| Atrial fibrillation has long been a kind of frequently-encountered arrythmia. It was reported that the incidence increases with the age. Atrial fibrillation can cause the disturbance of blood flow and produce symptoms of palpitation and short of breath, besides, it can also tragically induce or aggravate heart failure and predispose thromboembolism. Atrial fibrillation and its serious complications severely affect the life quality of the patients, and for this reason, it has been a hotspot of research all through both clinically and basically.Atrial fibrillation can be seen in patients with any kind of cardiovascular disease, and also met in "normal" people who do not show any evidence of cardiovascular or pulmonary disease. The mechanisms for the initiation and maintenance of atrial fibrillation are still not clear. "Maze procedure" was based on multiple-circuit reentry theory, while the catheter ablation of focal atrial fibrillation found its foothold in the concept of ectopic focus.Except for the treatment of fundamental cardiovascular disease, three aspectsshould be considered for dealing with atrial fibrillation: cardioversion and maintenance of sinus rhythm, rate control and stroke prevention.After cardioversion, the atrium resumes the normal function of contraction and relaxation, which can relieve or even eliminate the atrial fibrillation-induced symptoms and at the same time radically prevent thromboembolism after the normalization of blood flow. Therefore, atrial fibrillation once initiated, it should theoretically be restored to sinus rhythm. However, a large portion of patients cannot be given cardioversion attempt because of the long duration of persistent atrial fibrillation, notably enlarged left atrium or serious heart failure etc. Moreover, during the process of cardioversion, the risk of thromboembolism cannot be eliminated due to atrial stunning. For the reason mentioned above, the decision for cardioversion is restricted.Because rate control cannot restore the normal function of atrium, in the past it was selected only for those patients who was not eligible for cardioversion, who was given cardioversion but failed or who was difficult to maintain sinus rhythm after cardioversion. However, according to the results of AFFIRM, RACE and PIAF, Rhythm does not excel rate control, what's more, if with hypertension being the cause of atrial fibrillation, rate control should be the first choice for persistent atrial fibrillation.Of course, when rate control therapy is taken, blood flow stasis in left atrium will facilitate thromboembolism, therefore, positive strategy should be followed for stroke prevention. Anticoagulation agents are supposed to be introduced. Whereas anti-platelet agent Aspirin is also being widely used. Based on the results of several clinical trials like SPAF, non-rheumatic atrial fibrillation patients, once the age being ≥75 years old, having hypertension or a history of thromboembolism, should be given Warfarin for stroke prevention. As for those patients who do not have high risks of stroke mentioned above, Aspirin can be used instead of Warfarin.Other than the research work on the treatment of atrial fibrillation, its mechanisms of initiation and maintenance also arouse immense interest.In the past 50 years, multiple-circuit reentry has been the dominant conceptual model of atrial fibrillation. "Electrical remodeling" theory consolidates the foundation of multiple-circuit reentry and the success of Maze procedure also substantiates its rationality. However, we still cannot conclude that multiple-circuit reentry is the only mechanism for atrial fibrillation. Recently, focal atrial fibrillation of a pulmonary vein origin support ectopic theory, and catheter ablation based on this hypothesis has achieved great triumph.To make sure, the mechanism of atrial fibrillation has not been clear, and its treatment hasn't found the last word too. The focus of this research is on atrial fibrillation patients in our hospital. We hope the result can direct...
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