Ms. Zhao, 55, is always flustered and has a chaotic heartbeat.
When I went to the hospital for an electrocardiogram, my heart rate was 110 beats/min, and my heart rate was irregular.
The doctor said it was atrial fibrillation. After a period of observation, the use of drugs did not restore atrial fibrillation to normal sinus rhythm. The doctor advised her to take long-term anticoagulation therapy, that is, to prevent blood clots and prevent cerebral infarction. At the same time taking lorol class heart rate control drugs.
After 3 months of treatment, Ms. Zhao’s symptoms of palpitation disappeared. She went to the hospital for re-examination, and the result was atrial fibrillation on the electrocardiogram. The doctor said: I have to continue to take the medicine, even if there is no symptoms of palpitation, I have to continue to take the medicine.
Ms. Zhao took the medicine for another 3 months and felt no change. On the contrary, sometimes her arms and legs were blue and purple. The doctor also explained that this may be caused by drugs, because taking anticoagulant drugs, there may be small-scale subcutaneous bleeding, which is not a big problem, so don’t worry.
But Ms. Zhao felt that taking medicine was no different from taking no medicine, and the medicine had side effects, so she stopped taking anticoagulants.
One day half a year after the drug was discontinued, Ms. Zhao suddenly fainted in the toilet and was sent to the hospital. After excluding the cause of heart disease, she underwent a brain CT, which indicated a cerebral infarction.
The final comprehensive consideration is the cerebral infarction caused by arrhythmia and atrial fibrillation. Now Ms. Zhao is still living in the ICU and is not out of danger.
First, arrhythmia and atrial fibrillation, why does it still cause cerebral infarction?
1. Irregular heart rhythm, not necessarily atrial fibrillation. The rhythm of our healthy heart beating is called sinus rhythm. Generally, the beating is relatively regular. So in most cases, our normal ECG is sinus rhythm. But even if sinus arrhythmia occurs, it is not necessarily a heart disease. Most sinus arrhythmias are not heart disease.
2. Atrial fibrillation is a common cardiac arrhythmia. Simply put, it means that the heart is beating erratically without any regularity. Like Ms. Zhao, most patients will feel palpitation and rapid heartbeat. The diagnosis of atrial fibrillation is also relatively simple, and can be diagnosed by an electrocardiogram. Of course, there are very few patients with atrial fibrillation who don’t feel anything, so they won’t panic, they won’t go to the doctor, and they won’t do an electrocardiogram, so it’s difficult to detect them in time.
3. The harm of atrial fibrillation is not just as simple as causing palpitation and rapid heartbeat. Atrial fibrillation occurs when the heart cannot beat normally, and the heart is prone to blood clots. Once the heart has a thrombus, the thrombus may fall off. After the thrombus falls, it will flow with the blood vessels, run to the cerebral blood vessels, block the cerebral blood vessels, and cerebral thrombosis will occur, that is, cerebral infarction.
Statistics show that 20% of cerebral infarctions are related to cardiogenic thrombosis, mainly atrial fibrillation. The risk of cerebral infarction in patients with atrial fibrillation was five times higher than that in patients without atrial fibrillation. Patients with atrial fibrillation also have a 2-fold increased risk of heart failure.
Second, why does atrial fibrillation occur? How to prevent atrial fibrillation?
Many heart diseases can lead to atrial fibrillation. For example, our common hypertension, coronary heart disease, rheumatic heart disease, valvular disease, cardiomyopathy, pulmonary heart disease, etc. may all cause atrial fibrillation. Hyperthyroidism is also one of the most common causes of atrial fibrillation, and age itself is a factor in atrial fibrillation. As we get older, even if we don’t have any disease, we may have atrial fibrillation. For example, Lao Bai in the United States has no basic heart disease. It is because of our old age that atrial fibrillation occurs.
Age is a factor that we cannot prevent. But for cardiovascular aspects, we can prevent it, such as early detection and early control of high blood pressure, regular treatment of various heart diseasesDisease, control of hyperthyroidism, etc. can prevent the occurrence of atrial fibrillation.
How to treat atrial fibrillation?
Most atrial fibrillation is incurable, which means that once atrial fibrillation occurs, most people have atrial fibrillation for life. Except for a few people who can cure atrial fibrillation through radiofrequency ablation, most people have atrial fibrillation for a lifetime.
Not all atrial fibrillation is suitable for radiofrequency ablation, only a small part of atrial fibrillation is suitable for radiofrequency, and the cost is high, the success rate is relatively low, and there is a possibility of recurrence.
Most treatments for atrial fibrillation fall into two categories:
1. Paroxysmal atrial fibrillation, that is, a burst of atrial fibrillation, and a burst of normal sinus rhythm. This type of atrial fibrillation is generally dominated by drugs to prevent atrial fibrillation, such as amines iodine, propafenone, etc.
2. Persistent or permanent atrial fibrillation, which is always atrial fibrillation. The main risk of atrial fibrillation comes from thrombosis, so antithrombotics are the mainstay. Currently, commonly used antithrombotic drugs: Warfarin, Dabigatran, Rivaroxaban, etc.
The drug that Ms. Zhao was given was anticoagulant, but Ms. Zhao thought that if she didn’t feel the pain, she didn’t need to take the drug. As we said above, with the continuation of atrial fibrillation, many people’s palpitation and heartbeat will disappear. So Ms. Zhao did not panic later and went for an electrocardiogram or atrial fibrillation. The absence of atrial fibrillation does not mean that there is no harm. As long as the heart is beating with atrial fibrillation, there will be a risk of thrombosis, and anticoagulant drugs will be taken for a long time or even life to prevent thrombosis and cerebral infarction.
The radiofrequency ablation surgery we mentioned above is a method for radical treatment of atrial fibrillation. In addition, left atrial appendage occlusion can also be selected according to the specific situation, which is a kind of prevention of thrombosis. shedding surgery.
In short, when we have arrhythmia and panic, do an electrocardiogram. If the electrocardiogram indicates atrial fibrillation, we must pay attention to it and need regular treatment to avoid atrial fibrillation. Cause thrombosis, leading to cerebral infarction, hemiplegia, coma, and regret!