Diagnosis, determination of atrial fibrillation Atrial fibrillation, also known as atrial fibrillation, or AF for short, is one of the most common cardiac arrhythmias in clinical practice. The prevalence of atrial fibrillation increases with age. The overall prevalence in the general population is 0.4%, and the prevalence in adults is between 0.5% and 0.95%, with a prevalence of 1% in those over 60 years of age. With increasing age, atrial fibrillation has a tendency to gradually increase, reaching 10% in those over 75 years of age. During an episode of atrial fibrillation, the regular sinus rhythm disappears from the ECG and is replaced by rapid and disorganized atrial electrical activity (also known as atrial fibrillation waves), while the QRS waves representing the ventricles vary in speed due to different conduction ratios, resulting in an irregular ventricular rate. The diagnosis of atrial fibrillation can be made clinically by the ECG at the time of the attack. In some patients, if the fibrillation episode lasts for a relatively short period of time, the diagnosis can be made by self-measurement of pulse and heartbeat, which is characterized by an irregular pulse rate and a pulse count that is less than the heartbeat count. Of course, the presence or absence of atrial fibrillation can also be determined by a 24-hour ECG or longer ECG telemetry, with the same diagnostic criteria as a general ECG. The diagnosis of atrial fibrillation generally requires a rapid disorganized atrial arrhythmia lasting more than 30 seconds to be diagnosed. Symptoms of atrial fibrillation The symptoms of atrial fibrillation are varied, depending on the presence or absence of underlying heart disease, cardiac function, the rapidity of the ventricular rate and the form of the attack, and individual sensitivity. When the ventricular rate (i.e., the final heartbeat) is not fast, there may be no symptoms, especially in patients with chronic or long-term persistent atrial fibrillation. On the contrary, if the ventricular rate increases, there may be symptoms such as panic, chest tightness, shortness of breath, dizziness, and fatigue, and in some patients, a combination of sweating, increased urination, and other signs of vegetative dysfunction (due to increased secretion of a hormone by the heart). Patients with particularly fast heartbeats may experience a drop in blood pressure and cardiac insufficiency, while exhibiting chest tightness, shortness of breath and dyspnea; in severe cases, this may lead to acute pulmonary edema, angina pectoris or cardiogenic shock. In addition, some patients with paroxysmal atrial fibrillation may experience a slowed heartbeat or even temporary cardiac arrest during the process of termination of atrial fibrillation automatically converting to normal sinus rhythm. Typically, if no heartbeat appears for 2-3 seconds, some sensitive patients will experience blackness before their eyes or even a brief loss of consciousness to the point of fainting. Of course, there are some patients who are particularly tolerant of this condition, especially elderly patients, who sometimes present with up to 20 seconds without a heartbeat only as dizziness and discomfort, without fainting. A significant number of patients (especially those with chronic or long-term persistent atrial fibrillation) may have no obvious conscious symptoms, yet the dangers of atrial fibrillation remain, and many of these patients are discovered incidentally during a physical examination or even when they have a stroke. The incidence of atrial fibrillation is not only high, but also harmful. The hazards of atrial fibrillation are mainly manifested in the following aspects: 1. Thrombosis and embolism. Because the heart beats very disorderly in atrial fibrillation, the normal flow of blood will be affected, and eventually small blood clots (i.e. thrombus) will be formed in the heart (especially in the left atrium in the left ear), and once this thrombus is dislodged, it will block the blood vessels, and the damage to the corresponding organs will be caused by blocking the blood vessels; for example, brain embolism (also known as stroke) occurs after blocking the cerebral blood vessels, and blocking the arteries of the limbs causes The blockage of the arteries of the limbs causes necrosis (serious cases even require amputation), and the blockage of the kidney vessels causes necrosis of the kidneys, etc. 2. Heart enlargement and heart failure. Atrial fibrillation can occur through a series of complex pathological changes, resulting in corresponding adaptive changes in the heart, which, if not terminated in time, will lead to the gradual expansion of the heart like a “balloon” and eventually develop into heart failure. The enlarged heart and heart failure will again lead to the further continuation of atrial fibrillation, the two interact with each other, resulting in a vicious circle. 3, increased mortality. Many studies have shown that atrial fibrillation is a risk factor for increased mortality. In the absence of other combined cardiovascular diseases, atrial fibrillation can increase the mortality rate by a factor of 1. When combined with heart failure, atrial fibrillation increases mortality by 2.2 times in men and 1.8 times in women than in those without atrial fibrillation. 4, affect the quality of life and work. In general, patients with atrial fibrillation (especially those with paroxysmal rapid ventricular rate) will have palpitations, dizziness, shortness of breath, etc., and thus feel uncomfortable, and their quality of life and work will be affected. Especially if the heart function is poor, daily life is not competent. Some patients with atrial fibrillation have severe symptoms, such as weakness, dyspnea and syncope, and those with underlying cardiac insufficiency can suffer from acute pulmonary edema. Studies have shown that the quality of life scores of patients with AF are much lower than those of healthy individuals without AF. Treatment of atrial fibrillation: Treatment of atrial fibrillation requires a combination of patient factors, including the cause, triggers, frequency, symptoms, and economic conditions. For those causes or triggers that can be eradicated, the first thing that is definitely needed is to correct those causes or triggers. The etiologies or triggers that can be corrected or eradicated include: hyperthyroidism, acute cardiac insufficiency, pericarditis, acute infarction, acute tachyarrhythmia, etc. We often see some patients with supraventricular tachycardia and ventricular tachycardia develop atrial fibrillation when the arrhythmia is of relatively long duration. After these relatively simple arrhythmias are eradicated by radiofrequency ablation, these patients no longer have atrial fibrillation.