Is excessive exercise afraid of arrhythmia or sudden death? Doctor: Type 2 "exercise mode" is the most dangerous
Is excessive exercise prone to arrhythmia? Doctors reveal 2 major mistakes in “exercise mode”
There have been recent reports of sudden death in China due to drinking ice water after exercise. Is it related to sudden “arrhythmia”? Dr. Zhang Bocheng from the Department of Cardiovascular Medicine at Linkou Chang Gung Memorial Hospital said in an interview with “healthorn” that the triggering factors of arrhythmia are multiple factors. Emotions, sleep, changes in body temperature during exercise and external air temperature may all affect it. However, the prevention of arrhythmia still requires focusing on the risk factors themselves. For example, three-high control is more important.
Dr. Xie Minxiong, director of the Department of Internal Medicine at Taipei Municipal Wanfang Hospital and professor of the Department of Medicine at Taipei Medical University, pointed out that being too cold or too hot will cause changes in the heartbeat. The reason is that the autonomic nervous system is affected. When the sympathetic nerve is stimulated, it will cause the heartbeat to accelerate and the parasympathetic nervous system to It will slow down the heartbeat, and excessive temperature changes may affect the autonomic nervous system and cause arrhythmia.
Exercise is an important key to maintaining health, but attention must be paid to exercise intensity and exercise pattern. Dr. Xie Minxiong pointed out that scientific evidence shows that athletes who exercise excessively for a long time have a higher risk of arrhythmia and sudden death. The definition of “excessive exercise” refers to intense exercise every day. In addition, if you lack exercise training, it is not recommended to rush into high-intensity exercises such as mountain climbing, especially if you have a history of heart disease. Climbing steep slopes will increase the burden on the heart and easily increase the risk of severe cardiovascular changes.
Asymptomatic atrial fibrillation may cause stroke! Which anticoagulant should I take?
Dr. Zhang Bocheng said that arrhythmias can be divided into ventricular fibrillation and atrial fibrillation. Although the triggering factors of the two overlap partially, their mechanisms are not exactly the same. High-risk factors for atrial fibrillation include older age, lung disease, and thyroid disease; high-risk factors for ventricular fibrillation include previous myocardial infarction and heart failure. Although ventricular fibrillation has a higher rate of sudden death, the incidence is not as high as that of atrial fibrillation.
Overall, the prevalence of atrial fibrillation in adults is about 2 to 4%. However, the prevalence increases with age. Because it can easily cause blood clots and lead to stroke, patients need to take anticoagulants regularly to reduce the risk of stroke. If a risk occurs, drugs to control atrial fibrillation should be used to prevent symptoms. Dr. Zhang Bocheng reminded that patients must follow the doctor’s instructions for regular treatment to prevent complications caused by arrhythmia and atrial fibrillation.
Dr. Zhang Bocheng explained that patients with cardiovascular disease must take anticoagulant drugs on time as secondary prevention. These drugs are divided into two categories, one is vitamin K (Coumadin) drugs, and the other is new anticoagulant drugs. There are currently 4 drug options for coagulants. Clinically, medication will be considered based on whether the patient has ever had an artificial valve, whether he or she has mitral stenosis, and whether the kidney function is good or bad.
Dr. Zhang Bocheng reminded that it is very important to take anticoagulants regularly. If patients need tooth extraction or surgery, they must first consult a cardiologist. Nowadays, some of the new anticoagulants do not necessarily need to be discontinued as long as the bleeding is properly stopped after tooth extraction, unlike aspirin, which requires a week’s discontinuation. It is recommended that patients consult their cardiologist in advance to reduce the possible risks of discontinuing medication.
1 in 3 atrial fibrillation cases are asymptomatic! Smart watch ECG monitoring available
Dr. Zhang Bocheng said that atrial fibrillation does not occur anytime and anywhere. Most patients are “paroxysmal” and may develop within hours or days, and have recovered by the time they have a stroke, so it cannot be measured in time. Past studies have found that even using 24-hour electrocardiograms, the detection rate of atrial fibrillation is only 10%-20%. In addition to encouraging patients to have regular health check-ups, smart watches can also be used to help monitor.
Dr. Xie Minxiong also explained that up to one-third of patients with atrial fibrillation are asymptomatic, and most symptomatic patients suffer from “paroxysmal attacks”. Wearable smart devices with electrocardiogram recording functions can be used to effectively treat atrial fibrillation. When palpitations or symptoms occur, measure and record the ECG for more than 30 seconds. The preliminary diagnosis accuracy rate on the smart device can reach 70-80%, which can be used as an indicator for doctors to evaluate the condition.
How can high-risk groups avoid another stroke? Is it wrong to only exercise without taking medicine?
Dr. Zhang Bocheng reminded that if patients who have had a stroke have another stroke, the mortality rate will increase significantly. The most important thing after the first stroke is to receive medical treatment, eat as little fat and salt as possible, slowly start rehabilitation and increase the amount of exercise, in order to reduce the risk of another stroke.
Dr. Xie Minxiong pointed out that for high-risk groups who have had a stroke or have cardiovascular disease, the most important aspects of “secondary prevention” are two aspects: first, control risk factors, including cholesterol, high blood pressure, and high blood sugar, and at the same time quit smoking, Drinking and other bad habits; firstly, there should be no myth of refusing medical treatment or taking medicine, thinking that heart problems can be cured by just controlling life.
Dr. Xie Minxiong emphasized that high-risk groups should not think that exercise is a panacea for improving cardiovascular disease and ignore the importance of drug treatment. Today’s medicine has made great progress. In particular, drug treatment of atrial fibrillation can reduce the risk of stroke by about 50%. Coupled with electrocardiogram monitoring of wearable devices and regular check-ups, the chance of recurrence can be greatly improved.
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