Li Guangping: Patients with various risk factors of atrial fibrillation should be treated strictly

Beijing, November 13 atrial fibrillation is a common arrhythmia, but due to the complex etiology, there are many hazards to the human body, so that people’s quality of life is affected. What complications does atrial fibrillation have? What are the current innovative drugs and treatments Recently, Li Guangping, director of Tianjin Institute of Cardiology and director of Department of internal medicine of the second hospital of Tianjin Medical University, visited the Xinhua health lecture hall to share with you the contents related to atrial fibrillation. < p > < p > Li Guangping: atrial fibrillation, referred to as atrial fibrillation, is a common arrhythmia. Arrhythmia has many types of diseases, such as tachycardia, atrioventricular block, premature beat, premature beat, arrhythmia and so on. The etiology of atrial fibrillation is very complex. Most patients are caused by many factors, and the etiology is not clear. Most patients and hypertension, diabetes, heart failure and other diseases have a close relationship, drinking, sleep apnea and the occurrence of atrial fibrillation are also related, is a part of the cause of atrial fibrillation. In terms of clinical diagnosis, there are many diseases that may coexist with atrial fibrillation, but they have no direct relationship with atrial fibrillation itself. For example, in patients with long-term hypertension, through the change of heart structure, the heart load is increased, which leads to the occurrence of atrial fibrillation after the change of heart. Therefore, the etiology of atrial fibrillation is a series of very complex causes. The harm of atrial fibrillation is very serious. There are a large number of stroke patients in China, which has caused a great burden on society, family and medical resources. For stroke patients, from the perspective of Neurology, 18% ~ 20% of neurological patients hospitalized for stroke are caused by atrial fibrillation. How does atrial fibrillation form stroke? Normal cardiac contraction is in accordance with a certain rhythm of contraction and relaxation, when the onset of atrial fibrillation, the original contraction and relaxation of the atrium will be disrupted, there is a micro fibrillation of the atrial wall, is no regular contraction activity. At this time, the blood in the atrium is easy to gather in the atrium. After the aggregation, blood stasis forms thrombus. These thrombi adhere to the atrial wall of the atrium, and most of them exist in the left atrial appendage. When the thrombus falls off, it will cause stroke with the blood flow to the brain. Thrombus can also flow to many other places, such as the spleen, intestinal blood vessels and so on, resulting in different parts of the thrombus plug, a lot of dangerous situations. Therefore, the harm of atrial fibrillation is very big, atrial fibrillation itself can cause stroke, can also cause heart failure. So why is atrial fibrillation not very good cure? Because the mechanism of atrial fibrillation is complex, the etiology is complex, the elderly patients with a variety of diseases, such as hypertension, diabetes, coupled with drinking and other bad habits, need more comprehensive treatment. In addition, because atrial fibrillation can cause structural changes, which are often irreversible, it is very difficult to treat. < / P > < p > patients with atrial fibrillation will also face many symptoms. The most prominent symptom is the patient’s palpitation after the activity. For example, if the patient moves a little, the heart rate can reach 120, 130, 150 times per minute. In this case, the patient will have the feeling of palpitation, rapid heartbeat and palpitation. In addition, patients with atrial fibrillation heart rate too fast will cause a series of problems, such as acute myocardial infarction, angina pectoris, heart failure, and other complications caused by thrombosis, clinical manifestations are complex. < / P > < p > how to judge if you have atrial fibrillation? When patients with atrial fibrillation attack, experienced doctors can judge through the stethoscope; if the attack signs are not obvious, the stethoscope may also be missed, which can be detected by ECG; if the patient has no attack at ordinary times, it is a burst of attack, and the ECG may not detect abnormalities, then it is necessary to carry the whole 24-hour ECG detection; if the patient has a very infrequent attack It may occur once a month or two. It can be detected by subcutaneous implantation to record the number of AF episodes and how long each time. So the diagnosis of AF is not difficult. The first is to control the ventricular rate of atrial fibrillation. The function of controlling the ventricular rate of atrial fibrillation is to let the patient’s heart rate drop very fast, so that the patient’s symptoms can be relieved. For example, the patient’s heart rate is 130 beats per minute, and the patient’s heart rate needs to be controlled by drug treatment, or other means to reduce the patient’s heart rate, so that the patient’s symptoms can be relieved. < / P > < p > the second is to see a doctor Whether the patient is converted to atrial fibrillation, that is to say, the patient has atrial fibrillation now. Doctors need to stop the occurrence of atrial fibrillation and restore the normal rhythm of the heart. They need to restore the normal sinus rhythm by means of drugs, cardioversion and minimally invasive surgery. < / P > < p > the third is to prevent the thromboembolic complications of atrial fibrillation. If patients are prone to stroke thromboembolism, how to reduce this risk is an important step in the treatment of atrial fibrillation, and also an important link to improve the quality of life of patients. In addition, it is symptomatic treatment or treatment of primary diseases. If the patient has heart failure, hypertension, diabetes and other diseases, the treatment of these diseases is very important for the comprehensive management of atrial fibrillation, and the management of doctors also includes the treatment of diseases such as hypertension, diabetes and heart failure. The fourth is the treatment of symptoms. Patients may be complicated with many symptoms caused by atrial fibrillation and non atrial fibrillation, such as anxiety, tension, etc., including some symptoms caused by heart failure and hypertension, which need symptomatic treatment. < / P > < p > the fifth is that patients should follow the doctor’s advice. Different management measures should be considered according to the different stages of the patient’s illness, such as drug therapy for controlling the ventricular rate of atrial fibrillation and converting atrial fibrillation, and anticoagulant therapy to prevent thrombosis. If the indications of patients are suitable, catheter ablation can be performed through minimally invasive surgery to solve the problem of recovery rate and rhythm maintenance of atrial fibrillation. Li Guangping: there are two key points in the prevention of atrial fibrillation, one is stroke, the other is heart failure. Controlling the ventricular rate of atrial fibrillation is very important for patients, it can prevent the occurrence of heart failure or reduce the risk of heart failure, control ventricular rate. Under the guidance of doctors, heart rate control drugs should be used regularly to reduce the risk of heart failure and relieve symptoms. < / P > < p > for the prevention of stroke, we emphasize the comprehensive evaluation of patients with atrial fibrillation, and use anticoagulant drugs to prevent the risk of stroke. For patients with atrial fibrillation, we do the risk assessment of stroke bleeding for patients with atrial fibrillation, and adjust the strategy of antithrombotic therapy. In addition to the anticoagulants used before, there are also some new oral antibiotics, which are very simple and do not require patients to go to the hospital frequently for testing. Oral administration once or twice a day can achieve very good anticoagulant treatment effect. Therefore, under the guidance of doctors, patients should scientifically assess their own risk of complications and take anti thrombotic drugs regularly and correctly to reduce the risk of stroke.