Arterial embolism: an unbearable pain for patients with atrial fibrillation

Atrial fibrillation: one of the more common types of arrhythmias, one of its greatest risks is the arterial embolism caused by the combined atrial thrombus dislodgement, in the lower extremity, mesenteric artery, carotid artery, subclavian artery, and other arteries, in order of prevalence, and even cerebral embolism combined with lower extremity artery embolism or lower extremity artery embolism combined with mesenteric artery embolism, which increases the mortality rate significantly. Cerebral embolism (ischemic stroke) is the main embolic event caused by atrial fibrillation and is the most disabling complication in patients with atrial fibrillation. Most strokes accompanying atrial fibrillation are due to cerebral artery embolism caused by dislodgment of a thrombus in the left atrium. The risk of cerebral embolism is related to the presence and nature of the underlying heart disease, with a higher risk in patients with rheumatic valve disease and after prosthetic valve replacement. The risk of embolic events in non-valvular atrial fibrillation is about 5% per year, twice the incidence in non-atrial fibrillation patients, and accounts for 15% to 20% of all cerebral embolic events. The incidence of embolism is higher in older patients with atrial fibrillation, with an annual incidence of stroke due to atrial fibrillation of 1.5% in patients aged 50 to 59 years, rising to 23.5% in those aged 80 to 89 years. The incidence of embolism is higher in male patients than in females at all ages. Most of the strokes, abdominal pain, intestinal necrosis, and cold gangrene of lower limbs that occur on the basis of rheumatic heart disease can be associated with arterial embolism. Since most of the patients have poor cardiac function, many doctors are afraid to operate; even if the specialist is bold enough to prepare for emergency surgery, he is constrained by anesthesia, which leads to repeated delays in the timing of the operation and eventually loses the best window of time for surgery. Therefore: purely from the perspective of treating the disease and saving lives, in view of the great danger of arterial embolism, it is recommended to operate as soon as possible, with appropriate relaxation of indications and good doctor-patient communication, in order to achieve a better clinical benefit, otherwise, the clinical benefit will be greatly reduced if there is already intestinal necrosis on the basis of tethered artery embolism, brain hemorrhage on the basis of stroke, or calf gangrene after femoral artery embolism, and even if the rescue is successful, the clinical economic cost and high disability rate will be huge. Even if the resuscitation is successful, the clinical cost and disability rate are huge.