Regular readers of our “Healthy Heartbeat” should already have a preliminary understanding of atrial fibrillation, a common heart arrhythmia (what? If you don’t know, then click on the top right corner to follow our WeChat platform!) . Today, let’s go a little further and talk about how cardiovascular doctors understand atrial fibrillation. I believe that after reading this article today, readers will understand how doctors assess a disease, and readers with atrial fibrillation will have a better understanding of their current treatment options. Don’t be afraid my friends, I am not trying to quiz you, this is a normal electrocardiogram, a waveform recorded through multiple body surface locations. What we are more concerned about is the “heart rate” and “heart rhythm” indicated by the ECG; the heart rate is easily understood as the number of beats per minute, while the heart rhythm refers to the rhythm of the heartbeat, that is, whether the heartbeat is regular or not. We know that the normal human heartbeat is not as accurate as a clock, but it is always very neat. The irregular heartbeat is basically a problem, and atrial fibrillation is one of the common ones. During an episode of atrial fibrillation, whether the patient feels it or not, his/her heart rhythm is definitely irregular, and at the same time, atrial fibrillation will also show changes in heart rate, most of which will accelerate to more than 100 beats per minute or even close to 200 beats per minute, while some patients will be below 60 beats per minute or slower. Therefore, in addition to the prevention of stroke and other complications mentioned in the previous issues, the focus of the physician’s treatment is on rhythm and rate. In a new patient with atrial fibrillation, the first consideration of the physician is whether the patient can or can not return to normal rhythm through treatment, because only when normal rhythm is restored can atrial fibrillation be said to be gone, and then the risk associated with atrial fibrillation is greatly reduced, which is certainly acceptable to the patient. Therefore, for atrial fibrillation that is not of advanced age (over 80 years), paroxysmal or of short duration, physicians always tend to advise patients to try to restore a normal rhythm (referred to as resuscitation). There are several methods of rhythm restoration, including medications, electrical shock resuscitation, and radiofrequency ablation, which we can cover separately in the future if the reader is interested. In contrast, for some patients who have had atrial fibrillation for a long time (10-15 years or more) or in combination with other serious diseases, physicians choose relatively conservative treatment options, most commonly heart rate control, to try to keep the patient’s heart rate from becoming too fast or too slow and to delay the effects of long-term atrial fibrillation on the patient’s heart function and systemic organs. However, sometimes, despite repeated adjustments to medications, some patients with severe heart rate control are not ideal, and at this time, doctors may also recommend that patients consider resuscitation therapy.