How to prevent cerebral infarction when atrial fibrillation occurs? What should be paid attention to during drug treatment?

Atrial fibrillation is one of the common causes of cerebral infarction. Several friends suffering from atrial fibrillation asked Huazi if he could talk in detail about the treatment of atrial fibrillation, how patients with atrial fibrillation can prevent cerebral infarction, and what they need to pay attention to when taking medication?

Hua Zi said that atrial fibrillation is a common arrhythmia, which means that the atria lose their normal and orderly contraction and produce rapid and disordered tremors, resulting in the loss of the normal pumping function of the atria. The blood flow in the atria slows down and is prone to coagulation and formation of wall thrombi. After the thrombi fall off, they will form emboli, causing cerebral artery embolism.

1. Treatment of the primary disease A healthy person may also experience atrial fibrillation when they are emotionally excited, stimulated by alcohol, or overworked. However, the duration is usually very short, generally less than 48 hours, and the longest is no more than 7 days, and then it will recover on its own. This occasional atrial fibrillation is not harmful, so there is no need to worry too much, and no special treatment is required.

What we need to pay attention to is atrial fibrillation that persists for a long time and cannot be terminated by itself. Most of them are caused by diseases related to the heart, lungs, and endocrine system, such as coronary heart disease, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, chronic obstructive pulmonary disease (COPD), and hyperthyroidism, and the primary disease needs to be treated.

2. Drug treatment for atrial fibrillation The main cause of atrial fibrillation is the disorder of electrophysiology of myocardial cells, and the electrophysiology of myocardial cells is achieved through the influx or outflow of charged ions such as sodium, potassium, and calcium into or out of myocardial cells. Therefore, commonly used antiarrhythmic drugs include sodium channel blockers, such as propafenone; non-dihydropyridine calcium channel blockers (i.e., not "dihydropyridines"), such as verapamil and diltiazem.

There are also beta-blockers that can inhibit cardiac nerve excitation, such as melotol and bisoprolol; drugs that prolong the duration of action potential, such as amiodarone and sotalol; cardiac glycosides, such as digoxin, etc., which can all treat atrial fibrillation.

It should be noted that although there are many drugs to treat atrial fibrillation, there are also many causes of atrial fibrillation. Therefore, in the process of using drugs, some patients cannot achieve the effect of "drug cure", but need a "drug trial" process to find the drug that suits them. Moreover, for most patients, atrial fibrillation may recur after stopping the drug, so atrial fibrillation requires long-term and continuous drug treatment.

During the treatment, medications must be taken under the guidance of a doctor. Because these drugs act on the heart, they may cause bradycardia, or aggravate arrhythmias such as reentry enhancement and ventricular tachycardia. Self-medication or unauthorized adjustment of medications can easily lead to danger.

3. About surgical treatment of atrial fibrillation Some people have idiopathic atrial fibrillation, which refers to atrial fibrillation without obvious cause, normal heart morphology and other functions, and no obvious expansion or damage. For this type of idiopathic atrial fibrillation, synchronous direct current cardioversion, catheter ablation and other methods can be considered for conversion therapy.

However, for atrial fibrillation caused by atrial dilation with a clear cause, the effect of ablation may be worse. In addition, due to atrial dilation, the atrial wall will become thinner, and the risk of catheter ablation will be higher.

4. Anticoagulation treatment for patients with atrial fibrillation Some patients with atrial fibrillation cannot recover to normal heart rhythm, or atrial fibrillation recurs after medication or surgery. People with moderate to severe mitral valve stenosis, regurgitation, or mechanical valve replacement may also suffer from permanent atrial fibrillation. In addition to long-term medication to control atrial fibrillation, these patients also need long-term anticoagulation treatment to avoid wall thrombosis and prevent cerebral infarction.

Warfarin, rivaroxaban, and dabigatran are all commonly used anticoagulants. During medication, liver function and coagulation function need to be monitored to prevent liver damage and adverse reactions such as bleeding. Only by following the doctor's instructions and taking drug treatment under medical supervision can safety and effectiveness be ensured.

To sum up, people who have atrial fibrillation need to find out the cause of atrial fibrillation and treat the primary disease. There are many methods to convert atrial fibrillation, such as electrical cardioversion, ablation, and drug cardioversion, but a considerable number of patients will have recurrences of atrial fibrillation. For those whose atrial fibrillation cannot be converted, long-term anticoagulant therapy is required, which can effectively reduce the risk of cerebral infarction. Drugs need to be used under the guidance of a doctor to ensure safety and effectiveness. I am pharmacist Huazi, welcome to follow me and share more health knowledge.