The development of atrial fibrillation is a poor prognostic sign of heart disease. He indicates the attending physician on the increase of heart failure, the rhythm out of control of normal regulatory mechanisms. Treatment of atrial fibrillation of the heart against the background of therapy of the underlying disease should be selected carefully taking into account the possible mechanism of occurrence.
In the mid-nineteenth century, scientists called this kind of rhythm disturbance "heart delirium"( Delirium cordis) for special sounds resembling muttering, which are heard over the heart region.
To understand the possibilities of treatment, give some attention to the causes of atrial fibrillation( the term "flickering" is incorrect).
How the atrial rhythm of
is formed Four sections of the heart( two atria and two ventricles) receive impulses that guide the sequence of contractions. The main nerve node is located in the left atrium. From it, the transformed "directions" normally go to other nodes and conduct paths. With atrial fibrillation, a lot of foci of excitation are formed in the atria. They give up to 600 pulses per minute. Only part is transferred to the ventricles. As a result, blood is ejected from the heart unevenly. During the time of relaxation, she does not have time to fill the ventricles. Semi-empty cameras emit clapping sounds and noises, which really look like delusional speech.
The pulse study includes not only the rhythm, but also the impact strength of the
. The pulse wave brings the unequal portions of blood to the periphery. A study of the pulse in patients makes it possible to identify the difference( deficiency) between a large number of heartbeats and the number of pulse strokes.
The reasons for such changes can be:
- sharp mental effects( cases with a brain injury with concussion of the brain are known);
- myocardial ischemia as a result of an atherosclerotic process;
- development of focal cardiosclerosis;
- heart disease with an increase in the left atrium( mitral stenosis);
- hypertensive crisis;
- metastasis of a cancerous tumor in the left atrium.
Infringement of blood supply of peripheral organs causes symptoms of ischemia, heart failure is formed.
Clinical manifestations of the disease and diagnosis
In some cases, patients completely do not feel a change in the rhythm of the heart, in others they complain of "interruptions", frequent palpitations with periods of "fading", note dizziness, swelling of the dyspnea, swelling on the legs.
Treatment of atrial fibrillation depends on the form of the disease.
Atrial fibrillation may be temporary( occurs and disappears on its own) or permanent. There are three forms:
- tachyarrhythmic - heart rate from 90 to 120 per minute;
- bradyarrhythmic( 60 - 90);
- paroxysmal - occurs suddenly, the number of heartbeats is over 120, while the heart deficit significantly increases.
ECG studies allow you to determine the source of the heart rhythm
Diagnosis fits into the possibility of electrocardiography. At the same time, fibrillation and atrial flutter are distinguished. Fluttering is more favorable, since the number of pulses is much smaller, the atrial and ventricular contractions coincide periodically. In case of unstable changes in the rhythm Holter monitoring is used: the electrodes are fixed with "Velcro" and are left on the examined patient for up to three days. The data are recorded on a special sensor, then they are examined by the physician of the functional diagnostics cabinet.
Methods of treatment
To cure atrial fibrillation, it is necessary to eliminate the causes of its occurrence, which, unfortunately, is most often impossible. With conservative treatment, one should think about compensating for heart failure, controlling blood pressure, slowing the development of atherosclerosis, and ischemia of the heart muscle.
Nutrition and lifestyle
A diet with atrial fibrillation should eliminate as much as possible annoying effects on the excitability of the heart. Strictly forbidden: alcohol, coffee, strong tea, carbonated sweet drinks. The amount of fluid should be agreed individually with the doctor. When edema it will have to be limited.
Diet is built taking into account frequent meals. You can not tolerate overeating, bloating and flatulence. A diaphragm with a pressure from below on the heart can provoke paroxysms of flicker. Therefore, beans, cabbage, milk are not recommended.
Types of cardiac arrhythmia
A salt-free diet means consuming no more than 5 grams of salt per day( one teaspoonful).This takes into account the salt used in cooking. Such a serious restriction may be necessary for severe heart failure. Usual recommendations: do not eat salty and spicy food, because you want to drink and for salt will follow the bust in the liquid.
We need products rich in microelements - potassium and magnesium. This includes rye bread with bran, soya additives, spinach, nuts, raisins, dried apricots, oatmeal, cheese, baked potatoes, carrots, pumpkin, watermelon, bananas.
To maintain normal blood cholesterol levels, foods containing animal fat( fatty meat, butter), eggs, mayonnaise, sausages, culinary products, sweets are limited. Recommended poultry meat in a boiled form, vegetables and fruits, vegetable oil, low-fat cottage cheese, cereals, pasta from durum wheat, green tea.
If the work is connected with constant stressful situations, night shifts or a lot of physical stress, you will have to think about replacing it. You can learn to deal with stress with the help of a psychologist, in groups of auto-training, in classes in yoga. The intake of vegetable soothing agents like motherwort infusions, valerian helps to avoid a breakdown in the normal heart rhythm.
Smoking is a permanent toxic effect on the heart. Abandoning this habit will prevent and cure many diseases.
There are ways to self-relieve( relieve) attacks of atrial fibrillation:
- deep rare breathing helps slow the rhythm;
- at the height of inspiration, take in more air and hold your breath, while straining your abdomen, repeat several times;
- described cases of arresting paroxysmal tachycardia when the patient was hanging from the bed with his head down on his stomach. This can be tried at home.
Drugs used to treat atrial fibrillation can be divided into three groups according to the methods of influence on the body:
- means to maintain a normal rhythm frequency of not more than 90 per minute;
- preparations preventing thrombus formation;
- medications that help restore normal rhythm.
It is considered not necessary to return the heart to a normal rhythm, if the heart rate is within the normal range, there is no pulse deficit, the symptoms of decompensation develop, there are no seizures of paroxysms. Such means that do not affect the rhythm are groups of drugs from cardiac glycosides( Digoxin), beta-blockers( Concor, Betaloc), calcium channel blockers( Amlodipine, Norvascus).
To prevent thrombosis with subsequent complications in the form of a heart attack or stroke, anticoagulants are used, which reduce the ability of platelets to glue. The most famous of them are Aspirin Cardio, Kardiask.
Treat the heart with medicines only by a qualified technician. Patients should carefully consider the recommendations of the doctor, study the instructions, learn how to count the pulse.
In cases of seizure of paroxysmal tachycardia with ineffective intravenous administration of drugs to prevent ventricular fibrillation, defibrillation is performed routinely or according to vital indications. For this purpose, using a special apparatus, a defibrillator, a high-voltage current is passed through the heart in a separate discharge.
Timely defibrillation allows to prevent the lethal outcome of
Surgical treatment of
Surgical treatment of atrial fibrillation is used in the absence of the effect of drug therapy, when the disorders cause cardiac decompensation, significantly complicate the course of the underlying disease, become life-threatening to the patient. In cardiosurgery centers and departments, procedures are used to restore the rhythm or surgical treatment is selected.
- Catheter ablation of is the cauterization( removal) of groups of cells around the entrance of pulmonary veins into the left atrium or in the atrium itself. It is believed that in these places unnecessary impulses are formed. The operation is under general anesthesia. With long catheters through the femoral vein, a microelectrode is fed directly to the site of contact. After removal of the tissue should take up to three months to form a dense scar. At this time, atrial fibrillation remains and the patient takes medication. After scarring, the correct rhythm is restored.
- Installation of the pacemaker is the next mandatory step when removing the cells of the leading sinus node. Because the underlying fibers can not provide a sufficient independent rhythm of the heart.
One of the operations of choice is the removal of the left atrial appendage. This is an anatomical formation, around which random impulses can arise. In addition, this is the most dangerous place for the formation of a thrombus.
Atrial fibrillation may not be reminiscent of itself for a long time, but it has been established that it increases the risk of blood clots seven times, and therefore of strokes and heart attacks. Therefore, timely diagnosis and treatment of this pathology plays a vital role.