Atrial fibrillation treatment: not just radiofrequency ablation

When atrial fibrillation occurs, the atria are fibrillating randomly. Why is it fibrillating? Under normal circumstances, there is only one command in the atrium to direct the beating of the atrium; now there are some lesions, they start to rebel and disobey the command of the command, so it causes the atrium to fibrillate chaotically. We now have catheter radiofrequency ablation treatment can solve some of the ablation will, especially the symptoms are more serious, atrial fibrillation seriously affect the quality of life, the heart function is not good patients, these patients more should be treated. Radiofrequency ablation for atrial fibrillation is currently the most definitive contraindication to thrombosis, and the patient has some other acute disease, but otherwise, as long as the patient is considered to benefit more from ablation therapy, the treatment can be performed. The best population for radiofrequency treatment of atrial fibrillation 1, typical paroxysmal atrial fibrillation, young, no systemic heart disease, frequent attacks, no heart enlargement, such patients are the most typical, the success rate of a radiofrequency ablation can reach 80% to 90%. 2.Atrial fibrillation patients with paroxysmal atrial fibrillation, not particularly large heart, no underlying disease, or patients with high risk factors for stroke after sustained atrial fibrillation for less than one year. 3, atrial fibrillation lasts more than a year, the medical history is unknown, the atria may have become large, and there are some atrial fibrillation-related diseases, treatment should be difficult. Other options for the treatment of atrial fibrillation In fact, the treatment of atrial fibrillation is not the only radiofrequency therapy, the current treatment strategy for atrial fibrillation mainly has two aspects: drug therapy and non-drug therapy. 1, drug treatment mainly includes (1) conversion and maintenance of sinus rhythm, these drugs are mainly amiodarone, sotalol, propafenone, morethizine, etc., conversion of sinus rhythm drugs long-term use of side effects are obvious or even increase the mortality rate, and the success rate of long-term treatment is at most only about 50%. (2) To control the rapid ventricular rate during atrial fibrillation, these drugs mainly include digoxin and beta-blockers, calcium antagonists, etc. Controlling the ventricular rate can improve the symptoms but not the prognosis, and the risk of thromboembolism cannot be avoided because atrial fibrillation still exists. (3) Anticoagulation in patients at high risk of thromboembolism is a very effective and important treatment. The shortcoming of anticoagulation is that frequent blood tests are needed to reduce the risk of bleeding due to excessive anticoagulation or loss of prophylaxis due to insufficient anticoagulation. The main non-pharmacological treatments include (1) Electrical resuscitation therapy: It is a method to convert atrial fibrillation to sinus rhythm by direct current electric shock, the advantage of which is the high success rate of conversion, the disadvantage is that it requires hospitalization and does not have the effect of maintaining sinus rhythm. (2) Catheter radiofrequency ablation: This interventional procedure without surgery has been performed for more than 10 years in larger cardiac centers at home and abroad and has been proven to have a much higher ability to maintain sinus rhythm than drug therapy. (3) Surgery: At present, it is mainly used for patients with atrial fibrillation who need cardiac surgery due to other heart diseases, with good surgical results, but open-heart surgery is very traumatic. Minimally invasive surgery assisted by thoracoscopy developed in recent years is effective in isolating the pulmonary veins, but it is difficult to intervene in lesions outside the pulmonary veins, and the surgical trauma is greater than that of catheter radiofrequency ablation, and the expert consensus at home and abroad recommends that surgery is not suitable as the initial treatment for atrial fibrillation.