Objective To analyze the distribution characteristics of comorbid diseases in patients with atrial fibrillation(AF)and the current status of their medical intervention.Methods A retrospective cohort study was conducted using clinical data from AF patients at the AF center of Hainan Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine between October 2020 and September 2022.The data included information on hospitalizations,diagnoses and treatments,health assessments,physical examinations,tests,laboratory results,and medication treatments.Descriptive research methods were used to analyze the clinical distribution characteristics,comorbid diseases,and stroke intervention status.A Logistic regression model was employed to analyze the impact of comorbid diseases on the type of AF.Receiver operator characteristic curve(ROC curve)analysis was performed to evaluate the predictive value of comorbid diseases in AF for the development of persistent AF.Results Among the 667 AF patients,89.21%(595 cases)had comorbidities,with a total of 64 different comorbidity combinations observed.These combinations consisted of AF coexisting with 1-5 diseases,72.44%had 1-2 comorbidities.The top 5 most frequent comorbidity patterns,in descending order,were hypertension,hypertension and chronic heart failure,hypertension and coronary heart disease and chronic heart failure,hypertension and coronary heart disease,hypertension and diabetes.These 5 patterns accounted for 49.41%(294/595)of the total cases.All 8 diseases were associated with high abnormality rates in four key indicators:the CHA2DS2-VASc score,brain natriuretic peptide/N-terminal pro-brain natriuretic peptide(BNP/NT-proBNP),creatinine clearance rate(CCr),and left atrial diameter.The highest medication rates were observed for anticoagulants in valvular heart disease(84.62%),for antiarrhythmics in thyroid disease(70.97%),and for blood pressure control agents across all other diseases.For the 4 disease comorbidity combinations,the monitoring rates were highest for hypertension(100.00%)and lowest for diabetes mellitus(83.12%).The treatment rates were as follows:hypertension(highest 63.16%,lowest 60.91%),coronary heart disease(CHD,highest 73.96%,lowest 44.44%),diabetes mellitus(highest 75.29%,lowest 64.94%),chronic heart failure(highest 67.63%,lowest 62.50%).For stroke intervention in the 4 disease comorbidity combinations,the proportion of high-stroke-risk population was highest in patients with diabetes(98.46%)and lowest in those with chronic heart failure(92.18%).The anticoagulation therapy rate was highest in the chronic heart failure(56.25%)and lowest in the diabetes(46.88%).The proportion of patients with high bleeding risk was highest in the diabetes group(44.53%)and lowest in the chronic heart failure group(32.59%).Multivariate binary Logistic regression analysis revealed that AF comorbid with coronary heart disease[odds ratio(OR)=1.499,95%confidence interval(95%CI)was 1.016-2.214,P=0.042],valvular heart disease(OR=3.362,95%CI was 1.473-7.674,P=0.004),and chronic heart failure(OR=1.903,95%CI was 1.309-2.767,P=0.001)were all independent risk factors for the development of persistent AF.ROC curve analysis showed that coronary heart disease,valvular heart disease,and chronic heart failure all had certain predictive value for persistent AF,with areas under the curve(AUC)of 0.538,0.536,and 0.572,respectively.Combined assessment demonstrated an AUC of 0.654(95%CI was 0.610-0.698,P<0.001),sensitivity 54.50%,and specificity 69.20%.Conclusions The distribution of high-frequency comorbidity combinations in AF patients is highly clustered and warrants focused attention.In this center,patients with comorbidities exhibited high abnormality rates in comorbid disease detection and elevated stroke risk scores,yet targeted interventions remain insufficient and require optimization.AF combined with coronary artery disease,valvular heart disease,and chronic heart failure were identified as independent risk factors for persistent AF.

OBJECTIVE To explore the clinical efficacy of Chaihu Jia Longgu Muli Decoction Derivative in the treatment of non-valvu-lar paroxysmal atrial fibrillation based on the pathogenesis theory of"mutual fanning of liver wind and heart fire".METHODS A total of 80 patients with non-valvular paroxysmal atrial fibrillation admitted to Hainan Provincial Traditional Chinese Medicine Hospital from January 2021 to July 2022 were prospectively selected as the research subjects and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given conventional treatment such as western medicine anticoagulation and ventricular rate con-trol.The observation group was given Chaihu Jia Longgu Muli Decoction Derivative on the basis of the control group.The treatment course of both groups was 30 d.The two groups were compared in terms of TCM syndrome scores,atrial fibrillation episodes(number of episodes,du-ration),clinical efficacy,changes in electrocardiogram parameters(P wave duration,P wave dispersion),heart rate variability indexes[standard deviation of RR interval(SDNN),root mean square difference of adjacent RR intervals(RMSSD),standard deviation of the mean value of RR interval(SDANN)],left ventricular function indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),ear-ly diastolic mitral annular motion velocity(EM)and left ventricular early diastolic blood flow propagation velocity(VP)]and the occurrence of adverse reactions.RESULTS After treatment,the TCM syndrome scores of the two groups of patients were significantly reduced(P<0.05,P<0.01),and the observation group was better than the control group(P<0.05,P<0.01);the number and duration of atrial fibrilla-tion in the two groups were significantly decreased(P<0.05,P<0.01),and the observation group was superior to the control group(P<0.05,P<0.01);the clinical efficacy of the observation group was better than that of the control group(P<0.05);the heart rate variability indexes,electrocardiogram parameters and left ventricular function indexes were significantly improved(P<0.05),and the observation group was supe-rior to the control group(P<0.05);there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).CONCLUSION Based on the pathogenesis theory of"mutual fanning of liver wind and heart fire",the application of Chaihu Jia Longgu Muli Decoction Derivative for the treatment of non-valvular paroxysmal atrial fibrillation can improve clinical symptoms,reduce atrial fibrillation,enhance cardiac function,and has good clinical efficacy.

OBJECTIVE To explore the clinical efficacy of Chaihu Jia Longgu Muli Decoction Derivative in the treatment of non-valvu-lar paroxysmal atrial fibrillation based on the pathogenesis theory of"mutual fanning of liver wind and heart fire".METHODS A total of 80 patients with non-valvular paroxysmal atrial fibrillation admitted to Hainan Provincial Traditional Chinese Medicine Hospital from January 2021 to July 2022 were prospectively selected as the research subjects and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given conventional treatment such as western medicine anticoagulation and ventricular rate con-trol.The observation group was given Chaihu Jia Longgu Muli Decoction Derivative on the basis of the control group.The treatment course of both groups was 30 d.The two groups were compared in terms of TCM syndrome scores,atrial fibrillation episodes(number of episodes,du-ration),clinical efficacy,changes in electrocardiogram parameters(P wave duration,P wave dispersion),heart rate variability indexes[standard deviation of RR interval(SDNN),root mean square difference of adjacent RR intervals(RMSSD),standard deviation of the mean value of RR interval(SDANN)],left ventricular function indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),ear-ly diastolic mitral annular motion velocity(EM)and left ventricular early diastolic blood flow propagation velocity(VP)]and the occurrence of adverse reactions.RESULTS After treatment,the TCM syndrome scores of the two groups of patients were significantly reduced(P<0.05,P<0.01),and the observation group was better than the control group(P<0.05,P<0.01);the number and duration of atrial fibrilla-tion in the two groups were significantly decreased(P<0.05,P<0.01),and the observation group was superior to the control group(P<0.05,P<0.01);the clinical efficacy of the observation group was better than that of the control group(P<0.05);the heart rate variability indexes,electrocardiogram parameters and left ventricular function indexes were significantly improved(P<0.05),and the observation group was supe-rior to the control group(P<0.05);there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).CONCLUSION Based on the pathogenesis theory of"mutual fanning of liver wind and heart fire",the application of Chaihu Jia Longgu Muli Decoction Derivative for the treatment of non-valvular paroxysmal atrial fibrillation can improve clinical symptoms,reduce atrial fibrillation,enhance cardiac function,and has good clinical efficacy.

Objective To analyze the distribution characteristics of comorbid diseases in patients with atrial fibrillation(AF)and the current status of their medical intervention.Methods A retrospective cohort study was conducted using clinical data from AF patients at the AF center of Hainan Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine between October 2020 and September 2022.The data included information on hospitalizations,diagnoses and treatments,health assessments,physical examinations,tests,laboratory results,and medication treatments.Descriptive research methods were used to analyze the clinical distribution characteristics,comorbid diseases,and stroke intervention status.A Logistic regression model was employed to analyze the impact of comorbid diseases on the type of AF.Receiver operator characteristic curve(ROC curve)analysis was performed to evaluate the predictive value of comorbid diseases in AF for the development of persistent AF.Results Among the 667 AF patients,89.21%(595 cases)had comorbidities,with a total of 64 different comorbidity combinations observed.These combinations consisted of AF coexisting with 1-5 diseases,72.44%had 1-2 comorbidities.The top 5 most frequent comorbidity patterns,in descending order,were hypertension,hypertension and chronic heart failure,hypertension and coronary heart disease and chronic heart failure,hypertension and coronary heart disease,hypertension and diabetes.These 5 patterns accounted for 49.41%(294/595)of the total cases.All 8 diseases were associated with high abnormality rates in four key indicators:the CHA2DS2-VASc score,brain natriuretic peptide/N-terminal pro-brain natriuretic peptide(BNP/NT-proBNP),creatinine clearance rate(CCr),and left atrial diameter.The highest medication rates were observed for anticoagulants in valvular heart disease(84.62%),for antiarrhythmics in thyroid disease(70.97%),and for blood pressure control agents across all other diseases.For the 4 disease comorbidity combinations,the monitoring rates were highest for hypertension(100.00%)and lowest for diabetes mellitus(83.12%).The treatment rates were as follows:hypertension(highest 63.16%,lowest 60.91%),coronary heart disease(CHD,highest 73.96%,lowest 44.44%),diabetes mellitus(highest 75.29%,lowest 64.94%),chronic heart failure(highest 67.63%,lowest 62.50%).For stroke intervention in the 4 disease comorbidity combinations,the proportion of high-stroke-risk population was highest in patients with diabetes(98.46%)and lowest in those with chronic heart failure(92.18%).The anticoagulation therapy rate was highest in the chronic heart failure(56.25%)and lowest in the diabetes(46.88%).The proportion of patients with high bleeding risk was highest in the diabetes group(44.53%)and lowest in the chronic heart failure group(32.59%).Multivariate binary Logistic regression analysis revealed that AF comorbid with coronary heart disease[odds ratio(OR)=1.499,95%confidence interval(95%CI)was 1.016-2.214,P=0.042],valvular heart disease(OR=3.362,95%CI was 1.473-7.674,P=0.004),and chronic heart failure(OR=1.903,95%CI was 1.309-2.767,P=0.001)were all independent risk factors for the development of persistent AF.ROC curve analysis showed that coronary heart disease,valvular heart disease,and chronic heart failure all had certain predictive value for persistent AF,with areas under the curve(AUC)of 0.538,0.536,and 0.572,respectively.Combined assessment demonstrated an AUC of 0.654(95%CI was 0.610-0.698,P<0.001),sensitivity 54.50%,and specificity 69.20%.Conclusions The distribution of high-frequency comorbidity combinations in AF patients is highly clustered and warrants focused attention.In this center,patients with comorbidities exhibited high abnormality rates in comorbid disease detection and elevated stroke risk scores,yet targeted interventions remain insufficient and require optimization.AF combined with coronary artery disease,valvular heart disease,and chronic heart failure were identified as independent risk factors for persistent AF.

Objective To understand the distribution characteristics and stroke risk of hospitalized patients in single center atrial fibrillation in traditional Chinese medicine hospitals for guidance in prevention and treatment of atrial fibrillation.Methods A total of 667 clinical diagnosis and treatment data from Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation was collected[including hospitalization information,diagnosis and treatment,demographic information symptoms,European Heart Rhythm Association(EHRA),health assessment].Descriptive epidemiological methods were employed to analyze the distribution characteristics of different populations,and a Logistic regression model was used with CHA2DS2-VASc score as the dependent variable to analyze the risk factors of stroke in men and women with non-valvular atrial fibrillation respectively.Results Among patients with atrial fibrillation,valvular atrial fibrillation accounted for 5.85%(39/667),while non-valvular atrial fibrillation accounted for 94.15%(628/667).Persistent atrial fibrillation was the main type at 65.52%(437/667),with a higher proportion of patients in males than that in females(1.22∶1).The average age of patients was 75.14±11.23 years,mainly aged 71-80 years and 81-90 years,accounting for 33.28%(222/667)and 28.78%(192/667)respectively.Clinical symptoms mainly include palpitations(51.27%)and chest discomfort(45.43%),79.01%(527/667)of patients had EHRA symptom rating below gradeⅡ,while 20.99%(140/667)had ratings above gradeⅢ.The highest incidence of comorbidities of atrial fibrillation was hypertension at 64.62%(431/667),followed by chronic heart failure at 36.43%(243/667).The proportion of high-risk stroke population in the CHA2DS2-VASc score was significantly higher than that of the medium to low-risk stroke population[89.17%(560/628)vs.10.83%(68/628)].In contrast,the proportion of people with low risk of bleeding in the HAS-BLED score was significantly higher than that of people with high risk of bleeding[69.27%(462/667)vs.30.73%(205/667)].A univariate analysis was conducted on 628 patients with non-valvular atrial fibrillation by gender.The results showed that among 279 female patients with CHA2DH2-VASc score≥3 as the dependent variable,univariate analysis showed that there were significant differences in age,hypertension,coronary heart disease,cardiomyopathy,chronic heart failure,cerebrovascular disease,and thyroid disease between the two groups(all P<0.05).A total of 349 male patients with CHA2DH2-VASc score≥2 as the dependent variable,statistically significant differences were showed in age,education level,EHRA and whether had hypertension,coronary heart disease,chronic heart failure,cerebrovascular disease,and thyroid disease(all P<0.05)by univariate analysis.Multivariate Logistic regression analysis showed that the high-risk factors for stroke were age,systolic blood pressure,thyroid disease and cerebrovascular disease in women[female>75 years old:odds ratio(OR)=42.270,95%confidence interval(95%CI)was 9.130-195.800;systolic blood pressure>160 mmHg(1 mmHg≈0.133 kPa):OR=3.530,95%CI was 1.420-8.760,and thyroid disease:OR=0.140,95%CI was 0.040-0.460,cerebrovascular disease:OR=9.400,95%CI was 2.130-41.440;all P<0.05].While age,education level,systolic blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease in men were high-risk factors(male>75 years old:OR=81.270,95%CI was 27.730-238.210;education level:OR=0.250,95%CI was 0.120-0.530;systolic blood pressure>160 mmHg:OR=14.110,95%CI was 7.250-27.460;patients with chronic heart failure:OR=23.780,95%CI was 7.850-71.970;thyroid disease:OR=0.240,95%CI was 0.110-0.540;patients with cerebrovascular disease:OR=0.580,95%CI was 0.360-0.940;all P<0.05).Conclusions The proportion of male hospitalized patients with atrial fibrillation at Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital is greater than that of females.The majority of these patients are elderly,with an average age higher than recently reported.They face a more prominent of stroke,especially those with high blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease.It is crucial to strengthen targeted prevention and treatment efforts in this population.

Objective To analyze the population distribution pattern of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital to guide clinical diagnosis and treatment.Methods Clinical diagnosis and treatment(including hospitalization information,diagnosis and treatment,symptoms,health assessment,physical examination,examination,testing,therapeutic drugs),European Heart Rhythm Association(EHRA)symptom score,CHA2DS2-VASc score for predicting stroke risk stratification in atrial fibrillation,HAS-BLED score for predicting bleeding risk in anticoagulated were collected from Hainan Traditional Chinese Medicine Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation.The normal reference values of various examination indicators set for analysis are heart rate 60-100 beats/min,QTc interval <480 ms for males and<470 ms for females,ejection fraction(EF)0.50-0.75 for B-ultrasound,left atrial anteroposterior diameter <35 mm,left ventricular end-diastolic diameter(LVEDD)<55 mm for males and <50 mm for females,no left atrial thrombosis,International normalized ratio(INR)0.85-1.20,brain natriuretic peptide(BNP)0-100 ng/L,N-terminal pro-brain natriuretic peptide(NT-proBNP)0-125 ng/L in cardiology,0-250 ng/L in non cardiology.Results Among 667 patients,there were 39 cases of valvular atrial fibrillation and 628 cases of non valvular atrial fibrillation.The completion rate of various diagnostic(physical examination/examination/testing)indicators was 19.94％-100.00％.Statistically significant differences were showed in every EHRA symptom score,HAS-BLED score,BMI,hypertension,heart rate,EF,left atrial diameter,LVEDD,left atrial thrombus,INR(Warfarin user),BNP,NT-proBNP and atrial fibrillation treatment methods(all P<0.01).No statistically significant difference was shown in CHA2DS2-VASc scores for each gender,QTc and NT-proBNP(all P>0.05).409 patients were treated with antiarrhythmic drugs,with a treatment rate of 61.32％.Statistically significant difference was showed in the proportion of medication use among different populations with heart rates of<60,60-100,and ≥100 beats/min,respectively[46.51％(20/43)vs.54.60％(196/359),72.83％(193/265),P<0.01],and the highest drug usage rate was β receptor blockers.Statistically significant difference was shown in the use rate of different antiarrhythmic drugs(P<0.01).There were 342 patients treated with anticoagulant therapy,with a treatment rate of 51.27％,the treatment rate of valvular atrial fibrillation was significantly higher than that of non-valvular atrial fibrillation[84.62％(33/39)vs.49.20％(309/628)],with a statistically significant difference(P<0.01).No statistically significant difference was shown in treatment rates between individuals with CHA2DS2-VASc scores of ≥2 for males and ≥3 for females of non-valvular atrial fibrillation,and between individuals with CHA2DS2-VASc scores of <2 for males and <3 for females,as well as between individuals with HAS-BLED scores of ≤2 and ≥3 for treatment rates(all P>0.05).Statistically significant differences were shown in the usage rates of different anticoagulants,antiplatelet aggregation drugs,blood lipid control(statins)drugs,and blood pressure control drugs(all P<0.01).The types of medication used for blood pressure control are angiotensin converting enzyme inhibitor(ACEI),angiotensin Ⅱ receptor blocker(ARB),calcium channel blocker(CCB),β receptor blockers and diuretics.The single drug composition ratio of the medication plan was the highest(39.75％),and the diuretics composition ratio of drug use was the highest(48.00％),with statistically significant differences(all P<0.01).Conclusions The operation of the Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital has covered all clinical diagnosis and treatment projects,and the treatment plan is consistent with the guidelines.At present,the control of blood pressure,BMI,and heart rate of hospitalized patients needs to be further strengthened,especially the proportion of high-risk people with stroke,and there is insufficient anticoagulation treatment.The training of the guidelines should be improved to promote standardized treatment.