[Kok! Health] 'Atrial Fibrillation' Causing Cerebral Infarction, Accurate Diagnosis Starting with Electrocardiogram Examination

Heart Palpitations and Chest Tightness
Blood Clots Can Block Cerebral Blood Vessels
Abstinence from Alcohol and Smoking Is the Best Prevention

[Image source=Pixabay]

[Asia Economy Reporter Lee Gwan-joo] Atrial fibrillation, one type of arrhythmia, refers to a condition where the normally regular heartbeat suddenly becomes rapid and irregular. It is becoming common due to population aging, and there are even concerns that it may become as widespread as hypertension in the future. Although atrial fibrillation itself is not a dangerous condition that causes sudden death, it can lead to cerebral infarction by forming blood clots that block cerebral blood vessels, making early diagnosis and treatment very important.

The heart can be described as a pump that circulates blood regularly throughout the body. The sinoatrial node, located in the upper chamber called the atrium, generates electrical signals that cause the lower chamber, the ventricle, to contract regularly. However, when electrical signals spark like fireworks from other parts of the atrium instead of the sinoatrial node, the atrium trembles faintly. The ventricles are also affected, preventing blood from being forcefully ejected. This phenomenon is called atrial fibrillation.

"Heart palpitations and shortness of breath" - Attention Needed for Atrial Fibrillation

It mainly causes the heart to beat irregularly or palpitate, creating a feeling of anxiety. Due to decreased cardiac output, patients may feel chest tightness, shortness of breath, or weakness. Sometimes, there may be no symptoms at all. Because of this, patients often become confused when atrial fibrillation occurs. They may fear that their heart will stop, but atrial fibrillation does not immediately stop the ventricular heartbeat. When the upper chamber (atrium) trembles, the lower chamber (ventricle) also beats irregularly for a short time, but it does not cause sudden death.

However, it should not be ignored as it can lead to cerebral infarction. About 30% of patients with atrial fibrillation experience at least one stroke in their lifetime. When the atrium trembles, blood inside cannot flow down to the ventricle and pools, causing blood clots to form. If these clots break off and travel through blood vessels to block cerebral arteries, it leads directly to cerebral infarction. Without prompt response, serious aftereffects or death may occur.

Jin Eun-seon, Professor of Cardiology, Kangdong Kyung Hee University Hospital.

Accurate Diagnosis with Electrocardiogram (ECG) Testing

Early diagnosis and appropriate treatment of atrial fibrillation are crucial. It is usually diagnosed through an electrocardiogram (ECG). Persistent atrial fibrillation, where symptoms last all day, can be easily diagnosed with an ECG. However, for paroxysmal atrial fibrillation that occurs occasionally, patients undergo ambulatory ECG monitoring by attaching electrodes to the body to continuously record heart activity. This test can be conducted for periods ranging from 1 day to 2 weeks, playing a decisive role in detecting arrhythmias. If symptoms occur only a few times a year, a portable ECG device can be used to record arrhythmias when they happen. There is also an implantable ECG recorder, which involves placing a small chip under the skin near the heart, capable of recording for up to 3 years.

Treatment proceeds in two main directions. One is anticoagulant therapy to prevent blood clots. If the risk of clot formation is judged to be high based on the presence of comorbidities such as diabetes or hypertension, age, and medical history, medication is prescribed. The other is treatment of atrial fibrillation itself. In the early stages, medication is used to actively maintain a normal rhythm. If arrhythmia persists strongly despite medication, radiofrequency catheter ablation or cryoballoon ablation is performed.

To prevent atrial fibrillation, quitting smoking and alcohol is best. Professor Jin Eun-seon of the Department of Cardiovascular Medicine at Gangdong Kyung Hee University Hospital emphasized, "Excessive drinking can directly cause atrial fibrillation, so reducing or stopping alcohol consumption is more important than any other treatment," adding, "If you experience palpitations, do not just worry but get tested immediately."