How does atrial fibrillation occur? Normal heart rhythm is called “sinus rhythm”, while atrial fibrillation is an abnormality of the heart rhythm. There are many causes of atrial fibrillation, including various heart diseases and hyperthyroidism. Some patients with atrial fibrillation do not have a clear cause, and this is called idiopathic atrial fibrillation, which is mainly caused by abnormal electrical activity of the heart. How do I feel during an AF attack? During an attack of atrial fibrillation, you may feel panic, irregular heartbeat, or in severe cases, chest tightness and chest pain, and if you feel your pulse yourself, you may find that it is variable in strength and rhythm. Some patients do not feel it obviously and need to pay attention to the pulse. What should I do in case of an atrial fibrillation attack? Normally, an attack of atrial fibrillation does not cause a malignant cardiac event, so you should not be nervous. If you experience significant discomfort such as chest pain or dizziness during an attack, have a rapid heartbeat, or if atrial fibrillation persists for several hours and does not resolve on its own, go to the hospital or contact your doctor promptly. What are the risks of atrial fibrillation to the heart? The occurrence of atrial fibrillation can cause a decrease in heart function; in patients with underlying diseases and their own decompensated heart function, atrial fibrillation may lead to acute heart failure if the heart rate is fast, which is manifested by obvious breath-holding and wheezing, etc. At this time, the onset of atrial fibrillation must be controlled as soon as possible. When atrial fibrillation lasts for a longer period of time, due to abnormal contraction of the atria, blood stagnation and thrombus formation can easily occur in the atria. These thrombi, if dislodged, can enter the arteries of the brain, limbs and internal organs with the blood flow, causing serious problems such as brain embolism, limb artery embolism and internal artery embolism, leading to hemiplegia or even life-threatening. Therefore, atrial fibrillation needs to be treated aggressively. What are the goals of atrial fibrillation treatment? There are three main goals in the treatment of atrial fibrillation: control of the ventricular rate, prevention of thromboembolism, and correction of cardiac rhythm disturbances. What treatments are available for atrial fibrillation? Treatment during an episode of atrial fibrillation: An episode of atrial fibrillation can be restored to a normal rhythm (sinus rhythm) with intravenous or oral medications, and may require electrical shock resuscitation in emergencies or when medications are ineffective. In the case of atrial fibrillation, if the patient is not seen in time, after the duration of atrial fibrillation exceeds 48 hours, a thrombus may have formed in the atrium, and the immediate conversion of the thrombus may easily dislodge causing serious embolism time, so anticoagulant drugs need to be applied first for 3 weeks before considering conversion. Therefore, the discovery of atrial fibrillation episodes should be promptly consulted, if the consultation is too late may delay the timing of treatment, increasing the difficulty and cost of treatment. Long-term treatment for patients with atrial fibrillation: Medication: For patients with recurrent episodes of paroxysmal atrial fibrillation, long-term oral medication should be taken to prevent episodes. The efficiency of medications for the prevention of atrial fibrillation attacks is about 50-70%, and the efficacy of a drug may diminish after prolonged application, and side effects often occur with long-term medication, so the side effects need to be monitored during medication. Commonly used drugs to prevent atrial fibrillation episodes include amiodarone (Cortolone), propafenone (Eflornithine, cardioplegia), mirexazine, and sotalol. Patients with persistent atrial fibrillation should take medications to control their heart rate, such as betalactam and digoxin. Since atrial fibrillation is still present, the heart rate is reduced but the patient’s prognosis does not improve and the risk of thromboembolism remains. Anticoagulation: In patients with persistent AF or very frequent episodes of paroxysmal AF, they should receive anticoagulation in addition to the application of medications to control the heart rate. Patients who are older, have hypertension, diabetes mellitus, or cardiac insufficiency should take long-term warfarin to prevent thrombus formation in the atria. Other patients should take aspirin. Warfarin is a special drug, the dose of which varies from person to person and is susceptible to the effects of other drugs or food. The use of warfarin requires frequent blood sampling for INR (an indicator of coagulation) and close monitoring of coagulation to achieve optimal efficacy and to prevent bleeding. Please discuss with your physician which medication you should take for anticoagulation. Radiofrequency ablation: This is indicated for both paroxysmal and persistent atrial fibrillation. Primarily used for patients who have had poor results with medications and side effects, you may also choose to receive radiofrequency ablation at the beginning of your treatment. Radiofrequency ablation is a cure for atrial fibrillation and is a proven treatment that has been widely performed both at home and abroad, with a success rate of 85-90%.