The heart pounded, and it developed into heart failure?

Because persistent atrial fibrillation leads to heart failure, the patient's heart enlarged because of the disease. Atrial fibrillation is the most common arrhythmia. Because the heart has been overloaded when atrial fibrillation occurs, the attack of atrial fibrillation will lead to the loss of normal systolic function of the heart. For some patients with atrial fibrillation without obvious symptoms, the incidence of atrial fibrillation is also closely related to coronary heart disease, hypertension and other chronic diseases. Another easily overlooked cause is hyperthyroidism (hyperthyroidism). The incidence of atrial fibrillation caused by obesity is on the high side. The clinical symptoms of atrial fibrillation are not typical, this kind of patients often do not have time to go to the hospital for ECG examination "to judge whether the patient is mental illness or atrial fibrillation." At present, the simple and easy method for the diagnosis of atrial fibrillation is ECG examination. if atrial fibrillation can not be found in a short time, patients can also observe the regularity of heart rate by taking blood pressure, pulse and wearing intelligent devices.

A Mr. Zhang, who was about 50 years old, was relatively fat because persistent atrial fibrillation caused heart failure and could not sleep flat at night. He could not walk and could not go to work. Finally, he found Huang Xingfu, deputy chief physician of the Department of Cardiology of Nanfang Hospital of Southern Medical University, and gave him radiofrequency ablation surgery. The operation was very successful. the patient's heart enlarged because of the illness, but the heart shrunk slowly a month later, and there was no problem walking and lying flat.

What the heck is atrial fibrillation?

Atrial fibrillation is one of the most common arrhythmias. During the attack of atrial fibrillation, the atrium loses its effective systolic function, resulting in a much faster heart rate and irregular heartbeat. The patient may feel the heart missing a beat, or pounding, accompanied by dizziness, chest tightness, fatigue and other uncomfortable symptoms. If AF occurs repeatedly for more than 7 days, it is called persistent AF.

What harm does atrial fibrillation have to the human body?

• Heart failure: because the heart is always overloaded when atrial fibrillation occurs, the atrium and ventricle will become larger, resulting in a decline in heart function, a decrease in diastolic function, and heart failure, just like when the heart is "tired" and people's exercise is boring. Finally, you have to stop and rest. This is the case with Mr. Zhang mentioned earlier.
• Stroke (commonly known as "stroke"): the attack of atrial fibrillation will lead to the loss of normal contractile function of the heart, the blood is easy to accumulate and form thrombus, and the thrombus flows to the blood vessels of the brain along with the arterial system, which can easily lead to stroke; in severe cases, it may also lead to myocardial infarction, which is instantly fatal.

What are the high risk factors related to the incidence of atrial fibrillation?

According to Dr. Huang Xingfu, atrial fibrillation is more common in the elderly, and the incidence of atrial fibrillation in people over 75 years old is 10%. However, with the change of modern life style, the incidence of atrial fibrillation has a younger trend. At present, the incidence of atrial fibrillation among residents over 35 years old in Guangdong is about 1.46%, which is higher than the national average of 1%. There may be several reasons: first, the high level of urbanization in Guangdong, people's fast pace of life, stress, frequent overtime, meals, lack of exercise, all of which may induce atrial fibrillation. In addition, the level of medical care has improved, and the proportion of patients with atrial fibrillation who have no obvious symptoms has also increased through screening.

The incidence of atrial fibrillation is also closely related to chronic diseases such as coronary heart disease and hypertension. Huang Xingfu pointed out, "another easily overlooked cause of high incidence of atrial fibrillation in Guangdong residents is hyperthyroidism (hyperthyroidism), especially in coastal areas, people's increased intake of iodine, the risk of hyperthyroidism will be higher."

In addition, obesity is also a risk factor for atrial fibrillation. The incidence of atrial fibrillation caused by obesity is higher than that of normal weight. Therefore, if high-risk groups have symptoms of palpitations, palpitations or chest tightness in daily life, it is recommended to go to the hospital as soon as possible, early detection and early treatment.

Electrocardiogram examination is simple and easy to diagnose atrial fibrillation.

"the clinical symptoms of atrial fibrillation are not typical, so it is easy to be missed and misdiagnosed." Huang Xingfu pointed out, "in addition to the persistent atrial fibrillation just mentioned, another type of atrial fibrillation is paroxysmal fibrillation, that is, the onset of atrial fibrillation is relatively short. This kind of patients often do not have time to go to the hospital for an ECG examination during the attack. Therefore, if the problem is not found in time, it may also be diagnosed with anxiety or other mental illness."

In fact, modern people are under great stress in work and life, and they always have problems of chest tightness and palpitation. to judge whether a patient is a mental illness or atrial fibrillation, it depends on whether there is arrhythmia, which requires a more detailed assessment.

At present, electrocardiogram examination is a simple and easy method to diagnose atrial fibrillation. If atrial fibrillation cannot be detected by short-term ECG examination, 24-hour ambulatory electrocardiogram can be passed. In addition, patients can also observe the regularity of heart rate by taking blood pressure, pulse and wearing smart devices. If there is irregular heart rate, it is recommended to go to the hospital for further professional examination.

Radiofrequency ablation is the first choice for the treatment of atrial fibrillation.

Drugs are the most common means for the treatment of atrial fibrillation, but the pain point of drug treatment of atrial fibrillation is difficult to cure. Some antiarrhythmic drugs such as amiodarone are commonly used in clinic. Long-term use of amiodarone has certain side effects on patients. If patients have persistent atrial fibrillation, anticoagulants should be added to prevent stroke.

Studies have confirmed that the attack of atrial fibrillation is related to the abnormal potential of the pulmonary vein, which is equivalent to a "fire" in the human pulmonary vein, and matches are thrown into the atrium, causing atrial "fibrillation." therefore, the potential of the pulmonary vein can be isolated by radiofrequency ablation, which can restore the normal heartbeat of patients with atrial fibrillation.

Patients with paroxysmal atrial fibrillation maintain sinus rhythm (that is, normal rhythm) by radiofrequency ablation, with a success rate of 90%, while the success rate of drug therapy for maintaining sinus rhythm is only 30% and 50%. For persistent atrial fibrillation, experienced professional hospitals can achieve a success rate of 70% and 80%. The symptoms of patients are significantly improved and the possibility of heart failure will be reduced.

At present, according to international guidelines, radiofrequency ablation is the first choice for the treatment of paroxysmal and persistent atrial fibrillation. There is also a special case of patients with atrial fibrillation complicated with heart failure, there is sufficient clinical evidence to prove that radiofrequency ablation can bring more benefits to these patients. In other words, radiofrequency ablation is recommended for patients with atrial fibrillation if there are conditions and surgical indications.

A brief introduction to experts

Huang Xingfu, deputy director doctor, MD, graduated from Fuwai Cardiovascular Hospital, Peking Union Medical College, specializing in the diagnosis and treatment of arrhythmias (especially interventional therapy). He serves as a young member of the Heart failure Group of the Chinese Medical Association, the secretary of the basic Research, testing and Heart failure Group of the Cardiovascular Branch of Guangdong Medical Association, the Young member of the Cardiac pacing and Cardiac Electrophysiology Branch of Guangdong Medical Association, a member of Guangdong Health Management Committee, and a member of Guangdong Provincial Hypertension Committee of Integrated traditional Chinese and Western Medicine.

Source: southern PLUS, reporter ou Xujiang, the article and title have been adjusted