There is a kind of panic that may be "atrial fibrillation", and the elderly should be more vigilant

Expert of this issue: Cui Xiaoyun, chief physician of the Department of Cardiology, Oriental Hospital, Beijing University of Chinese Medicine

Emotional tension, strenuous exercise, heavy drinking... In our daily lives, there are many factors that may cause the heartbeat to accelerate and make us feel panic. However, if panic occurs without a clear cause, we have to consider heart-related diseases, such as "atrial fibrillation."

1. What is atrial fibrillation?

Atrial fibrillation is actually also called atrial fibrillation. Simply put, it is the irregular beating of the atria of the heart.

There is a part called the sinoatrial node in the upper right corner of the heart. The heart can beat because of it. It is like an engine, driving the heart to beat regularly. The sinoatrial node can issue instructions, and other parts of the heart will also issue instructions. We can call the sinoatrial node the central command center and the other places where electricity is generated the local areas. Under normal circumstances, the center controls the local areas, and the heart will be fine. When the sinoatrial node as the center becomes weak, or the power of other places that generate electrical activity becomes stronger, then things will get chaotic: the heart receives instructions from all directions, and the beating becomes irregular. The normal atrial rate of a person is 60-100 beats/minute. When atrial fibrillation occurs, the heart begins to beat irregularly, and the atrial rate can reach 350-600 beats/minute, causing the ventricular rate to accelerate. If you feel your heart is beating irregularly or tachycardia, or your blood pressure shows an irregular heart rhythm, or you have had a stroke, you must be alert to atrial fibrillation. [1]

This disease is very common, with a prevalence rate of about 1% among adults, but it is closely related to age, and the prevalence rate is significantly higher among the elderly. Studies have reported that the prevalence rate among the elderly over 75 years old is about 10%; and among the elderly over 80 years old, the prevalence rate is about 20%. [2]

2. What are the “danger signs” of atrial fibrillation?

1. Under normal circumstances, people cannot feel their own heartbeats, but when atrial fibrillation occurs, they may clearly feel their heart beating "bang bang".

2. The human pulse is normal and has the same strength. However, when atrial fibrillation occurs, the pulse will feel irregular, sometimes strong and sometimes weak, or there will be "missed beats".

3. Frequent symptoms of chest tightness and chest pain; feeling short of breath and breathlessness after a little bit of activity; easy fatigue and weakness; occasional dizziness, blacking out, and even fainting.

3. How to treat atrial fibrillation?
After atrial fibrillation is discovered, the cause of the condition should be treated. This includes controlling blood pressure, quitting smoking and drinking, and controlling weight. At the same time, treatment for atrial fibrillation should also be provided. Treatments for atrial fibrillation mainly include electrical cardioversion, drug therapy, and interventional ablation. [3]

Using electrical cardioversion can quickly restore normal sinus rhythm, but atrial fibrillation is prone to recurrence; taking antiarrhythmic drugs can also restore normal heart rhythm, but it is easy to relapse when the drug is stopped and the side effects are large. Relatively speaking, interventional ablation can cure atrial fibrillation, but ablation has certain risks, and some patients are prone to recurrence. Therefore, the doctor needs to choose the appropriate treatment method according to the patient's condition.

In short, atrial fibrillation is a very common disease, especially for the elderly. If there are "danger signs" of atrial fibrillation, go to the hospital for examination in time, intervene early if problems are found, and choose appropriate treatment under the guidance of a doctor.

References
[1] Huang Congxin, Zhang Shu, Huang Dejia, et al. Atrial fibrillation: current knowledge and treatment recommendations-2018[J]. Chinese Journal of Cardiac Pacing and Electrophysiology, 2018, 32(04): 315-368. DOI: 10.13333/j.cnki.cjcpe.2018.04.001.

[2] Guo Yutao. Current status and changes of clinical epidemiology and antithrombotic management of atrial fibrillation in the elderly in China[J]. Chinese Journal of Geriatric Cardiovascular and Cerebrovascular Diseases, 2017, 19(09): 988-990.

[3] Li Xiaoying, Ding Wenhui, Hua Qi, et al. Chinese expert recommendations on the diagnosis and treatment of atrial fibrillation in the elderly (2011)[J]. Chinese Journal of Practical Internal Medicine, 2012, 32(04): 260-270.