Atrial fibrillation (atrial fibrillation) is the most common type of arrhythmia, increasing the risk of stroke, heart failure, and even death. Mr. Shi, 56, is a person with atrial fibrillation, but he did not expect that it was the cause of sleep disorders. "Treatment should be cured, sleep apnea and atrial fibrillation are closely related, snoring people should be particularly vigilant about atrial fibrillation!" Chen Ailan, chief physician of the Department of Cardiovascular Medicine of the First Affiliated Hospital of Guangzhou Medical University, reminded.
The root cause of stroke is actually related to sleep
Mr. Shi, 56 years old this year, is an old fisherman who has been engaged in fishing and selling fish for many years, and his health has always been relatively strong. However, more than four months ago, he suddenly felt that he often broke out in a cold sweat, and from time to time he had dizziness and headaches. The family thought he was overworked and let him rest at home for a while, but the situation did not improve, and even vomiting symptoms. Mr. Shi rushed to the local hospital for examination, and the doctor diagnosed a stroke caused by atrial fibrillation, commonly known as stroke, and suggested that he go to the big hospital for further treatment. On the recommendation of a friend, he came to the First Affiliated Hospital of Guangzhou Medical University and found Chen Ailan, chief physician of the Department of Cardiology. "This patient did not have high risk factors for stroke such as hypertension, coronary heart disease, and COPD, but he was obese and had a history of atrial fibrillation, so we speculate that he may have sleep disorders." Chen Ailan invited the sleep disorder team of the Department of Respiratory Medicine to consult and monitored Mr. Shi's sleep, and it turned out that it was already severe sleep apnea syndrome.
Sleep apnea and atrial fibrillation are closely linked. The data showed that people with sleep apnea syndrome were 4 times more likely than normal people to develop atrial fibrillation. Studies have shown that people with sleep apnea develop arrhythmias when they sleep at night, with hypoxia several times a day for a few seconds at a time. Lack of oxygen in turn leads to chemical changes and mechanical tone changes in the heart, resulting in atrial fibrillation. "We followed the vine and found the root cause of the patient's atrial fibrillation, which is the cause of the stroke." Chen Ailan said. Chen Ailan proposed that the treatment of diseases should be treated from the root, in order to obtain better long-term efficacy, Mr. Shi is very serious when he sleeps at night, just like "during the day in Guangzhou, when sleeping at night to the plateau", if sleep apnea is not effectively treated, it will resist the treatment of atrial fibrillation, reduce the treatment effect, and if the problem of atrial fibrillation can not be solved, the left atrial appendage of the heart is easy to "grow" thrombosis, thrombosis with the blood flow to the cerebral blood vessels, it may induce stroke, resulting in serious consequences.
Interventional surgery makes prevention "one step in place"
The doctor formulated a detailed treatment plan for Mr. Shi, on the one hand, let him start to wear a ventilator to sleep, fundamentally solve the problem of low oxygen at night, on the other hand, to carry out standardized anticoagulation treatment, while requiring him to strive to "lose weight". Mr. Shi is very obedient to the doctor's advice, from three meals a day without meat and unhappiness, to minimize the intake of meat and carbohydrates, and to strengthen exercise, get up at four or five o'clock every morning to go to the brisk walk to exercise, three months later, the weight lost more than a dozen pounds. He came to Chen Ailan's outpatient clinic again for review, standardized anticoagulation treatment has a certain effect, can already do interventional surgery, through radiofrequency ablation technology will be easy to form a blood clot of the left atrial appendage blocked, for the prevention of stroke to achieve "one step in place", and there is no need to take anticoagulant drugs for life.
On the day of the operation, Mr. Shi was admitted to the interventional operating room. Radiofrequency ablation technology is carried out under local anesthesia, the patient is awake throughout the whole process, and can communicate with the doctor in language, Mr. Shi said, he felt a warm current directly to the heart site, the doctor began a very focused operation, the process "not at all painful."
Long-term effects depend on the joint efforts of doctors and patients
The operation was smooth, and the postoperative ECG monitoring showed that Mr. Shi's original abnormally fluctuating ECG gradually returned to sinus rhythm, and his blood pressure was in a stable state. On the day of discharge, Chen Ailan visited him in the ward, and repeatedly advised him to continue to lose weight and control his weight, complete the operation is only the beginning of success, return home to do an electrocardiogram regularly, measure blood pressure, etc., and make a record to communicate with the doctor in time.
Chen Ailan sent a form saved in his mobile phone to Mr. Shi and instructed him to do a good job of daily monitoring and recording, "Every patient we have done radiofrequency ablation surgery will give him such a form, and the patient needs to continue to do remote management when he returns home." Director Chen Ailan found a record sent by a previous patient and said, "If the data is abnormal, the doctor can understand the patient's situation in time and give guidance, although this may add a little workload to the doctor, but it can ensure the long-term efficacy of the patient." Written by: Nandu reporter Li Chunhua correspondent Han Wenqing Photo: Provided by the First Hospital of Guangdong Medical University