Coronary heart disease, atrial fibrillation, how to take warfarin

If atrial fibrillation is caused by hyperthyroidism, can radiofrequency ablation be performed**Patient: Atrial fibrillation caused by hyperthyroidism, can radiofrequency ablation be performed**?

Liu Shaowen, Department of Cardiology, Shanghai First People's Hospital: If hyperthyroidism has been ** and there is still atrial fibrillation, catheter ablation can be considered, and its absolute contraindication is mainly left atrial thrombosis. View the original post

What tests are needed for atrial fibrillation?Patient: What tests are needed for atrial fibrillation?Yu Mengyue, Department of Cardiovascular Medicine, Beijing Fuwai Hospital: Yu Mengyue, Department of Cardiovascular Medicine, Beijing Fuwai Hospital Please check the echocardiography** and 24-hour ECG monitoring first.

Any idea what these are?I researched this for an afternoon. There are a lot of styles, atrial fibrillation sinus axis left and right eccentric ventricular high voltage... That's it.,There's still interference in the magnetic field.,The head is bigger.。。。 View the original post

Patients with atrial fibrillation: How to atrial fibrillation?Liu Shaowen, Department of Cardiology, Shanghai First People's Hospital:

Liu Shaowen, Department of Cardiology, Shanghai First People's Hospital, should first rule out abnormalities of the thyroid gland, if there is no abnormality, you can first choose drugs**, if atrial fibrillation is not well controlled, catheter ablation can be considered**. View the original post

Antiarrhythmic drugs (propafenone) prolong the duration of action potentials and the effective refractory period, reduce the spontaneous excitability of the myocardium, reduce automaticity, and slow down conduction velocity. In addition, it also blocks receptors and L-type calcium channels, and has a mild negative inotropic effect. It is used for supraventricular and ventricular tachycardia and premature contractions, and patients with pre-excitation syndrome with tachycardia or atrial fibrillation.

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When atrial fibrillation occurs, the control function of the sinus node is lost, and another bioelectricity is emitted by a certain part of the atrium, which is fast and irregular, causing the atrial contraction to stop, causing the ventricles to beat quickly and irregularly, up to 100-150 times, and as fast as 200 times, and the heart rate and pulse rate are not consistent. Because the original rhythm of the atrium disappears, it cannot contract regularly, which not only affects the heart function, but also tends to grow blood clots in the atrium, and once the thrombus falls off, it will cause acute embolism of the peripheral arteries, and embolization to the brain will cause stroke.

Therefore, if patients with atrial fibrillation cannot be effectively anticoagulated**, the risk of stroke will be increased.

Warfarin is an anticoagulant that prevents blood clots. Warfarin was associated with a 68% reduction in stroke and a 33% reduction in overall case fatality in patients with atrial fibrillationHowever, the biggest complication of warfarin is bleeding, taking warfarin needs to monitor the coagulation function, pay attention to the international standardized value (INR), control if you also take traditional Chinese medicine such as salvia, ginkgo, ginseng and licorice while taking warfarin, you need to reduce the amount of warfarin, because these traditional Chinese medicine ingredients can enhance the anticoagulant effect of warfarin, while American ginseng weakens the anticoagulant effect of warfarin, and warfarin needs to be increased appropriately when taking American ginseng.

Suggestion: Hello. Warfarin is an anticoagulant that prevents blood clots. Warfarin was associated with a 68% reduction in stroke and a 33% reduction in overall case fatality in patients with atrial fibrillation

In recent years, with the development of aging society, the incidence of atrial fibrillation has shown a significant upward trend. Studies have shown that atrial fibrillation causes 5 times more ischemic stroke than non-AF patients. At present, the prevalence of AF in China is about 70-year-old AF patients, and the incidence of ischemic stroke is as high as that of hospitalized AF patients over 80 years old.

Anticoagulants and antiplatelet drugs are effective means to prevent stroke in atrial fibrillation, and a large number of randomized clinical studies have confirmed that warfarin sodium tablets are more effective, and the use of warfarin in patients with AF over 75 years of age is more effective than antiplatelet drugs to reduce stroke, and does not increase the risk of bleeding. So, what is the effect of the combined use of warfarin sodium tablets + aspirin in patients with coronary heart disease AF to prevent stroke? Is it safe?

A pooled analysis of 31 randomized clinical studies completed up to 1999 showed that warfarin sodium tablets were not superior to aspirin alone at low-intensity anticoagulant INR plus aspirin, and warfarin sodium tablets + aspirin were superior to aspirin alone in reducing the risk of myocardial infarction and stroke at moderate intensity (INR or high-intensity (INR), but also increased the risk of bleeding (up to double). Four clinical studies published in 2002 reaffirmed this conclusion.

In recent years, with the popularization of standardized diagnosis and treatment of coronary heart disease, the ratio of long-term anticoagulation** (long-term oral warfarin sodium tablets) combined with aspirin in elderly patients with coronary heart disease AF has increased to about 1 3, but doctors and patients should note that this combination of drugs brings benefits but also significantly increases the risk of bleeding.