The dangers and treatment of atrial fibrillation

  Atrial fibrillation is a relatively common arrhythmia, especially in the elderly, and according to statistics, the incidence can be as high as 8-10% in people over 60 years of age (with or without hypertension, coronary heart disease or rheumatic heart disease, etc.). There is generally a development process of paroxysmal atrial fibrillation – persistent atrial fibrillation – permanent atrial fibrillation.  There are three main hazards of atrial fibrillation: (1) Reduced quality of life: due to the absolute irregularity of the heartbeat, patients may feel panic and discomfort, decreased activity tolerance, work restrictions, affecting daily life, etc.  (2) Occurrence of stroke (about 15C20%): due to poor blood flow in the atria, thrombus is easily formed and the thrombus is dislodged and floats to the brain with the blood flow causing infarction. It is 3 to 5 times higher than that of non-atrial fibrillation population, and the mortality rate is 2 times higher.  (3) Reduced cardiac function: Because the frequency of atrial fibrillation is 350-500 times per minute, the transfusion function of the atria to the ventricles is basically lost, and the pumping function of the heart to the whole body decreases by about 10% to 25%, and patients with long-term atrial fibrillation will have symptoms of heart failure such as shortness of breath after activity and inability to lie down.  Treatment of atrial fibrillation: (1) Traditional medications and electric defibrillation resuscitation: The main purpose of medication is to control the heartbeat, reduce symptoms, and prevent stroke. The drugs for heartbeat control include amiodarone, betaloc, etc. The drugs for prevention of cerebral infarction are mainly warfarin, etc. The advantage of traditional treatment methods is that the treatment is relatively simple, but the disadvantage is that some patients cannot receive regular treatment and follow up on time.  (2) Cardiology intervention (catheter radiofrequency ablation): ablation therapy is a rapidly developing treatment method for atrial fibrillation in recent years, which can be eradicated through a minimally invasive (through vascular puncture in the groin, etc.) method. The advantage is that it is minimally invasive and radical, but the disadvantage is that the success rate is limited (about 60-70%) and the cost is more expensive.  (3) Surgery (including surgical excision with additional radiofrequency ablation and freezing): Surgery is a precise and effective method for the radical treatment of atrial fibrillation. The advantages are higher success rate (more than 80%) and lower recurrence rate, but the disadvantage is the need for open heart and more expensive. In recent years, minimally invasive surgery (through thoracic puncture) has been gradually introduced.  Atrial fibrillation is a common arrhythmia, and despite the great danger, the choice of treatment plan must be decided after consultation and discussion with a specialist based on individual circumstances (including previous diseases, systemic condition, requirements for quality of life, affordability, etc.).