[Health Tip] Atrial Fibrillation with Fine Heart Tremors... Risk of Causing Cerebral Infarction

If you suddenly experience a trembling heartbeat, you should suspect atrial fibrillation, a type of arrhythmia. Aging is the main cause, with patients increasing from about 5% in their 60s to approximately 15% in their 80s. As the elderly population rapidly grows, there are concerns that the number of patients will rise significantly, similar to hypertension. With the help of Professor Jin Eun-seon from the Department of Cardiovascular Medicine at Gangdong Kyung Hee University Hospital, we explored atrial fibrillation.

Professor Jin Eunseon

Arrhythmia refers to a condition where the heartbeat is irregularly fast or slow. The range of arrhythmias is very broad, from those causing sudden death on the spot to those that can be ignored. Atrial fibrillation is one of these arrhythmias. Although atrial fibrillation is a common condition experienced by 10-15% of elderly people, many cases are left untreated, so caution is necessary. Since it can lead to cerebral infarction, early diagnosis and treatment are important.

Electrocardiogram (ECG) testing is useful for persistent atrial fibrillation, where symptoms last all day, but it has limitations for paroxysmal atrial fibrillation, which occurs occasionally. The ECG must be taken when atrial fibrillation is triggered. For such patients, a Holter monitor test, which involves attaching an ECG device to the body and recording for one or two days, is recommended. The ECG device is attached to the chest for 24 to 72 hours to record the pulse. There are also devices that measure for longer periods such as 3 days, one week, or two weeks. If symptoms occur only a few times a year, a portable ECG device can be carried and used when arrhythmia occurs. Additionally, there is an implantable ECG recording device inserted under the skin near the heart, which can record for up to 3 years.

Smartwatches with ECG functions are very useful for diagnosing arrhythmias. If you feel an unusual pounding sensation, you can immediately take an ECG with a smartwatch, or even if there are no specific symptoms but a warning about arrhythmia appears, it is good to take an ECG. However, Professor Jin Eun-seon added, “since smartwatches often misinterpret results, do not fully trust the smartwatch readings. Instead, print out the ECG and bring it to the hospital to get a specialist’s opinion.”

Treatment for atrial fibrillation proceeds mainly in two directions. One is anticoagulant therapy to prevent blood clots. Factors such as the presence of comorbidities like diabetes or hypertension, age, and history of cerebral infarction are considered to score the risk, and if the risk of clot formation is high, medication is prescribed. The other is treatment of the atrial fibrillation itself. In cases of paroxysmal atrial fibrillation, where episodes come and go, it is relatively early, so medication is used to actively maintain a normal rhythm. For patients whose arrhythmia strongly recurs despite medication, radiofrequency catheter ablation or cryoballoon ablation is performed to cauterize the affected area.