心房纤颤

简介

心房纤颤, 也被称为心房纤颤或房颤, 是一种常见的心脏疾病，会引起心律失常(心律不齐). 它有时被描述为颤抖的心脏或跳动的心跳. A change in the electrical charge that travels through the heart’s upper chambers can cause the rhythm of the heart to get out of sync. 在某集节目中, 典型症状包括心悸, 呼吸急促（气促）, 虚弱可能会来了又去，或者持续很长一段时间. A Fib is a treatable condition that should be managed by a cardiologist to prevent serious complications, 比如血凝块, 心脏衰竭, 或中风. 房颤不会危及生命, but emergency treatment may be required at times to restore regular rhythm.

解剖学

The heart is an organ whose primary function is to pump blood throughout the body. It is divided into four sections called chambers, with two on top and two on bottom. Blood comes in through the upper chambers (atria) and exists through the lower chambers (ventricles). There are four valves that regulate the flow of blood through the heart. The lub-dub sound your heart makes with each beat is the sound of heart values opening and closing. The pumping action of the heart is controlled by electrical impulses from the sinus node, 让每一次心跳都以稳定的节奏开始.

When the heart receives irregular electrical impulses, the rhythm becomes irregular. It will start beating irregularly in an attempt to correct and restore the natural rhythm. 在心房纤颤的例子中, 房室结, 哪个连接上宫和下宫, 充满了电脉冲. 这导致心脏底部比顶部跳动得更快, 节奏就不同步了.

原因

心房颤动的原因是心脏的异常. In some cases a heart defect you are born with or cardiovascular disease of some kind can be the cause. 有心脏病发作史, 高血压, 甲状腺机能亢进, 酗酒会增加患病风险. Lung disease, pneumonia, and previous heart surgery are other possible causes.

People with an otherwise healthy heart and no other risk factors can also have atrial fibrillation. The arrhythmia is caused by “hot spots” on the heart that act like abnormal pacemaker cells. 它们发射快速电脉冲, causing the upper chambers of the heart to flutter or quiver instead of beating normally.

症状

患有心房纤颤的人可能没有任何症状, 使其难以检测和诊断. 在某集节目中, 典型的症状是绝食, 心率不齐, 通常被描述为胸部颤动的感觉. This is usually accompanied by 呼吸急促（气促）, weakness, and fatigue (extreme tiredness). You may also experience dizziness, sweating, lightheadedness, anxiety, and chest pain.

诊断

Some people may never know they have A Fib until their doctor examines their heart. 正常情况下，你的心跳稳定，而你根本察觉不到. 如果你突然注意到自己的心跳, it may be due to a change in the electrical impulses that regulate the rhythm. 一定要马上去看医生. Take note of how long and how often you notice your own heart beat and what it feels like.

实验室检查和心脏成像被用来确认诊断. Common tests used to diagnose AF include a blood work (to eliminate other possible causes), 胸部x光片, 心电图(ECG), 和超声心动图. You may need to wear a Holter or Event monitor to detect an arrhythmic event during a 24 to 48-hour period.

治疗

The type of treatment you need will depend on the frequency and severity of your symptoms. Most commonly, symptoms will last for less than a week, which can be managed relatively easily. But for some, the symptoms will last indefinitely, which requires a different treatment approach. The overall goal of treatment is the same – restore your natural rhythm and prevent complications, 就像血凝块.

有两种方法可以使用心律转复来重置心率. An electrical shock can be delivered to your chest to shock the heart back into sync, or special medication can be administered while your condition is monitored to see if your heart will reset on its own.

在让心跳恢复正常之后, your doctor may prescribe certain medications to address the cause of A Fib. Normal treatment includes an anticoagulant (blood thinner) to prevent blood clots and reduce the risk of stroke. Anti-arrhythmia medication may also be prescribed to help regulate your heart beat and prevent future episodes. 可能还需要联合用药来控制心率.

对于一些心房纤颤的病例, surgical intervention may be needed to repair diseased or damaged areas in the heart that restrict blood flow. 在修复过程中可以插入支架或起搏器. Or, a special technique can be used to create scar tissue on the heart to redirect electrical impulses because electricity cannot travel across scar tissue. This can be accomplished with a catheter ablation or surgical maze procedure. 这些疤痕是用射频、冷冻疗法或加热造成的. A catheter ablation can correct arrhythmias without the need for medication or an implantable device. Ablation of 房室结 may be an option if a catheter ablation doesn’t work. 外科迷宫手术需要心脏直视手术, 除非所有其他选择都失败了，否则不建议选择哪一种.

预防

Preventing atrial fibrillation is usually handled with anti-arrhythmia medication and simple changes in lifestyle, 比如把咖啡换成不含咖啡因的茶. 即使服用药物, 你仍然有中风的危险, 心脏衰竭, 还有其他严重的并发症如果你有心房纤颤. 如果有潜在的疾病, 比如引起你症状的甲状腺功能亢进, 治疗甲状腺可以预防或减少心房纤颤.

If you know that you are at risk for A Fib because of heart disease or certain risk factors, 最好的办法是避免服用刺激性物质, 像酒精, 烟草, 咖啡因, 还有一些药物. 你也应该吃有益于心脏健康的食物, 进行适当的锻炼, 保持健康的体重, 避免压力, 当然, 定期去看医生检查以控制症状.

我有风险吗?

Because atrial fibrillation is usually associated with cardiac abnormalities, 患心脏病会增加患病风险. 其他的危险因素包括心房纤颤家族史, 肥胖, 酒精滥用, 高血压, 还有一些慢性疾病，比如睡眠呼吸暂停, 糖尿病, 甲状腺亢进, 还有肺部疾病.