep on my back (with modest elevation for my head with double pillows)--& in doing so the measured frequency & duration of my nighttime/at-sleep periods of AF...have diminished (6 months worth of measurement thus far) over time (since I began entraining myself to sleep on my back).

As for the temporal patterns & progression of paroxysmal AF: Of course, there will always be individual variability. The European study (I cited) is the only published study (using the NLM's PubMed database) explicitly addressing...the temporal patterns & progression of paroxysmal AF--& it documented variability between groups...while highlighting that the largest group of study participants experienced...stability in their AF phenotype.

The point? Thus far, there is no empirical basis to claim that progression of paroxysmal AF is...inevitable--& for my part, I am encouraged by these data.

More will be revealed--& I place my trust in the...scientific method (much more than I ever would in that mystical concept so revered in the "medical arts," that is, "clinical judgment").

And for this reason I take heart in the emergence of the "Medical Conservatism" movement, led by American EP cardiologist John Mandrola. Medical Conservatism prioritises data/findings/interventions...obtained through randomised, controlled clinical trials--with sham controls (which can be a matter of contention, one that even the FDA often side-steps in its regulatory oversight of FDA-registered clinical trials).

Stay safe & all the best--& thanks so much for sharing 🙂