Etiology: Atrial fibrillation is a very common clinical arrhythmia, heart valve disease, hypertensive heart disease, cardiomyopathy, coronary heart disease, chronic pericarditis, heart failure are prone to complicate atrial fibrillation, in addition to abnormal thyroid function, alcoholic myocardial injury can also cause atrial fibrillation. Zhang Wenju, Department of Cardiovascular Medicine, Zhengzhou People’s Hospital Classification: According to the characteristics of episodes, they are divided into: initial (first episode); paroxysmal (repeated episodes can be terminated by itself); persistent (cannot be terminated by itself and can be converted to sinus rhythm with treatment); and permanent (difficult to convert and maintain sinus rhythm). In addition, atrial fibrillation that lasts for 72 hours is generally referred to as acute atrial fibrillation and beyond 72 hours as chronic atrial fibrillation. Clinical manifestations: Symptoms such as panic, palpitations, chest tightness and shortness of breath may occur when the ventricular rate is fast, and patients with combined organic heart disease may develop cardiac insufficiency, or even acute induced heart failure and acute pulmonary edema. For patients with chronic atrial fibrillation and ventricular rate is not fast, the symptoms are mild, or even no discomfort, but activity tolerance decreases, the danger: sudden onset of atrial fibrillation will lead to obvious panic, chest tightness symptoms, combined with organic heart disease, such as coronary heart disease, cardiomyopathy, rheumatic heart disease, hypertensive heart disease patients will further aggravate heart failure, and even acute heart failure, sudden death may occur. Chronic atrial fibrillation is prone to the formation of left atrial appendage thrombus, and the dislodgement of the embolus leads to peripheral vascular embolism, such as pulmonary embolism, cerebral embolism, and lower limb artery embolism, all of which are highly fatal comorbidities. Diagnosis: The diagnosis of atrial fibrillation is confirmed by electrocardiogram, such as paroxysmal atrial fibrillation, and ambulatory electrocardiogram helps to diagnose. Treatment: Acute: For initial, paroxysmal and short duration persistent atrial fibrillation treatment is mainly aimed at conversion, initial treatment can be by applying non-dihydropyridine calcium channel blockers (verapamil, diltiazem), β-blockers (betalactam), combined with cardiac insufficiency can apply digitalis drugs (digoxin) to control the ventricular rate, some acute atrial fibrillation after ventricular rate control can be converted to If the ventricular rate is slightly reduced but still not converted, Class Ia, Class Ic and Class III antiarrhythmic drugs can be used for conversion, among which amiodarone is the most effective. For those who do not recover with drugs, extracorporeal synchronized electrical resuscitation can be chosen, and drug maintenance therapy can be continued after successful electrical resuscitation. Chronic: For longer duration of atrial fibrillation, pharmacologic reversal is not effective; for those with less than 1 year of history, with insignificant left atrial enlargement (<45 mm) and no atrial appendage thrombus, extracorporeal synchronous electrical resuscitation can be chosen; for those with unsuccessful electrical resuscitation, radiofrequency ablation under the guidance of point anatomical markers can be chosen. If atrial fibrillation lasts for a long time, the treatment is based on ventricular rate control and prevention of thromboembolism. Anti-thrombotic treatment: chronic atrial fibrillation is controlled by ventricular rate; anti-thrombotic treatment should be carried out three weeks before resuscitation treatment and within 4 weeks after conversion to sinus rhythm. Commonly used drugs are aspirin (commonly used in low-risk patients without comorbidities) and warfarin (patients with a history of thromboembolism, left atrial appendage thrombosis, heart failure, and combined diabetes). Precautions for drug administration: Digoxin tablets: Because the difference between the therapeutic dose of digoxin and the toxic dose is not large, and the metabolic variability of each person is large, it is easy to have toxic situation, so it is recommended to start with a small dose and apply it in small amount for several times, if symptoms such as poor appetite, nausea, vomiting, headache, dizziness, hallucinations, etc. occur, the drug should be stopped immediately and relevant treatment should be carried out. Amiodarone: The oral dose is generally 0.2g each time, three times a day, and can be reduced to 0.2g twice a day or even once after a week. However, some patients may experience a slow heart rate, and it is recommended to review the electrocardiogram regularly, especially during the first week of starting treatment. Maintenance therapy at the smallest dose after the condition has stabilized. Warfarin: A type of coumarin anticoagulant, it is the most commonly used class of drugs to prevent thrombosis, and the most common side effect is to cause bleeding. During the initial period of starting treatment, coagulation should be tested regularly and the indicator INR should be at 2.0-3.0; this will achieve the therapeutic effect and reduce the risk of bleeding.