Managing Atrial Fibrillation in a 63-Year-Old Patient: A Holistic Treatment Approach

Managing heart conditions often requires a comprehensive treatment strategy, especially in older patients with complex medical histories. In this case, a 63-year-old female patient was admitted to Qilu Hospital of Shandong University after experiencing persistent heart palpitations, shortness of breath, and chest discomfort. Following a detailed diagnosis in July 2021, she was identified as suffering from persistent atrial fibrillation, a type of arrhythmia that lasts more than seven days and can lead to serious complications such as heart failure and irregular heartbeat. Through a combination of Western medicine, traditional Chinese herbal therapy, intravenous treatments, and physical rehabilitation, the patient experienced significant improvement over a 12-day treatment period.

Patient Overview

The patient was a 63-year-old woman with a history of heart valve disease and atrial fibrillation. She had previously undergone heart valve replacement and coronary artery bypass surgery, but her condition persisted. Her symptoms worsened following a stressful emotional event, leading to her hospitalization.

Diagnosis and Treatment Plan

Upon admission, the patient exhibited a heart rate of 115 beats per minute, with irregular rhythm and a mechanical-sounding first and second heart sound. Diagnostic tests confirmed persistent atrial fibrillation and left atrial enlargement. The treatment plan combined Western and traditional Chinese medicine approaches:

Medications: Digoxin for heart rate control, rosuvastatin for lipid management, and warfarin for anticoagulation.
Intravenous Therapies: Trichosanthes kirilowii injection and danshen polyphenolic acid injection to promote blood circulation and reduce stasis.
Herbal Treatment: A traditional formula known as Guipi Tang, containing ingredients like astragalus, angelica root, and longan fruit to nourish the heart and calm the mind.
Physical Therapy: Medium-frequency electrical stimulation and external counterpulsation therapy to enhance circulation and support cardiac function.

Progress and Recovery

By the 8th day of treatment, the patient's symptoms of palpitations and shortness of breath had significantly improved. At discharge on day 12, she was in better general condition and appeared more energetic than at admission. She was advised to continue her prescribed medication regimen and participate in cardiac rehabilitation, with regular follow-ups to monitor her progress and adjust treatment as needed.

Post-Treatment Care and Lifestyle Recommendations

Following discharge, the patient was encouraged to adopt a heart-healthy lifestyle. This included:

Maintaining a low-fat, balanced diet while limiting vitamin K-rich foods like spinach and egg yolks.
Monitoring for signs of abnormal bleeding due to the anticoagulant effects of warfarin.
Regular INR (International Normalized Ratio) testing to ensure safe and effective blood thinning.
Avoiding stress, excessive fatigue, smoking, and alcohol consumption.
Practicing emotional well-being to prevent recurrence of arrhythmia.

Clinical Insights and Patient Education

Persistent atrial fibrillation is a progressive condition that requires both pharmacological and lifestyle interventions. Given the patient's history of heart disease and emotional triggers, it is crucial to emphasize the role of psychological well-being in cardiovascular health. Emotional stress can significantly impact heart rhythm, making it essential for patients to maintain calm and avoid intense emotional reactions.

This case illustrates the benefits of an integrative approach to managing atrial fibrillation. By combining evidence-based Western medicine with complementary therapies like traditional herbal medicine and physical rehabilitation, patients can achieve better symptom control and improved quality of life. Long-term follow-up and patient education remain key to preventing future cardiac events and maintaining heart health.