19Mar

Arrhythmia of the heart: causes, symptoms, treatment

Different types of arrhythmia are caused by diseases accompanied by a violation of the anatomical structure of the heart. Also, the causes may be violations of the metabolic processes occurring in the heart. To put the correct diagnosis and appoint treatment for arrhythmia of the heart can only a doctor, based on clinical and electrocardiographic data.

The normal heart rhythm in most healthy adults at rest should be uniform 60-80, an average of 70-75 beats per minute with the same pauses between contractions of the heart.

Normally, an electrical impulse occurs in the sinus node and spreads to the atria through special pathways, causing them to contract. Then the impulse penetrates into the ventricles of the heart, and under its influence they contract. If an obstacle appears on the path of the impulse, a rhythm of the cardiac contractions arises, an arrhythmia, which can manifest itself by a change in the frequency, sequence, and strength of the contractions of the heart.

Abbreviations: Heart Rate.

Bradycardia - Heart rate at rest less than 60 bpm.

Tachycardia - HR in rest more than 90 beats per minute.

Paroxysmal tachycardia - heart rate at rest more than 140 beats / minute, which occurs suddenly as an attack.

With a pulse below 40 or more than 200 beats per minute, the patient may experience loss of consciousness, since insufficient oxygen is supplied to the brain.

Every third patient on admission from a cardiologist in a polyclinic or being treated in a cardiac hospital makes complaints about interruptions or heart palpitations. It can be a single fade of the heart - extrasystoles, only 3-5 times for 1 min, and there are interruptions every 2-3 cardiac contractions. With a rapid pulse, the rhythm can also be either uniform or random.

Types of cardiac arrhythmias: ciliary, sinus and extrasystole

Different types of cardiac arrhythmias are of different nature and can differ significantly from each other. So what are arrhythmias and what is their difference?

Sinus arrhythmia occurs in children and young people. Symptoms of such an arrhythmia of the heart are a rapid pulse on the inspiration and slowed down on exhalation, that is, the pulse depends on the breath. This phenomenon is associated with a change in the activity of the autonomic nervous system during respiration. Such an arrhythmia does not require treatment.

Extrasystole is one of the most common types of arrhythmias, representing an extraordinary( premature) contraction of the heart.

Another thing - atrial fibrillation of the heart, or atrial fibrillation. At present, at international and Russian standards, atrial fibrillation is called atrial fibrillation.

Every two-hundredth inhabitant of the planet suffers from atrial fibrillation. The frequency of this disease depends significantly on age( in the 50-60 year period, 3.5% are sick, 9% in the 80-90 period) and sex( men are 1.5 times more likely than women).

A sinus node controls the operation of a healthy heart. In atrial fibrillation, uncoordinated excitations of individual atrial fibers occur due to the fact that along with the sinus node they begin to produce pulses with a frequency of more than 350 per minute( sometimes up to 800).In this case, on the inner surface of the atria appears a lot of different in strength sources of electrical signals. It seems that the atria "flicker".There is no full reduction, and the work of the atria to push blood into the ventricles is not effective. The function of the ventricles worsens, as they are filled with a smaller volume of blood, therefore less blood flows to the organs.

In atrial fibrillation, the incidence of ventricular contractions is significantly less than the incidence of atrial contractions.

All this a large number of electrical pulses through the conduction system of the heart enters the atrioventricular node, which tries not to overpass the extra impulses. If the irregular impulses do go away, the heart beats incorrectly at a frequency of 45 to 150 beats per minute. Against this background, the course of angina may worsen, signs of heart failure may even worsen, and even a stroke may develop. Atrial fibrillation can complicate the course of such diseases as IHD, AH, diabetes mellitus, etc. It is one of the most common disorders of the heart rhythm. Having identified the symptoms of cardiac arrhythmia, treatment is prescribed exclusively by the doctor.

Cardiovascular diseases account for 56.7% of the total mortality in Russia.30% of deaths from CVD are observed in people of working age. Many of them die suddenly, because they never consulted a doctor about heart problems.

Causes of cardiac arrhythmia

The causes of cardiac arrhythmia are cardiac diseases or non-cardiac problems that affect electrical instability of the atria, causing congestion and expansion of the heart cavities( in these patients, as a rule, the size of the atria is increased, especially the left one).The causes of arrhythmia of the heart can be such diseases and pathological conditions as ischemic heart disease;heart defects( more often the defect of the mitral valve);cardiomyopathy;hypertonic disease;chronic heart failure;Wolff-Parkinson-White syndrome;syndrome of weakness of the sinus node;hereditary predisposition.

Non-cardiac problems: Thyroid disease( more often hyperthyroidism), some hormonal disorders;Diabetes mellitus, especially in combination with obesity and hypertension;Heart failure in acute or chronic alcohol poisoning( cardiac arrhythmia of holidays);Electrolyte disturbances( lack of potassium and magnesium).

In 20 - 30% of cases, the causes of arrhythmia of the heart can not be established by symptoms, that is, arrhythmia is causeless( idiopathic).Often arrhythmia develops after surgical interventions, stroke, various stresses. The reasons why such an arrhythmia appears are alcohol consumption, abundant food, physical overload, stress, constipation, diarrhea, tight clothes, some medications.

Cardiac arrhythmia examination

For all cardiac rhythm and conduction disorders, a thorough examination is necessary, as this pathology of the heart rhythm has a different origin and forms of manifestation.

When examining an arrhythmia, CPES( transesophageal pacing) is performed, which allows recording of electrical activity of the heart and stimulation through a specially inserted probe-electrode into the esophagus.

Necessary cardiological examination:

  • Electrocardiography;
  • Echocardiography;Holter Day ECG monitoring;
  • of the thyroid gland;
  • Blood test for thyroid hormones;
  • Clinical blood test;
  • Blood test for the international normalized ratio( INR).

Additional examination:

  • Transesophageal electrophysiological study;
  • Test with physical activity;
  • Transesophageal echocardiography;
  • Intracardiac electrophysiological study.

Methods of treatment and drugs for arrhythmia of the heart

If after the first attack of atrial fibrillation, paroxysms occur rarely( 1-2 times a year) and are relatively well tolerated by patients, the appointment of a permanent antiarrhythmic therapy is not required. The probability of developing side effects of these drugs in this case is greater than the complications from the arrhythmia itself.

All methods of treatment of cardiac arrhythmia should be aimed at restoring the sinus( correct) rhythm of the heart and its further maintenance. In this case, the cardiologist will prescribe antiarrhythmic drugs that must be taken to prevent arrhythmic disorders, and will tell you how to act in case of an attack of a specific arrhythmia, what medicines and in what doses to take in the first place.

Treatment of a constant form of atrial fibrillation should normalize the incidence of ventricular contractions;prevent clotting of blood, the formation of thrombi and complications( antithrombotic therapy).

In particularly severe arrhythmia, only medications for treatment may not be sufficient. At expressed bradycardias, less than 40 beats per minute, with attacks of loss of consciousness, the patient is shown the installation of a permanent pacemaker, which will create a constant and correct heart rhythm with an individual frequency of 60-75 beats / min. There are no drugs that give such an effect.

In other cases, with congenital or acquired defects in the conduction system of the heart and frequent paroxysmal arrhythmias( more than 140 beats per minute), electrophysiological examination of the cardiac pathways and surgical treatment - ablation( moxibustion, excision of additional pathological pathways) is necessary.

Antiarrhythmic drugs for the treatment of cardiac arrhythmias and the prevention and treatment of seizures: Propanorm, Sotalex, Cordarone.

Preparations for the normalization of the frequency of contraction of the ventricles of the heart. Egilok, Betalok-Zok, Concor, Nebilet, Verapamil, Digoxin.

Antithrombotic therapy: Aspirin, Warfarin.

Emergency ambulance for cardiac arrhythmia

When helping with cardiac arrhythmias, take the following measures:

1. Provide fresh air, unbutton the clothing.

2. Comfortably sit down, relax. With weakness or dizziness, it is better to lie down.

3. When providing first aid for arrhythmia of the heart, measure blood pressure and pulse.

4. Do not take antiarrhythmic drugs without the appointment of a doctor.

5. If necessary, take Corvalol( Valocardin) or another soothing remedy that your doctor has prescribed.

6. If the doctor chooses an effective stopping antiarrhythmic therapy, then take these medications. If emergency care for arrhythmia of the heart does not work, call the ambulance.

Introduce these rules to your family and friends so that in a critical situation they can provide you with the proper first aid.

How can you help your doctor in choosing the best treatment?

First aid for arrhythmia of the heart will be more effective if the patient provides information to the attending physician about the course of the disease as a record in a special diary.

Each day

Date 1.01.09 2.01.09 3.01.09 4.01.09 5.01.09 6.01.09 7.01.09
Hg, mm Hg. Art. 120/80 140/90 135/90 150/90 130/90 150/90 140/85
Pulse, UD / min 72 84 80 90 75 85 88

During an attack of

Date, time 1.01.09 12.30
Pulseand AD 106 bpm, 160/90 mm Hg. Art.
What preceded the seizure( stress, alcohol, physical activity, high blood pressure, discontinuation of treatment, etc.) stress
Complaints on an attack( palpitations, dyspnea, weakness) dyspnea
Attack duration 2 hours
What medications,in what dose and when you took for the arrest of the arrhythmia Propane 600 mg, at 13 o'clock.
The state of health after recovery of the rhythm has improved