Diagnosis and treatment of atrial fibrillation Atrial fibrillation is a common arrhythmia in middle-aged and elderly people, with causes such as hypertension, coronary artery disease, hyperthyroidism, valvular disease, alcoholic cardiomyopathy, excessive stress and fatigue, and electrolyte disorders. The diagnosis is mainly based on the electrocardiogram, which shows the disappearance of P waves and their replacement by rapid fibrillation waves with variable size, shape and rate, irregular R-R, and usually fast ventricular rate. Atrial activity is uncoordinated, with subsequent impairment of mechanical function. Atrial fibrillation can be classified as primary, paroxysmal, persistent or permanent. The diagnosis is based on the patient’s symptoms, frequency, duration, triggers and termination, and the efficacy of medications. Some necessary tests are done. ECG, Holter monitoring for heart rate and rhythm, myocardial ischemia, etc. Chest radiographs for lung parenchyma and pulmonary vessels. Echocardiogram to understand heart valve disease, atrial size and function, left ventricular hypertrophy, left atrial thrombus, pericardial disease, and labs for thyroid function. The cause of the disease is clarified after a comprehensive examination. Targeted treatment. It is very important to treat the primary cause, control hypertension, improve myocardial blood supply, correct thyroid function, and eliminate tension. The treatment of atrial fibrillation is comprehensive. Indications for conversion to sinus rhythm: Immediate electrical cardioversion of paroxysmal rapid atrial fibrillation. Hemodynamically stable, atrial fibrillation symptoms can not be tolerated, under the supervision of a doctor to restore the rhythm of the drug: amiodarone oral 0.8-1.8 / day, a total of 10 grams; after the conversion of 0.2, 2 / day, after 7 days 0.2 / day maintenance. Effective maintenance of sinus rhythm for one year accounted for 87%, five-year maintenance 57%, with many side effects. Propafenone (cardioplegia), 450-600mg/day orally, 1.5-2.0mg/kg intravenously, 10min sedation, effective maintenance of sinus rhythm, not suitable for ischemic heart disease. Sotalol is effective in maintaining sinus rhythm and has the same efficacy as cardioplegia. Prevention and treatment of thromboembolism is an important issue in the treatment of atrial fibrillation. Anticoagulants are used in all atrial fibrillation, unless there are contraindications such as bleeding. Aspirin is the commonly used anticoagulant, and warfarin may be used in high-risk patients.