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[Kuala Lumpur]

Do you often feel irregular heartbeat or a flip-flopping in your chest, and may even be accompanied by symptoms such as dizziness, chest tightness, and difficulty breathing?

Be careful, your heart “circuits” may be out of order, and you may have suffered from atrial fibrillation (AF) without knowing it. The coronary arteries are the main conduits for nutrition to the heart. The strong door wall is the heart’s various heart valves, and the heart wall is full of “circuits” like a house. The circuit of the heart is equivalent to our heartbeat. Normal and regular heartbeat only can ensure the normal and smooth operation of the heart’s “circuit”.

When the circuit is disordered or the heartbeat rhythm is abnormal, it will cause AF (also referred to as Atrial Fibrillation) is the most common arrhythmia in clinical practice.

Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Cardiologist and Cardiac Electrophysiology Specialist, Datuk Dr Razali Omar bluntly stated that many people have ignored the danger of atrial fibrillation: ” Decades ago, people did not pay much attention to the problem of atrial fibrillation, and even considered this disease as one of the ageing processes. However, advances in medicine and more global data show that atrial fibrillation is a dangerous disease, which may cause heart failure, stroke, and even death, and it also seriously affects the quality of life of patients.”

He urged the public to learn to measure the pulse at their wrists and learn to master the speed, the regularity, and the strength of their pulses. If they feel anything unusual or feel unwell, they should consult a doctor for further examination as soon as possible. In life, we should try to prevent or avoid the risk factors that cause atrial fibrillation. Besides, you can consider using mobile ECG, wear a mobile ECG monitor on your wrist to monitor your heart rhythm for a long time, clearly record it and provide it to the doctor during the consultation for more comprehensive evaluation and monitoring.

Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Cardiologist and Cardiac Electrophysiology Specialist, Datuk Dr Razali Omar believe that the public should pay attention to the risk of atrial fibrillation, early diagnosis with suitable treatment can help prevent serious complications such as stroke, heart failure, and eventually may help reduce the risk of death.

Datuk Dr Razali Omar: Treatment Delay May Worsen

Maybe you think that atrial fibrillation is nothing, just an irregular heartbeat, which is no big deal, but actually, you are wrong!

One of the greatest dangers of atrial fibrillation is stroke. In fact, stroke caused by atrial fibrillation is more harmful than a stroke caused by atherosclerosis such as hypertension. Under normal circumstances, our heart contraction and relaxation are coordinated, but when atrial fibrillation occurs, the blood in the atrium will stagnate and form a thrombus. This kind of thrombus from the atrium is often larger in size. Once the thrombus flow with blood enters the brain, the ​​brain tissue leads to necrosis, and it will cause serious consequences such as stroke or death. What’s more worrying is that atrial fibrillation is getting in the younger generation.

Datuk Dr Razali Omar said bluntly that there were not many patients with atrial fibrillation in clinical outpatient clinics in the past 20 or 30 years ago, and most of them were elderly patients. This pattern has changed in recent years, and recently more young people are facing atrial fibrillation and Its risk of complications.

Datuk Dr Razali Omar also pointed out that the actual incidence of atrial fibrillation may be higher than the statistics. The reason is that some patients have not obvious symptoms, so they have not received the proper diagnosis and treatment, especially young patients who are not aware that they may have atrial fibrillation problems: “This is a progressive disease. If it is not treated in time, it may worsen. Once it worsens, the episodes of atrial fibrillation will be more frequent and the duration of each episode will be longer. Therefore, immediate treatment is very important. If atrial fibrillation develops to be persistent or permanent, treatment becomes more difficult.”

Thrombosis must be prevented

Besides that, he emphasized that all treatments for atrial fibrillation require pre-assessment of the patient’s risk of stroke to further develop an appropriate treatment plan: “If the assessment shows that the patient’s risk of stroke is low, the focus can be on treating atrial fibrillation, but if confirmed patients have a higher risk of stroke, so they need to formulate a stroke prevention and management plan, start with anticoagulation therapy as soon as possible, and then decide the treatment plan for atrial fibrillation according to individual circumstances.”

In short, atrial fibrillation requires early diagnosis and early treatment. When formulating a treatment plan, the prevention of thrombus must not be ignored. Appropriate drugs or Catheter Ablation therapy must be taken according to the patient’s condition to control the heart rhythm and avoid irreversible strokes, heart failure, etc.

According to data from a study published by MedSpace, people aged 40 or above may have about a quarter probability of developing atrial fibrillation in their lifetime. The prevalence of atrial fibrillation is more closely related to the increase in diseases such as stroke and heart failure, and its incidence will increase with age. According to predictions, by 2050, atrial fibrillation will become one of the most popular cardiovascular diseases.

In another word, the harm of atrial fibrillation is manifold. Statistics show that atrial fibrillation may not only induce severe stroke (the risk of stroke increased by 5 times) and heart failure (the risk of heart failure increased by 3 times), the disability rate and fatal also extremely high. And it is also a heart disease that causes a huge burden on society and individuals!

Catheter ablation therapy is one of the most common and recognized treatment strategies that can effectively reduce the risk of triggering atrial fibrillation.

High success rate with early treatment

The main purpose of atrial fibrillation treatment is to try to restore normal sinus rhythm, control the ventricular heart rate within a relatively normal range, and prevent the formation of thrombosis. At present, the treatment of atrial fibrillation mainly includes drug therapy and non-drug therapy. Drug therapy mainly includes antiarrhythmic drug therapy and anticoagulant drug therapy, while non-drug therapy mainly includes: electrical cardioversion therapy (external electric shock), catheter ablation therapy and surgical treatment.

Catheter ablation therapy is one of the most common and recognized effective treatment strategies in recent years helps to reduce the risk of triggering atrial fibrillation. This is a minimally invasive interventional treatment. Through a tiny puncture in the groin, a catheter is sent into the atrium through a vein or artery to ablate the diseased cells, and necrosis the cardiomyocytes at the target site help to prevent the transmission of abnormal electrical signals. This can help to treat atrial fibrillation.

Catheter ablation surgery must be performed by a cardiologist (cardiac electrophysiology speciality) who specializes in arrhythmia examination and treatment, and it must also be performed in a dedicated cardiac catheterization laboratory (Cath-Lab). Patients usually need to receive local anaesthesia (injection of anaesthetic at the puncture site) and intravenous sedation.

In other words, atrial fibrillation is like a circuit problem in the house, which requires a professional cardiac “electrician” to treat it. Datuk Dr Razali Omar emphasized that the success rate and cure rate of atrial fibrillation diagnosed and correctly treated in the early stage are relatively higher!

Know more about Atrial Fibrillation

What is Atrial Fibrillation?

Atrial fibrillation is one of the most common arrhythmias in clinical practice, and its incidence increases with age. The human heart is divided into left and right atria and left and right ventricles. The sinoatrial node located in the upper right atrium will regularly send out pulse commands. After a short delay in the atrioventricular node, the electrical signal reaches the entire heart through the conduction system, causing the heart to produce synchronized and coordinated contractions. Every time an impulse occurs in the sinus node, the heartbeats once. It is called “sinus rhythm” in medicine. Sinus rhythm is one of the indicators of normal heart activity. The normal heart rate of the human body is rhythmically beating 60 to 100 times per minute. When atrial fibrillation occurs, the atrium loses its normal and effective contraction function and no longer beats regularly, but becomes irregularly trembling, with a frequency per minute. It may be as high as 300 to 600 times, in a state of rapid turbulence.

 

Atrial Fibrillation Classification

Atrial fibrillation is mainly classified according to the onset time of atrial fibrillation:

  • Paroxysmal atrial fibrillation

The onset of atrial fibrillation lasts within 7 days, mostly within 48 hours, and can return to sinus rhythm on its own.

  • Persistent atrial fibrillation

The attack of atrial fibrillation lasts more than 7 days and requires medication or an electric shock to convert to sinus rhythm.

  • Long-term persistent atrial fibrillation

Cannot terminate on its own or relapse after termination.

How is atrial fibrillation diagnosed?

The diagnosis of atrial fibrillation is mainly based on the ECG examination and clinical manifestations of the patient at the onset. Besides, to understand the cause of atrial fibrillation, or determine whether there are other complications and risk factors, the doctor may need to do some related tests, such as blood tests (check whether there are other conditions that may cause atrial fibrillation, such as abnormal thyroid function), X-ray imaging examination (to check whether the heart is enlarged or whether there is lung disease), 24-hour dynamic electrocardiogram (which can record the heart rhythm when symptoms appear, determine whether there is atrial fibrillation and the duration of atrial fibrillation), cardiac ultrasound examination (Check whether the structure and function of the heart valve are abnormal, whether there are blood clots in the heart, etc.), CT scan of the heart, etc.

 

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