The overall incidence of atrial fibrillation is 0.4%, and the incidence of atrial fibrillation increases with age, reaching 10% in people over 75 years of age. The frequency of atrial excitation in atrial fibrillation is 300-600 beats/min, and the heart rate is often fast and irregular, sometimes reaching 100-160 beats/min, which is not only much faster than the normal heart rate, but also absolutely irregular, and the atria lose their effective contraction function. Large-scale research studies in China have shown that the prevalence of atrial fibrillation is 0.77%, and the prevalence of atrial fibrillation is higher in men (0.9%) than in women (0.7%), and the prevalence of atrial fibrillation over 80 years of age is 7.5%. In addition, the increase in the prevalence of atrial fibrillation will be closely related to the increase in coronary heart disease, hypertension and heart failure, and atrial fibrillation will become one of the most prevalent cardiovascular diseases in the next 50 years. Symptoms of the disease Common clinical symptoms of atrial fibrillation include: 1) palpitations: feeling of a disturbed or rapid heartbeat, physical fatigue or exertion; 2) dizziness: dizziness or fainting; 3) chest discomfort: pain, pressure or discomfort; 4) shortness of breath: difficulty breathing during light physical activity or at rest; in addition, some patients may not have any symptoms. Disease hazards: Atrial fibrillation, the atria lose their contraction function, and blood is easily stagnated in the atria to form thrombus, which can be dislodged to all parts of the body, leading to cerebral embolism (stroke), limb artery embolism (serious cases even require amputation), etc. Risk factors for stroke in patients with atrial fibrillation include previous history of embolism, hypertension, diabetes, coronary artery disease, heart failure, left atrial enlargement, and age over 65 years. Loss of atrial systolic function and prolonged heart rate increase in atrial fibrillation can lead to heart failure and increased mortality (twice the normal rate). Recent advances in the treatment of atrial fibrillation We have made some major breakthroughs in the treatment of atrial fibrillation. The first is the introduction of new anticoagulants that not only do not require monitoring but are also more effective than warfarin in reducing bleeding. The second is catheter ablation, whose higher success rate has led to guidelines expanding its indications by 50%. Both of these areas have been stagnant for the past two decades and have grown exponentially in the past few years. I believe that in the future there will be very effective treatments for atrial fibrillation as there are for hypertension and coronary artery disease. The latest European guidelines for atrial fibrillation classify patients with atrial fibrillation who are ineffective on medication as a Class I indication and those who are effective as a Class IIA indication. This means that catheter ablation has been adopted as the first-line treatment for atrial fibrillation in that guideline. This is mainly because catheter ablation is significantly better than drug therapy in terms of symptom control and efficacy, and has the potential to improve patient prognosis and reduce the incidence of stroke. Because of the high recurrence rate of catheter ablation, more than 50% of patients require a second treatment, which requires full understanding by both physicians and patients. However, if each patient is treated with an average of two catheter ablations, more than 80% of patients with paroxysmal and persistent atrial tachycardia are largely cured without the need for oral anticoagulation. The European anticoagulation guidelines for atrial fibrillation adopt a nine-point stroke risk score. It adds peripheral vascular disease, female, and age 65-74 years, one point for each, for a total of three additional points. The European guidelines consider oral anticoagulation mandatory for patients with a stroke risk score of more than two points or just two points on a nine-point scale, with a preference for oral anticoagulation, warfarin or aspirin for those with one point. Compared to the US guidelines, the European guidelines expand the range of oral anticoagulants by 50%. Secondly, on the use of aspirin, the European guidelines emphasize that patients with atrial fibrillation with low stroke risk may not need to use aspirin, while the US guidelines recommend the use of aspirin. In addition, for patients who need but cannot take oral anticoagulants, European guidelines recommend dual antiplatelet agents, but US guidelines do not advocate this practice. In addition to this, in terms of indications for catheter ablation, the European recommendations list it as a first-line treatment, Class IIA indication, but the US guidelines do not have this recommendation. In China, there are three guidelines from the Chinese Medical Association, designated by the Society of Cardiovascular Medicine, the Society of Pacing and Electrophysiology Medicine, and the Society of Geriatrics. All three guidelines are different regarding the intensity of anticoagulation therapy, or INR. Why? This is because we lack sufficient research and evidence of our own, experts from different societies have different views, and experts can only judge how to treat based on experience. Therefore, we should strengthen our national studies in the future in order to develop a suitable treatment for the national population. The choice of anticoagulation strategy when anticoagulated patients are at risk of bleeding. Comparing the stroke risk score with the bleeding risk score on a nine-point scale shows that patients with a high bleeding risk score have a correspondingly high stroke risk score. It is important to emphasize in the public media that stroke is the greatest risk of AF and that there is a cost to prevent it, including medication, monitoring, etc. One of the most important costs is bleeding, which cannot be eliminated. Therefore we need to trade the cost of bleeding for the benefit of significantly reducing stroke, i.e., for patients at risk of bleeding, in addition to increased monitoring, the benefits of taking anticoagulants outweigh the harms if their risk of stroke is high. There are two options for the future treatment of atrial fibrillation: the first is the use of new oral anticoagulants and the second is catheter ablation. Catheter ablation is effective in improving symptoms, whereas oral anticoagulants only improve the prognosis and do not contribute to symptomatic improvement. However, in patients with chronic persistent atrial fibrillation, newer oral anticoagulants should be preferred. Therefore, in the next decade, catheter ablation will follow the new oral anticoagulants as one of the trump cards in the treatment of atrial fibrillation. There is no evidence to support the association of psychosocial factors on the occurrence and severity of cardiovascular disease. The American Heart Association’s “Healthy American Heart Goals 2020,” released two years ago, lists diet, exercise and smoking as factors for a healthy heart, but does not add psychological factors. However, mental factors are definitely associated with cardiovascular disease, but there is a lack of research and evidence. In Western countries, there is an average of one counseling psychiatrist per 1,000 people, while in China, there is no psychiatrist per 10,000 people. The attention and treatment of psychiatric disorders in China is far from adequate, and this may also be a reason for the lack of research in this area.