Atrial fibrillation (AF) is currently the most common persistent clinical arrhythmia, with a prevalence of 0.77% among residents aged 30 to 85 years in China. Atrial fibrillation is a typical disease of the elderly, and the older you are, the higher the chance of developing it, which can reach 30% in people over 80 years old. Does this mean that young people will not suffer from atrial fibrillation? 1, first acquaintance with “atrial fibrillation” Atrial fibrillation can be divided into two types, one is the organic disease caused by associated atrial fibrillation, and the other is not yet clear cause of idiopathic atrial fibrillation. Young people are vulnerable to this type of atrial fibrillation. Atrial fibrillation is no longer an “exclusive” disease of the elderly. Atrial fibrillation is a typical “three highs” disease with high incidence, high disability and high mortality rates, and it can cause inconvenience in life and work for patients. Patients with atrial fibrillation are often prone to dizziness, headache, fatigue, shortness of breath and other symptoms, and in some cases, chest pain, resulting in cardiac insufficiency, cerebral ischemia and, in severe cases, heart failure. Atrial fibrillation is the most important factor causing strokes, and the mortality rate of patients with atrial fibrillation is 2-4 times higher than that of normal people. It is true that atrial fibrillation is very rare in young people, but it can occur in some special patients, and healthy people can have atrial fibrillation in some specific situations. 2. Special states Atrial fibrillation can occur in healthy people when they drink a lot of alcohol, exercise vigorously, are mentally overstressed or are overly tired. In the various studies on the relationship between diet and atrial fibrillation, the role of alcohol in promoting atrial fibrillation is relatively clear. A small amount of alcohol is good for health, but excessive alcohol consumption not only predisposes to atrial fibrillation, but may also lead to alcoholic cardiomyopathy, liver cirrhosis, and gastric mucosal damage, which are extremely harmful to health. Excessive fatigue may also contribute to atrial fibrillation, but this atrial fibrillation is often transient. It can be seen that a healthy lifestyle and a combination of work and rest can also contribute to the prevention of atrial fibrillation. In addition, atrial fibrillation can also occur in the acute phase of disease, such as during fever or infection, or after surgery. The incidence of atrial fibrillation after cardiac surgery is as high as 25 to 50%. This atrial fibrillation is also often transient, and when the disease improves or recovers after surgery, atrial fibrillation usually disappears as well. 3, combined with organic heart disease Some patients with organic heart disease have an increased incidence of atrial fibrillation, some of which are often found in the young population, such as rheumatic heart disease, congenital heart disease and cardiomyopathy. Rheumatic heart disease (rheumatic heart disease) can damage the heart valves, and those with combined mitral valve disease (stenosis or incomplete closure) are more likely to have atrial fibrillation. Although rheumatic heart disease has become very rare in developed countries, its incidence is still high in China, especially in areas with relatively poor economic, nutritional and health conditions. Severe valvular lesions require surgical treatment, which can be used to treat AF at the same time. Catheter radiofrequency ablation can be considered for atrial fibrillation when the valve lesion is mild and does not require surgery. Congenital heart disease (congenital heart disease), especially atrial septal defect, is more closely related to atrial fibrillation. Even after patch repair, postoperative folding loops can form around the patch to induce atrial fibrillation or atrial flutter (atrial flutter). The incidence of atrial fibrillation is higher in patients with either dilated or hypertrophic cardiomyopathy than in the general population. Atrial fibrillation in these patients can also be treated by catheter radiofrequency ablation, but it is relatively more difficult and has a lower success rate. 4. Patients with preexcitation syndrome have an additional atrial to ventricular electrical conduction pathway, which is a congenital abnormality, and a typical “preexcitation wave” is seen on the ECG. However, this ECG abnormality is often detected during the teenage years at school entry or during military medical examinations. Preexcitation syndrome can be combined with other tachyarrhythmias, with supraventricular tachycardia being the most common, at 80%, and atrial fibrillation in 15-30% of cases. 5, hyperthyroidism As mentioned in the previous article, atrial fibrillation is the most common cardiac manifestation of hyperthyroidism (hyperthyroidism). Hyperthyroidism is most often seen in women between the ages of 20 and 50, and can be considered one of the causes of atrial fibrillation in young people. Therefore, young people should be alert to the occurrence of atrial fibrillation when hyperthyroidism is detected, and thyroid function tests should also be performed when atrial fibrillation occurs. 6, genetic factors Similar to hypertension and diabetes, atrial fibrillation also has certain genetic factors, but unlike diseases such as phenylketonuria and hemophilia that are clearly caused by a certain genetic abnormality. The risk of atrial fibrillation can be increased by 40% in those who have relatives with atrial fibrillation. If there are multiple relatives with AF, especially if the age of onset is young and there are no other contributing factors, I need to be aware of this and suggest that family members be tested for relevant genetics. The mechanism of atrial fibrillation is complex, and there is a subset of younger patients with atrial fibrillation for whom no known cause can be identified, called “idiopathic atrial fibrillation”. Of course, perhaps with advances in technology, some of these “idiopathic” causes will be identified. This shows that young people are not far from atrial fibrillation, and it is necessary to know about atrial fibrillation, and to help their elders prevent and treat atrial fibrillation as well as to pay attention to their own health.