Atrial fibrillation, known as atrial fibrillation, is a common cardiac arrhythmia. Atrial fibrillation can cause discomfort to patients in mild cases, and in severe cases, it can cause heart failure, loss of labor force, and even life-threatening cerebral thromboembolism and sudden death. The prevalence of atrial fibrillation in the population is about 0.5%, and the incidence increases significantly with age, and can be as high as 6% or more in people over 60 years of age. Atrial fibrillation – arrhythmia occurring in the atria Human life is maintained by the beating of the heart. The heart takes back the used blood from the whole body, expels carbon dioxide in the lungs through breathing, and brings oxygen into the blood, which is then sent to the whole body, which is the main function of the heart. The structure of the heart is like a two-story house with four rooms, the lower “room” we call the ventricle, and the upper two “rooms” are called the atria (the right atrium on the right and the left atrium on the left). The right atrium has a special tissue called the sinus node, which under normal circumstances is the commander of the entire heartbeat, and it controls the heartbeat by regularly and neatly distributing bioelectricity like a firefly. A normal heartbeat is 60-100 beats per minute, with a regular frequency and coordinated contractions of the atria and ventricles, called sinus rhythm. When atrial fibrillation occurs for some reason, the control function of the sinus node on the right atrium is lost, and a part of the left atrium emits another kind of bioelectricity, which is fast and chaotic, causing the atrial contractions to be as high as 300-600 beats/min, forming atrial fibrillation – “atrial fibrillation “. Atrial fibrillation first causes loss of atrial function and causes a fast and irregular beating of the ventricles, a significant decrease in the blood supply to the ventricles, which in turn causes the human brain and other organs to not get enough blood supply. There are various causes of atrial fibrillation: advanced age, high blood pressure, coronary artery disease, valve disease, heart failure, excessive caffeine or alcohol intake, and chronic diseases such as thyroid and lung disease. Symptoms of atrial fibrillation Patients with atrial fibrillation can be symptomatic or asymptomatic. The manifestation of symptoms of atrial fibrillation depends on a variety of factors, including the patient’s ventricular rate during an episode of atrial fibrillation, cardiac function, concomitant disease, duration of atrial fibrillation, and the patient’s sensitivity to perceiving symptoms. Due to the rapid heart rate during an AF attack, patients usually experience the following symptoms: palpitations – panic, disturbed or rapid heartbeat, physical fatigue or exertion; vertigo – dizziness or fainting; chest discomfort – pain, pressure or discomfort; shortness of breath -feeling of difficulty breathing during light physical activity or at rest. Some patients with atrial fibrillation may be asymptomatic and only be detected by chance or when serious complications of atrial fibrillation, such as stroke, embolism or heart failure, occur, with serious irreparable consequences. We often encounter two misconceptions in clinical practice: 1. Atrial fibrillation “gets better on its own”; some patients have obvious symptoms when atrial fibrillation first occurs, but as the disease lengthens, the self-perceived symptoms diminish or disappear. This is because the symptoms of atrial fibrillation are also affected by the sensitivity and tolerance of the patient’s own perception of the symptoms, it is best to go to the hospital for a review so as not to miss the time for treatment. 2, atrial fibrillation does not need to be treated. Now people have a deeper understanding of coronary heart disease, and some of the symptoms of atrial fibrillation are more similar to coronary heart disease, so treating atrial fibrillation according to coronary heart disease is obviously “bullheaded”. Some patients who have undergone coronary angiography to rule out coronary heart disease think that they are not ill and that atrial fibrillation does not need to be treated. Therefore, it is recommended that patients with atrial fibrillation should not simply assume that they have coronary artery disease, but should receive regular specialized treatment for atrial fibrillation after a comprehensive cardiac examination. The unbearable tremor of life – the dangers of atrial fibrillation Atrial fibrillation is not a benign disease. The duration and frequency of atrial fibrillation episodes tend to increase with time, and eventually many untimely atrial fibrillation will evolve from occasional episodes at the beginning to continuous episodes, bringing further harm. Atrial fibrillation brings palpitations, dizziness, fatigue, shortness of breath and other obvious discomfort to patients, mainly because: 1. Patients with atrial fibrillation have strong and weak heartbeats, and when the heart rate is too fast and too slow and severe arrhythmia, patients can obviously feel the heart beating and palpitations. 2. Patients can feel dizziness when the cardiac output is reduced and the blood supply to the brain is affected by the arrhythmia. 3. feel tired and short of breath. The heart function of patients with atrial fibrillation is reduced by about 30%, and patients’ discomfort may worsen or even heart failure may occur. More seriously, atrial fibrillation can lead to a series of serious complications. The main one is that atrial fibrillation can easily lead to atrial thrombus, which is basically located in the left heart ear and can easily fall off, leading to stroke, heart and kidney infarction and other important organs. According to statistics, the incidence of stroke in patients with atrial fibrillation is 6-8 times higher than that of non-atrial fibrillation population, up to 13.9%. The 26-year follow-up data from Framingham Hospital in the United States proved that the mortality rate of patients with atrial fibrillation is 2-4 times higher than normal and that sudden death may occur, and the data showed that 18% of ventricular fibrillation is triggered by atrial fibrillation. The deterioration of cardiac function in atrial fibrillation with abnormal sympathetic excitation and fast and uneven RR intervals predispose to ventricular fibrillation. Recently, a new disease chain of atrial fibrillation-ventricular fibrillation-sudden death has been proposed. Therefore, atrial fibrillation is one of the serious health hazards and an important cause of disability and death in middle-aged and elderly people. Returning the heartbeat to a normal rhythm – treatment of atrial fibrillation Atrial fibrillation, as a heart disease, can exist alone (isolated atrial fibrillation) or can be a complicating symptom of other diseases. In general, patients with atrial fibrillation need to stop smoking, limit alcohol consumption, and avoid caffeine-containing substances such as tea, coffee, cola, and some over-the-counter medications. Currently, the treatment of atrial fibrillation involves three major goals: prevention of thromboembolism, control of the ventricular rate, and restoration of normal sinus rhythm. Medications are ineffective in the treatment of atrial fibrillation and have significant toxic side effects with long-term use; long-term use of anticoagulants to prevent thrombosis may carry the risk of bleeding from vital organs. Therefore, the most desirable treatment goal is to convert the atrial fibrillation rhythm to normal rhythm, which can eliminate all the hazards of atrial fibrillation and achieve the purpose of curing atrial fibrillation. The current treatment can be achieved mainly by catheter interventional radiofrequency ablation and surgical ultra-minimally invasive treatment, but the results of catheter interventional radiofrequency ablation for atrial fibrillation are poor. In isolated atrial fibrillation, surgical ultra-minimally invasive treatment achieves the best treatment outcome and avoids surgical trauma and pain. Compared with medical catheter ablation, surgical ultra-minimally invasive surgical treatment has four major advantages: first, surgical treatment has a high success rate with precise, wall-transparent, and complete isolated ablation line of the left atrial pulmonary vein; second, surgical treatment can intraoperatively remove the left auricle, which is most prone to thrombus formation (which is not possible with medical treatment), greatly reducing the risk of thrombus formation and embolism due to AF; third, the epicardial autonomic ganglion, the Fourth, both the doctor and the patient do not need to experience prolonged X-ray exposure during catheter ablation, and there is no radiation damage and potential hazards, no kidney damage caused by the application of large amounts of contrast agents, and the treatment cost is only about 70% of that of medical catheter ablation. At present, the most advanced surgical ultra-minimally invasive method for the treatment of isolated atrial fibrillation has been applied in the Cardiothoracic Surgery Department of Shanghai Xinhua Hospital with very good results, bringing a blessing to the majority of atrial fibrillation patients. The surgical ultra-minimally invasive approach requires only two small 2 cm holes in the left chest wall, and the treatment can be completed within 2-3 hours. The minimally invasive surgical approach greatly shortens the operation time and reduces the surgical trauma, with a single success rate of about 93%. For atrial fibrillation complicated by organic heart disease, including valvular heart disease (mostly mitral valve lesions), coronary heart disease, hypertension, and congenital heart disease. The only chance to cure atrial fibrillation is to perform atrial fibrillation ablation along with surgery. If only conventional surgery is performed without treating atrial fibrillation, the patient loses the opportunity to treat atrial fibrillation and the harm caused by atrial fibrillation is not relieved. At present, the application of new radiofrequency energy, atrial fibrillation therapeutic instrument and electrophysiological instrument, and atrial fibrillation treatment surgery (modified “maze surgery”) at the same time of direct intracardiac surgery is the safest and most effective method to eliminate atrial fibrillation, with very high safety and effectiveness. The long-term results of atrial fibrillation treatment surgery performed at the same time as valve replacement at Xinhua Hospital show that the success rate of atrial fibrillation becoming normal sinus rhythm is 92%.