让我们谈谈心房颤动

Most of thetime, your heart beats like a champ, delivering oxygen-rich blood to your every nook and cranny. But, sometimes, irregular rhythms occur. Called arrhythmias, most are infrequent and harmless, like when your heart skips a beat during times of high stress. Others, though, can be life-threatening. Of these, atrial fibrillation is the most common. While “Afib” is incurable, the good news is that it can be managed with treatments—so never ignore your symptoms. The sooner you see your doctor, the better chance you’ll have to avoid dangerous complications from this condition. Have we got your attention? Good. Keep reading, and we’ll tell you everything we know.

Atrial Fibrillation

我们的专业面板

We went to some of the nation’s top experts in atrial fibrillation to bring you the most up-to-date information possible.

Daniel Cantillon, M.D.

Electrophysiologist

Cleveland Clinic

Cleveland, OH

Laurence M. Epstein, M.D.

System Director of Electrophysiology

Northwell Health

Manhasset, NY

Andrew Freeman, M.D.

Director of Cardiovascular Prevention and Wellness

National Jewish Health

Denver

无论如何是什么是心房颤动？

Bu-bump … Ba-bump … Ba-da-ba-bump.An arrhythmia is an abnormal heart rhythm. There are many kinds. Some arrhythmias you barely notice. Others are bothersome, if benign. But a few, like atrial fibrillation, can trigger dangerous symptoms that get progressively worse without treatment, putting your health—and sometimes, even your life—at risk.

Why? Because “Afib,” as this condition is often called, interferes with your heart’s ability to pump blood efficiently and effectively to the rest of your body, including your brain. With this disorder, the heart’s electrical activity can get super erratic. Instead of promoting healthy blood flow, your heart’s pump allows blood to pool and stagnate within the heart’s chambers.

The Centers for Disease Control and Prevention (CDC) estimate that anywhere from 3 million to 6 million Americans have atrial fibrillation. While it can occur at any age, it’s most common in adults over 65. It's also more common in men than women, although women with Afib are more likely to have a中风or early death.

To clearly explain why such a chaotic rhythm occurs, it’s important to first understand how the heart functions when it’s working properly.

In brief, the heart has four chambers:

• 在上面是right atriumandleft atrium(together, called theatria).

• On the bottom are theleftandright ventricles.

Those chambers work in tandem, employing a system of valves that open and close as your heart beats in order to bring blood in and pump blood out. Remember, the heart is a muscle, and when it’s healthy, it’s quite strong. As a pump, it provides sufficient pressure so that your entire blood supply, rich with oxygen and nutrients, cycles through your body every 60 seconds.

Your heart also has its own pacemaker that controls your heartbeats. It sends out electrical signals, which travel along a variety of pathways to your heart’s four chambers and elsewhere, telling the upper and lower chambers to beat on a fixed schedule. This allows blood to flow normally into, through, and out of your heart.

有时候，那些信号就会出错。在这些情况下，你的心可以开始跳过太快，太慢，或以不稳定的方式。这导致您的心脏效率不太有效地运作。

With Afib, rather than contracting in the rhythmic way that it should, the atria quiver, or fibrillate. The resulting haywire electrical signals that occur can reach the left and right ventricles and upset their rhythm, too.

Is Atrial Fibrillation Dangerous?

Left untreated, this erratic quivering can lead to serious—even life-threatening—health risks, including:

• Stroke:When your atria aren’t functioning properly, some of the blood that should be passing through them instead pools in the left atrium. That pooled blood can clot, and if one of those clots breaks away into your bloodstream, it can travel to your brain and cause a stroke. In fact, atrial fibrillation is the leading preventable cause of stroke.

• 心脏衰竭：Over time, your rapid and irregular heartbeat can weaken your heart and heighten your risk ofheart failure, which makes it progressively more difficult for your heart to pump an adequate amount of blood to the rest of your body.

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What Causes Atrial Fibrillation in the First Place?

有时,Afib发展即使你的心是perfectly healthy in the structural sense—the Cleveland Clinic estimates that this happens in one out of 10 cases—but most people who are diagnosed with it already have some form of heart disease or other health problem, including:

High Blood Pressure, a.k.a. Hypertension

当你有慢性高血压,你的他art must work harder to pump blood to the rest of your body. Over time, this extra strain causes your heart to enlarge and stiffen. This makes it more difficult for the heart’s electrical system to function properly. Atrial fibrillation may result.

Coronary Artery Disease (CAD)

从血管中构建的斑块产生的动脉缩小和加强 -叫做CAD.-often导致心脏病发作，这损害了心脏组织。反过来，损坏可能会干扰心脏的电气系统并引起心房颤动。

Congestive Heart Failure

When your heart is failing, your atria can thicken and scar over time, which makes it harder to conduct electricity. That can lead Afib.

电气问题

No, this is not your 50-watt light bulb type of current, but rather an electrical stimulus that travels down through the heart’s conduction pathways to help your ventricles pump out blood. With this current goes rogue (stress, diabetes, sleep apnea, hypertension, or other health problems are common culprits), contractions can begin in the wrong area of the heart, or the current doesn’t flow in an organized, top-to-bottom way, causing the heart to quiver, or fibrillate.

Heart Valve Disorders

Like high blood pressure, heart valve disorders can cause parts of your heart to enlarge, increasing your risk of atrial fibrillation. Valve problems can be present at birth, or be caused by infection, aging, or injury.

Hyperthyroidism

When you have an overactive thyroid, or hyperthyroidism (a.k.a. Graves’ disease), you’re at higher risk of atrial fibrillation. Why? Your thyroid gland produces hormones involved with setting your heart’s pace. When too many of those hormones get produced, fast and irregular heartbeats can result.

What Are the Risk Factors for Atrial Fibrillation?

We know that certain health problems, like hypertension and CAD, can lead to Afib. But what are the risk factors that might give you a greater chance for developing this unsafe heart rhythm? They include:

Diabetes

联系的原因仍然尚不清楚，但它认为糖尿病也增加了心脏病的风险，可能会影响你的心脏系统的工作方式。

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Your heart has to work harder when you carry more weight. This can lead to its enlargement, making your ticker more prone to atrial fibrillation. Obesity also can cause inflammation in the heart, which in turn may cause scarring that affects the way the heart conducts electricity.

Sleep Apnea

睡眠呼吸暂停引起的中断呼吸起到开发高血压和糖尿病的几率。它也可能直接影响你的心，部分地通过通向扩大的上腔室，这可能有助于心房颤动。

年龄较大的年龄

The older you get, the weaker your heart muscle becomes, raising the odds of system malfunction. Also, aging raises the likelihood of developing conditions that put you at risk of atrial fibrillation, such as heart disease and diabetes.

Family History

如果您有一个紧密的亲戚，例如父母或兄弟姐妹，具有心房颤动，您自己的风险比正常高约40％。

Stimulants

有些人对兴奋剂敏感，这增加了心率和血压，可以触发AFIB插曲。These include what you’d expect (caffeinated beverages like coffee and energy drinks, as well as illicit drugs like cocaine), and also what might surprise you (certain over-the-counter cold medications, semi-legal drugs like marijuana, and even alcohol).

Binge Drinking

Speaking of alcohol, binge drinking can cause what’s known asholiday heart syndrome, in which excessive booze can trigger an episode of atrial fibrillation. It’s not clear why alcohol has this effect, but in general the bigger the bender, the higher the risk.

What Are the Symptoms of Atrial Fibrillation?

The first thing you should know is that you can have atrial fibrillation and experience no symptoms at all. In other words, your heart may be beating chaotically, but you don’t always feel it. What you may feel: Fatigue, weakness, and shortness of breath—the result of your heart not being able to keep pace with your body’s demands for the oxygen that your blood delivers.

Still, such symptoms are pretty vague, and can be written off as signs of getting older, of slowing down with age. (Once properly diagnosed and treated, people are often amazed at how much stamina they recover.) Other symptoms of atrial fibrillation may include:

胸痛

This happens when the heart does not get enough oxygen during an episode of atrial fibrillation.

Palpitations

This is a sensation of feeling like your heart is beating erratically or too rapidly, which usually occurs when your heart rate tops 120 beats per minute. It can be quite unpleasant.
For some people, such symptoms can be debilitating, causing extreme fatigue and even leading to blacking out. Head straight to the emergency room if you experience any of the following:

• Dizziness

• Fainting

• Uncomfortable chest pain

• And/or severe shortness of breath

心房颤动的阶段是什么？

AFIB通常从突然但短而不常见的剧集开始。他们在心脏恢复正常节奏之前持续约5到10分钟。但这种情况一般随着时间的推移而恶化。剧集变得更频繁，心脏不太可能自己恢复正常节奏。有些人不会被诊断出患有心房颤动，直到他们已经有了中风。

Atrial fibrillation has four types, or stages:

1. Paroxysmal:Early on in this first stage, episodes might last just a few minutes. But over time, they become more frequent and last longer, eventually lasting hours or days. Usually, they stop on their own.

2. Persistent:In the second stage, an episode of atrial fibrillation needs medical intervention in order to stop it and return your heart to normal.

3. Long-Term Persistent:一旦你有持久的心房颤动超过一年，你已经进入了这个阶段。

4. Permanent:In this stage, your heart’s rhythm can’t be restored to normal; it remains in atrial fibrillation. Medications can help moderate your heart rate and also reduce your risk of blood clots and stroke.

Because symptoms of Afib are not always noticeable, many people with this condition can cruise right through the paroxysmal stage and not even know it until they’re diagnosed at a later stage that requires medical intervention. Others, like those with overactive thyroid disorders (such as Graves’ disease) may actually begin in the persistent stage.

What’s important to know is that Afib varies from person to person, and that doesn’t just refer to how the condition begins and advances—but also to the frequency and severity of episodes, too. You might have an Afib event only once a year, for example, while someone else could go into and out of atrial fibrillation several times a day. Both of you could require medical intervention to right your rhythm—or either of your rhythms may right themselves, depending on the stage you’re in. Like we said, how Afib plays out is as individual as those who have this condition.

医生如何诊断心房颤动？

与大多数医疗问题,早些时候diagnosed, the better. You may not progress to the second stage of the disease if it’s caught and treated right away, and you likely will have longer intervals between episodes. As noted above, though, atrial fibrillation is tough to catch early because symptoms are minimal. Once you get to the doctor, diagnosis is pretty straightforward. Here’s what your visit will likely entail:

Physical Exam

Your doctor will review your symptoms and your health history, including any previous episodes of fainting, dizziness, or shortness of breath. You’ll also be asked about your family’s heart health.

Bloodwork

Your doctor also will run blood tests to see if you have an overactive thyroid, which can trigger atrial fibrillation.

心电图（ECG）

This painless test provides a view of your heart’s electrical activity. If you are in an episode of Afib, your doctor will spot it right away.

Portable ECG Devices

如果您是AFIB剧集不常见，如果您在预约时没有一个，您的医生将为您提供便携式的ECG设备，您将在几天到几周内穿。一种称为Holter Monitor的类型，连续记录了几天内的电气活动。然后分析那些记录，用于表现出心房颤动的异常。另一方面，事件记录器必须由症状开始发生时的人激活。他们可以佩戴大约一个月。

Echocardiogram

This is a test that uses sound waves to produce a picture of your heart. It can reveal problems with your heart’s structure, such as heart valve disorders, as well as the presence of blood clots.

Stress Test

This is an exercise test you take while you’re hooked up to a heart monitor. You’ll be asked to walk on a treadmill, gradually increasing your pace and the incline until it feels like you’re walking up a small hill. This makes your heart work harder. Your doctor will monitor your blood pressure, heart rate, and any discomfort you feel to identify any possible signs of Afib.

What Is the Best Treatment for Atrial Fibrillation?

The most critical goal of treatment: reducing your risk of stroke due to Afib, which can be fatal. Your doctor also will want to regulate your heart rate and rhythm so that your heart beats normally. Treatments include:

Antiarrhythmic Medications for Atrial Fibrillation

这些药物用于恢复和/或保持心脏的正常节律。您可能需要在开始这些MEDS时留在医院，以便可以监控您以确保他们对您安全有效。存在几种药物，所以如果一个人不起作用或停止工作，你有选择。它们包括：

• Betapace (sotalol)

• Cordarone (amiodarone)

• Norpace (disopyramide)

• Pronestyl (procainamide)

• Rythmol（Prophafenone）

• Tambocor (flecainide)

• Tikosyn（Dofetilide）

Rate Control Medications for Atrial Fibrillation

这些药物被规定减缓了太快的心率：

• Beta blockerssuch as Lopressor and Toprol XL (metoprolol) and Brevibloc (esmolol)

• Calcium channel blockerssuch as Calan, Verelan, and Verelan PM (verapamil) and Cardizem, Cardizem CD, Cardizem LA, Cartia XT, Dilacor XR, and Tiazac, (diltiazem)

• Digoxin, such as brands Digox or Lanoxin, though less effective than the above, may be prescribed if you have heart failure.

Anticoagulant Medications for Atrial Fibrillation

食疗药物如Coumadin（Warfarin），Eliquis（Apixaban），Plavix（Clopidogrel），Xarelto（rivaroxaban）和肝素，以及反击内阿司匹林，可以防止凝血并降低中风的风险。

Procedures for Atrial Fibrillation

有时候，药物治疗并不完全诀窍，或者你的医生认为你是一个很好的手术候选人，以便完全停止你的AFIB剧集。这些侵入手术包括：

• Electrical Cardioversion

  A jolt of electricity stops your heart’s electrical activity briefly to reset your heart’s rhythm and halt an Afib episode. Your doctor will sedate you so that you don’t feel any discomfort during the procedure. You may need to take an anticoagulant for a few weeks before and after the procedure to reduce the risk of dislodging a blood clot already in your heart, which would allow it to travel to your brain and cause a stroke.

• Catheter Ablation

  Your doctor inserts a long, thin tube, called a catheter, into a vein near your groin and threads it to your heart. Once there it delivers radiofrequency energy, heat, or extreme cold to kill tissue and create scarring that seals your heart’s rogue electrical pathways so your rhythm can return to normal.

• AV Node Ablation

  In this procedure, a catheter is used to destroy the part of the heart that enables electricity to pass from your heart’s upper to lower chambers. This will slow your heartbeat, but you will need an artificial pacemaker permanently implanted to activate your heart’s lower chambers, or ventricles.

Can Lifestyle Changes Help With Atrial Fibrillation?

照顾你的心也会有助于缓解你的交通界。事实上，上面列出的治疗将更加成功，当您解决充满风险的任何生活方式因素时。

管理其他健康状况

首先是最重要的？留在其他可能导致心房颤动的健康问题之上。这包括糖尿病，睡眠呼吸暂停和高血压。与您的医生讨论正确的方法，以治疗所有潜在的健康问题，以最好保护您的心脏。

Lose Weight

All those extra pounds, while difficult to shed, can strain your heart and trigger Afib—and potentially a stroke, too. We know it’s difficult, but do everything you can to lose weight. Try interactive apps likeNoomorWeightWatchersto help you do it.

Get Quality Sleep

Your heart health relies on consistent, quality zzz’s, so hit the sack each night for 7 to 9 hours. If you have sleep apnea, ask your doc about the CPAP (Continuous Positive Airway Pressure) machine, which keeps healthy airflow going all night long. With consistent use, it has been shown to help prevent dangerous arrhythmias and protect your heart from hypertension and heart failure.

Exercise Regularly

Regular exercise conditions and strengthens your heart, which in turn can help with your heart rhythm. If you’re concerned about triggering an Afib episode with too-intensive cardio, speak to your doctor about taking a stress test, or simply go for power walks instead.

管理压力

Emotional duress and high bouts of stress have been shown to be big Afib triggers. Make a point of decompressing every day with mindful meditation, deep breathing techniques, yoga, a walk with a friend, or other activities you enjoy—gardening, oil painting, cooking with your kids!—that help you to unwind and let go of the worries of the day.

Limit or Quit Caffeine and Alcohol

Arrhythmias can be set off in some people by even small amounts of stimulants like caffeine. If you have afib, try decaf brew in the morning, or limit your daily intake to just a single cup of coffee or black tea. Alcohol can act as a stimulant, too—and booze, even in small amounts, has been shown to be a common trigger for atrial fibrillation in some people. Talk to your doctor about the right amount for you.

What’s Life Like for People With Atrial Fibrillation?

Episodes of atrial fibrillation can sap you of your energy and make you less able to be active. But treatment likely will restore your stamina, as it gets your heart pumping blood normally once more. Make sure that you stick to the medication schedule your doctor gives you.

And if you have a romantic partner, you most likely can—and should!—enjoy a regular sex life. In fact, most doctors think sexual activity is good for the heart. If you’re fit enough to climb a few flights of stairs, you’re likely fine in the bedroom, too. Talk to your doctor (no blushing!) about what’s best for you.
Episodes of atrial fibrillation can occur randomly, but they can also be triggered, so you’ll want to pay attention to what’s going on when one starts—whether that’s stress or alcohol or even moderate exercise.

Above all, be aware of the symptoms of stroke, which come on suddenly. Call 911 immediately if you suspect you’re having one. Here’s what to watch for:

• Numbness or weakness on one side of your body

• 麻烦形成单词和糖类言论

• Drooping on one side of your face

To help remember these symptoms, think of the acronymFAST, which stands for:

• Facial drooping

• 手臂弱点

• Speech difficulties

• Time to call 911

With the possibility of stroke ever-looming, many people with atrial fibrillation report feeling anxious or even depressed. The American Heart Association offers anAfib digital community连接人与这个条件就不是alone. Sometimes sharing common fears and concerns with others who understand them is enough to make you feel better about life—which is waiting for you to go out and experience to the fullest, Afib or not.

Meet Our Writer

马特麦克米伦

马特麦克米伦has been a freelance health reporter since 2002. In that time he’s written about everything from acupuncture to the Zika virus. He covers breaking medical news and the latest medical studies, profiles celebrities, and crafts easy to digest overviews of medical conditions. His work has appeared, both online and in print, in华盛顿邮政,WebMD Magazine,Diabetes Forecast,AARP, and elsewhere.

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