There are many reasons for atrial fibrillation, including both heart and lung diseases and endocrine system diseases. Normal people may also have atrial fibrillation under the conditions of emotional excitement, alcohol consumption and tiredness, and the incidence of atrial fibrillation will also increase with age. The elderly with upper respiratory tract infection or water sodium retention are also easy to induce atrial fibrillation.
1. Organic heart disease
(1) Rheumatic heart disease
About 33.7% of the causes of atrial fibrillation are caused by mitral stenosis and insufficiency.
(2) Coronary heart disease
The incidence of atrial fibrillation was 1.5% in patients with coronary heart disease and angina pectoris confirmed by coronary angiography, and 3.8% in patients with old myocardial infarction; the incidence of acute myocardial infarction was 8.2%. The incidence of atrial fibrillation was 11% in patients with normal coronary artery confirmed by coronary angiography due to chest pain.
(3) Hypertensive heart disease
Many small arterial lumens of the atrial muscle can be narrowed or completely occluded due to the thickening of the intima, resulting in ischemic changes and fibrosis of the local myocardium.
(4) Hyperthyroidism
In the early stage, there was focal necrosis and lymphocyte infiltration in the myocardium. In patients with a long course of disease, the myocardium often presented small and localized fibrosis, with an incidence of 5%. It was mostly seen in patients aged 40 to 45 years old, and it was mostly paroxysmal in young patients.
(5) Sick sinus syndrome
The occurrence of atrial fibrillation can be promoted when the local muscular fiber structure of the sinus node artery is poorly developed, the collagen structure is abnormal, and the degeneration around the sinus node, especially the degeneration around the sinus node and the abnormality of sinus impulse.
(6) Cardiomyopathy
All types of cardiomyopathy are often accompanied by focal atrial muscle inflammation, degeneration or fibrosis, and atrial enlargement, which easily lead to the occurrence of atrial fibrillation. Among them, atrial fibrillation in patients with alcoholic cardiomyopathy is often the first manifestation of the disease, with a high incidence.
(7) Other heart diseases
Such as pulmonary heart disease (the incidence is 4% – 5%, most of which are paroxysmal, and the incidence will decrease after the improvement of respiratory function), chronic constrictive pericarditis, congenital heart disease, etc. Atrial fibrillation belongs to focal origin atrial fibrillation with increased self-discipline, while partial paroxysmal, partial persistent and chronic atrial fibrillation is caused by local micro-return mechanism in atrium, pulmonary vein and vena cava.
2. Preexcitation syndrome
It may be due to the short refractory period of the accessory pathway in patients with preexcitation syndrome. Once the reentry condition is established, the impulse through the accessory pathway increases, and this impulse reenters into the left atrial stress phase, which can induce atrial fibrillation. The incidence of atrial fibrillation complicated by preexcitation was 11.5%~39%. Atrial fibrillation associated with preexcitation syndrome is considered to be serious, because the bypass does not have the protective effect of physiological conduction delay like the atrioventricular node, so the ventricular rate transmitted via the bypass is more than 180 times/min, which seriously affects the cardiac output.
3. Other diseases
(1) Systemic invasive diseases: systemic lupus erythematosus, scleroderma, leukemia, amyloidosis, etc.
(2) Pulmonary and systemic infections and chronic pulmonary insufficiency.
(3) Heart surgery and trauma.
(4) Digitalis poisoning, aconitine poisoning, nicotine poisoning can induce atrial fibrillation.
(5) Various cardiac catheterization, transesophageal electrical stimulation and electrical cardioversion can directly induce atrial fibrillation.
(6) Alcoholism,smoking, emotional excitement, excessive smoking and urination can directly occur or induce atrial fibrillation on the basis of the original heart disease.
4. Familial atrial fibrillation
It is caused by gene mutation. The genetic mode belongs to AD inheritance. It mostly occurs after adulthood and is paroxysmal. Atrial fibrillation occurs and terminates unconsciously. The symptoms of atrial fibrillation attack are relatively mild, which are mainly induced by fatigue, nervousness, infection, pain, drinking, smoking and the cardiac function remains normal. Generally, the prognosis is good.
5. Cause unknown
Idiopathic atrial fibrillation in healthy people often has no basis for organic heart disease.
When you have atrial fibrillation, you can use the following app to monitor your heart rate, record it, and give it to the doctor for reference.
A free check atrial fibrillation app—”AFibCheck”：AFibCheck on the App Store(apple.com).
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