In clinical practice, some patients have no symptoms at all when atrial fibrillation attacks, and some do not know that they have atrial fibrillation until they go to the doctor for stroke. This condition is called asymptomatic atrial fibrillation.
Common symptoms of atrial fibrillation include palpitations, dyspnea, fatigue, dizziness, etc. A small number of patients will experience polyuria, blackout, and syncope. But asymptomatic patients with atrial fibrillation, they have none of the above symptoms, and they have no “feel” about atrial fibrillation.
Studies have found that compared with patients with symptomatic atrial fibrillation, patients with asymptomatic atrial fibrillation have the same risk of causing heart failure, thrombosis, or cardiomyopathy. Asymptomatic patients with atrial fibrillation are exposed to a rapid ventricular rate for a long time because they are not detected in time, resulting in tachycardia cardiomyopathy, which leads to heart failure.
If these patients are identified early, tachycardia cardiomyopathy can be reversed. Discovery of asymptomatic atrial fibrillation can be screened in the following ways:
First, opportunistic screening. The doctor routinely palpates the patient’s pulse. If the pulse is irregular and the pulse is inconsistent with the heart rate, consider further ECG examination. Some patients with asymptomatic atrial fibrillation accidentally discovered atrial fibrillation through Holter.
Second, systematic screening, that is, ECG screening of all target persons. In addition, with the advancement of technology, the popular wearable devices in recent years may also provide us with solutions.
Once asymptomatic atrial fibrillation occurs, anticoagulant therapy should be carried out in time and attention should be paid to control the ventricular rate.
Anticoagulant therapy for asymptomatic atrial fibrillation should be similar in principle to symptomatic atrial fibrillation. Patients with a history of atrial fibrillation and risk factors for embolism should take anticoagulants for life.
For young patients or patients with new-onset atrial fibrillation (symptomatic or asymptomatic), drugs or electroconversion should be used to restore sinus rhythm. Patients with frequent asymptomatic atrial fibrillation should consider radiofrequency ablation when medications are not effective.
