Atlas
BEIJING, Nov. 13 (Xinhuanet) -- Atrial fibrillation is a common arrhythmia, but due to the complex etiology, there are many hazards to the human body, which affects people's quality of life. What are the complications of atrial fibrillation? What innovative drugs and treatments are available? ...... Recently, Li Guangping, director of the Tianjin Institute of Cardiology and director of the Department of Internal Medicine of the Second Hospital of Tianjin Medical University, visited the Xinhua Network Health Lecture Hall to share the content related to atrial fibrillation.
Atrial fibrillation is a common arrhythmia with a variety of risk factors
Xinhua Net: What kind of disease is atrial fibrillation? Why is atrial fibrillation difficult to "cure"?
Li Guangping: Atrial fibrillation, referred to as atrial fibrillation, is a common arrhythmia. There are many types of arrhythmias, such as tachycardia, AV block, premature beats, premature beats, and irregular heart rate. The causes of atrial fibrillation are complex, and most patients are caused by multiple factors whose causes are unclear. Most patients are closely related to hypertension, diabetes, heart failure and other diseases, alcohol consumption, breathing and sleep apnea are also related to the occurrence of atrial fibrillation, which is part of the cause of atrial fibrillation.
From the clinical diagnosis, there are many diseases that may coexist with the patient's atrial fibrillation, but it is not directly related to the atrial fibrillation itself. Such as patients with long-term hypertension, through changes in the structure of the heart, increased cardiac load, resulting in changes in the heart after the occurrence of atrial fibrillation. Thus, the etiology of atrial fibrillation is caused by a very complex set of causes.
The harm of atrial fibrillation is very severe, and the number of stroke patients in China is relatively large, which has caused a great burden on society, families and medical resources. For stroke patients, from the perspective of neurology, 18% to 20% of neurology patients hospitalized due to stroke are caused by atrial fibrillation. How does atrial fibrillation form stroke? Normal cardiac contraction is to contract and relax according to a certain rhythm, when the onset of atrial fibrillation, the original contraction and relaxation of the atrium will be disrupted, there is a microfibrillation of the atrial wall, is a regular contractile activity. At this time, the blood in the atrium is easy to accumulate in the atrium, after the aggregation of stasis to form a thrombus, these thrombuses attached to the atrial wall, most of them stored in the left atrial ear, when the thrombus falls off, with the blood flow to the brain will cause stroke. Blood clots can also flow with the blood to many other places, such as to the spleen, intestinal blood vessels, etc., causing thrombosis in different parts, many dangerous situations occur. Therefore, the harm of atrial fibrillation is very large, atrial fibrillation itself can cause stroke, but also can cause heart failure. So why is atrial fibrillation not so easy to cure? Because the mechanism of atrial fibrillation is more complex, the etiology is complex, and middle-aged and elderly patients have a variety of diseases, such as hypertension, diabetes, etc., coupled with bad living habits such as drinking, and more comprehensive treatment is needed. In addition, because atrial fibrillation causes structural changes, which are often irreversible, it is very difficult to treat.
Atrial fibrillation patients will also face many symptoms, the most prominent symptom is the patient's palpitation after activity, such as the patient's slight movement, heart rate can reach 120, 130, 150 times per minute, in this case, the patient will have a panic, rapid heartbeat, heartbeat tremor sensation. In addition, patients with atrial fibrillation heart rate can cause a series of problems, such as acute myocardial infarction, angina, heart failure, etc., but also can cause complications caused by other blood clots, and the clinical manifestations are complex.
How do I know if I have atrial fibrillation? When a patient with atrial fibrillation has a seizure, an experienced doctor can judge through the stethoscope; if the signs of the seizure are not obvious, the stethoscope may also be missed, and can be detected by the electrocardiogram; if the patient usually has no seizures, it is a burst of seizures, the electrocardiogram may not detect abnormalities, then it is necessary to carry the 24-hour ELECTROCARDI for the whole process of detection; if the patient has a very infrequent seizure, it may occur once every one or two months, and it can be completely recorded how many atrial fibrillation attacks the patient has, how long each time, can be detected. Therefore, the diagnosis of atrial fibrillation is not difficult.
There are five key points in the treatment of atrial fibrillation Patients need to strictly follow the doctor's instructions
Xinhua Net: In daily life, what are the key points of patient self-management?
Li Guangping: For the treatment of atrial fibrillation, from a clinical point of view, there are the following aspects:
The first is to control the ventricular rate of atrial fibrillation. The role of controlling the ventricular rate of atrial fibrillation is to let the patient's heart rate drop very quickly, so that the patient's symptoms can be alleviated, such as the patient's attack on the atrial fibrillation heart rate 130 times per minute, the patient is more uncomfortable in this case, and it is necessary to control the drug treatment of the ventricular rate, or through other means to reduce the patient's heart rate, so that the patient's symptoms are alleviated;
The second is to see whether the patient is atorostabrillation, that is to say, the patient now has atrial fibrillation, the doctor needs to stop the occurrence of atrial fibrillation in the patient, restore normal heart rhythm, and need to restore the patient's normal sinus rhythm through drugs, cardioversion, minimally invasive surgery and other means;
The third is the prevention of thromboembolic complications of atrial fibrillation. If the patient is prone to stroke thromboembolism, how to reduce this risk is an important step in the treatment of atrial fibrillation and an important part of improving the quality of life of patients. In addition, symptomatic treatment or treatment of primary diseases, if the patient suffers from heart failure, hypertension, diabetes and other diseases, the treatment of these diseases is very important for the comprehensive management of atrial fibrillation, and the treatment of diseases such as hypertension, diabetes, and heart failure is also included in the management of doctors.
The fourth is the treatment of symptoms. Patients may have many symptoms brought about by atrial fibrillation and symptoms brought about by non-atrial fibrillation, such as anxiety, nervousness, etc., including heart failure and some symptoms brought about by hypertension, and need to be given symptomatic treatment.
Fifth, patients should follow their doctor's advice. Different management measures are considered depending on the patient's stage of illness, such as drug therapy to control the ventricular rate of atrial fibrillation and to revert atrial fibrillation, as well as anticoagulation to prevent thrombosis. If the patient's indications are appropriate, catheter ablation can also be performed through minimally invasive surgery to resolve the recurrence of atrial fibrillation and rhythm maintenance.
Xinhua Net: How to prevent the risk of complications?
Li Guangping: There are two key points in the prevention of atrial fibrillation, one is stroke, and the other is heart failure. Controlling the ventricular rate of atrial fibrillation is very important for patients to prevent the occurrence of heart failure or reduce the risk of heart failure and control the ventricular rate. Drugs to control the heart rate of atrial fibrillation should be applied regularly under the guidance of a doctor to reduce the risk of developing heart failure and relieve symptoms.
For the prevention of stroke, we emphasize the comprehensive assessment of patients with atrial fibrillation, the use of anticoagulant therapy drugs to prevent the risk of stroke, and now for patients with atrial fibrillation, we do stroke bleeding risk assessment for patients and adjust patient antithrombotic therapy strategies. In addition to the anticoagulants used before, there are now some new oral antibacterial drugs, which are very simple, do not require patients to go to the hospital frequently for testing, and oral administration once or twice a day can achieve very good anticoagulation effects.
Therefore, patients should make a scientific assessment of their own risk of complications under the guidance of a doctor, and take antithrombotic drugs regularly and correctly to reduce the risk of stroke.
Editor-in-Charge: Xiaoqian Gong