[Health Tip] Atrial Fibrillation Causing Stroke... "Young People Should Not Be Complacent"

Atrial fibrillation, known to occur mainly in the elderly, is now threatening younger generations as the age of smoking and drinking decreases. Atrial fibrillation is an arrhythmia in which the atria, the heart's auxiliary pump, fail to contract properly due to abnormal electrical signals, resulting in a very fast and irregular heartbeat. It is the most common yet feared arrhythmia. We explored atrial fibrillation with the help of Professor Choi Hyung-oh, a cardiologist at Soonchunhyang University Bucheon Hospital.

In the early stages of atrial fibrillation, symptoms may appear briefly in paroxysmal episodes and then disappear on their own. During this time, one may experience palpitations, shortness of breath, or chest pressure. If heart failure accompanies it, symptoms such as increased shortness of breath when lying down or swelling in the legs, known as peripheral edema, may occur. As atrial fibrillation progresses, it changes to a persistent form where the condition continues, but symptoms may no longer be felt. In such cases, it is often discovered incidentally during health checkups without clear symptoms, and patients may experience unexplained lethargy or chronic fatigue.

Professor Choi said, “The reason atrial fibrillation is dangerous is that it is a major cause of stroke,” adding, “Patients with atrial fibrillation have a fivefold higher risk of stroke, which can lead to severe neurological sequelae such as limb paralysis and cognitive decline compared to the general population.”

Atrial fibrillation occurs due to a combination of various factors. It is closely related to aging and is often accompanied by heart diseases such as hypertension, coronary artery disease, valvular disease, heart failure, and cardiomyopathy, as well as non-cardiac conditions like thyroid disease, obesity, diabetes, chronic lung disease, and sleep apnea. Lifestyle factors such as alcohol consumption and smoking also contribute.

Atrial fibrillation is generally diagnosed by measuring an electrocardiogram (ECG) when symptoms are present. Persistent atrial fibrillation can be detected by ECG even without symptoms, but paroxysmal atrial fibrillation is often difficult to capture during symptomatic episodes. Recently, Holter monitoring, which can record for 72 hours up to more than a week, is used for diagnosis.

Treatment of atrial fibrillation is broadly divided into stroke prevention and symptom control caused by atrial fibrillation. Patients with atrial fibrillation have a very high risk of stroke, and the risk increases with age and the presence of comorbidities, making stroke prevention crucial. The risk of stroke due to atrial fibrillation varies individually, so anticoagulant therapy decisions are made using a scoring system (CHADS2-VASc) based on the patient's age and comorbidities.

Professor Choi stated, “Many cases of atrial fibrillation occur in young people without special comorbidities due to excessive alcohol consumption. Alcohol is a major cause of atrial fibrillation, and the risk increases with higher alcohol intake. Smoking and secondhand smoke also worsen atrial fibrillation.” He advised, “Reducing alcohol consumption, quitting drinking and smoking, and maintaining healthy eating habits and exercise are essential to reduce the occurrence and recurrence of atrial fibrillation.”