Existing cardiac arrhythmias and their display on the ecg. Severe sinus arrhythmia of the heart Cardiogram showed arrhythmia

Purpose of the lesson: To teach clinical and ECG diagnostics of the main types of cardiac arrhythmias.

Before the lesson, the student should know:

Classification of arrhythmias.

Arrhythmias associated with dysfunction of automatism.

Arrhythmias associated with dysfunction of excitability.

Arrhythmias associated with impaired conduction function.

Complex types of cardiac arrhythmias.

At the end of the course, the student should be able to:

Correctly recognize various types of arrhythmias by clinical signs.

Correctly recognize various types of arrhythmias by ECG.

Motivation. Arrhythmias are a common complication of heart disease. They aggravate the course of the disease. Therefore, timely accurate diagnosis of arrhythmias is important for the treatment of patients.

Initial data.

Educational elements.

Basic functions of the heart . The work of the heart is carried out thanks to 4 main functions: automatism, excitability, conductivity, contractility.

Classification of cardiac arrhythmias . Arrhythmias are divided into groups depending on the violation of a particular function of the heart: automatism, excitability, conduction and contractility.

Violations of the function of automatism. The most common are sinus tachycardia, sinus bradycardia, and sinus arrhythmia. On the ECG, a sign of sinus rhythm is the presence of a positive P wave in front of the QRS complex.

Sinus tachycardia . It is caused by increased activity of the sinus node as a result of physical or nervous stress, fever, when taking stimulants, thyrotoxicosis, heart failure. Patients complain of palpitations, the pulse is frequent and rhythmic. On the ECG, the RR and TP intervals are shortened.

Sinus bradycardia . It is due to the rare production of impulses from the sinus node. It is observed with hypothyroidism, the action of a number of medications, with an increase in the tone of the vagus nerve during sleep, in patients with diseases of the liver and gastrointestinal tract, and in athletes. The pulse is rhythmic and slow. On the ECG, the RR and TP intervals are lengthened.

sinus arrhythmia . It is caused by non-rhythmic generation of impulses from the sinus node. There are 2 forms: respiratory (youthful) and non-respiratory (with myocardial diseases). On the ECG - different duration of RR intervals in sinus rhythm.

Violation of the function of excitability. Manifested by extrasystole and paroxysmal tachycardia. It is caused by the appearance in some parts of the myocardium of ectopic foci of excitation, which can generate an impulse leading to an extraordinary contraction of the heart. Such heterotopic foci occur with myocardial diseases, with an overdose of a number of medications, with increased nervous excitability, etc.

Diagnostic signs of extrasystole :

extraordinary reduction;

complete or incomplete compensatory pause;

drawing of an extrasystolic complex on an ECG.

In addition to single ones, there are group extrasystoles, and sometimes there is a pattern of extrasystoles, which is called allorhythmia. The types of allorhythms are as follows:

bigeminia (extrasystoles are repeated after each normal sinus complex);

trigeminia (every two sinus complexes are followed by an extrasystole);

quadrigeminia (every three normal cycles are followed by an extrasystole).

Atrial extrasystole . The ectopic focus of excitation is located in the atrium. In this case, excitation spreads to the ventricles in the usual way, so the ventricular QRS-T complex will not be changed, some changes in the P wave may be observed. time interval.

Atrioventricular extrasystole . In this case, an extraordinary impulse leaves the atrioventricular node. Excitation covers the ventricles in the usual way, so the QRS complex is not changed. Excitation goes to the atria from the bottom up, one hundred leads to a negative P wave. Depending on the conditions of impulse conduction in the affected myocardium, excitation may reach the atria earlier and negative P will then be recorded before the normal QRS complex ("upper nodal" extrasystole). Or the excitation will reach the ventricles earlier, and the atria will be excited later, then the negative P will move after the QRS complex ("lower nodal" extrasystole). In cases of simultaneous excitation of the atria and ventricles, negative P is layered on the QRS, which deforms the ventricular complex (“mid-nodal” extrasystole).

Ventricular extrasystole due to the release of excitation from the ectopic focus in one of the ventricles. In this case, the ventricle in which the ectopic focus is located is first excited, the other excitation reaches later along the Purkinje fibers through the interventricular septum. The impulse does not reach the atria in the opposite direction, so the extrasystolic complex does not have a P wave, and the QRS complex is expanded and deformed.

Paroxysmal tachycardia. This is a long chain of extrasystoles, due to the high activity of the ectopic focus, which produces 160-220 or more impulses per 1 minute. The sinus node is suppressed and does not work. There is a supraventricular form of paroxysmal tachycardia (ectopic focus - in the atrium), when all the complexes are of a normal type, since excitation to the ventricles goes in the usual way from top to bottom. There is a ventricular form of paroxysmal tachycardia (ectopic focus in one of the ventricles), when all the complexes are dilated and deformed due to the contraction of the ventricles at different times.

Conduction dysfunction- blockades. Blockade is a slowdown or a complete break in the conduction of an impulse, therefore, incomplete and complete blockades are distinguished. They are caused by a "lack of energy" for conducting an impulse in myocardial diseases, the presence of cicatricial, dystrophic, inflammatory changes in the heart muscle.

Sinoauricular blockade It is expressed in the fact that the entire cardiac cycle P-QRS-T falls out periodically, since “energy is quickly consumed” when conducting impulses from the sinus node to the atria.

Intra-atrial block noted with an increase in the size of the atria, it is right atrial (P-pulmonale) and left atrial (P-mitrale). Due to the fact that the P wave is caused by excitation first of the right and then the left atrium, with an enlarged right atrium, the P wave increases, becomes high and pointed. With an increase in the left atrium, the P wave is expanded, often two-humped.

Atrioventricular block subdivided into 3 levels.

1 degree manifested in the prolongation of the PQ interval for more than 0.20 s.

2 degree atrioventricular blockade is associated with an even greater slowdown in the conduction of the impulse from the atria to the ventricles due to a greater lack of energy. There are 2 types according to Mobitz. With atrioventricular blockade of the 2nd degree according to the 1st type of Mobitz, there is a gradual lengthening of the PQ interval with periodic prolapse of the ventricular complex - the Samoilov-Wenckebach periods.

At 3 degrees there is a complete break in the movement of the impulse from the atria to the ventricles. This is a complete transverse blockade. At the same time, the atria work from the sinus node (pacemaker of the 1st order) and P waves will be rhythmically present on the ECG. . Since the underlying pacemakers are less automatic, the ventricles contract less frequently than the atria, and QRS complexes will be recorded on the ECG less often than the P waves. With complete atrioventricular blockade, the pacemaker for the ventricles is periodically replaced, which leads to a short-term cardiac arrest. Clinically, this manifests itself Morgani-Edems-Stokes syndrome. There is a temporary cessation of cardiac activity, loss of consciousness, cyanosis and convulsive seizure. In the treatment of these patients, an artificial pacemaker.

Blockade of the legs of the bundle of His . With complete blockade of one of the legs of the bundle of His, the impulse from the atria passes to the unblocked leg, and to the other ventricle, the excitation goes along the Purkinje fibers through the interventricular septum. As a result, the ventricles contract alternately and after the P wave, a widened and deformed QRS will be recorded.

Complex rhythm disturbances - atrial fibrillation and atrial flutter. Most often observed in the triad of diseases: mitral stenosis, cardiosclerosis, thyrotoxicosis. In this case, all 4 functions of the heart are disturbed. Initially, the excitability function is disturbed, since due to pronounced dystrophic changes in the atria, many ectopic foci with high activity appear. In 1 minute, from 600 to 900 pulses are generated. The sinus node is suppressed and does not work. Due to the very large number of impulses, the atria do not contract, but fibrillar twitching of individual muscle fibers is observed (the atria "flicker"). The atrioventricular node non-rhythmically conducts only a part of the impulses, and blocks the majority. The ventricles work irregularly, therefore, with different blood supply and force of contraction. Clinical signs: the pulse is non-rhythmic and uneven, the work of the heart is non-rhythmic with different loudness of tones.

On the ECG atrial fibrillation manifested by 4 signs: different duration of the R-R interval, different height of the R wave in the same lead, absence of the P wave, the presence of a wavy isoelectric line, especially noticeable in 1-2 chest leads.

atrial flutter has the same mechanism, but fewer impulses are produced from ectopic foci in the atria (300-400 per 1 minute). Therefore, instead of a wavy isoline, step-like teeth are recorded on it, due to inferior weak contractions of the atria.

Test questions:

List the main functions of the heart.

Describe the classification of cardiac arrhythmias.

What are the signs of sinus rhythm on an ECG?

What are the clinical and ECG signs of sinus tachycardia?

What are the clinical and ECG signs of sinus bradycardia?

What are the clinical and ECG signs of sinus arrhythmia?

Define extrasystole.

The mechanism of development of extrasystole.

What are the clinical and ECG signs of different types of extrasystoles?

What is paroxysmal tachycardia?

What is the violation of the conduction function?

Describe sinoauricular blockade.

What is intra-atrial blockade?

What is atrioventricular block?

What degrees of atrioventricular blockade and their manifestations do you know?

What is the blockade of the bundle of His bundle?

What functions of the heart are impaired in atrial fibrillation?

What is the mechanism of atrial fibrillation?

What are the clinical and ECG signs of atrial fibrillation?

situational tasks.

Task 1. The patient complains of palpitations. There is a frequent and rhythmic pulse. On the ECG, the R-R and T-P intervals are shortened, a positive P wave precedes the QRS complex.

Purpose of the lesson: To teach clinical and ECG diagnostics of the main types of cardiac arrhythmias.

Before the lesson, the student should know:

Classification of arrhythmias.

Arrhythmias associated with dysfunction of automatism.

Arrhythmias associated with dysfunction of excitability.

Arrhythmias associated with impaired conduction function.

Complex types of cardiac arrhythmias.

At the end of the course, the student should be able to:

Correctly recognize various types of arrhythmias by clinical signs.

Correctly recognize various types of arrhythmias by ECG.

Initial data.

Educational elements.

Basic functions of the heart . The work of the heart is carried out thanks to 4 main functions: automatism, excitability, conductivity, contractility.

Diagnostic signs of extrasystole :

extraordinary reduction;

complete or incomplete compensatory pause;

drawing of an extrasystolic complex on an ECG.

In addition to single ones, there are group extrasystoles, and sometimes there is a pattern of extrasystoles, which is called allorhythmia. The types of allorhythms are as follows:

bigeminia (extrasystoles are repeated after each normal sinus complex);

trigeminia (every two sinus complexes are followed by an extrasystole);

quadrigeminia (every three normal cycles are followed by an extrasystole).

Atrioventricular block subdivided into 3 levels.

1 degree manifested in the prolongation of the PQ interval for more than 0.20 s.

Test questions:

List the main functions of the heart.

Describe the classification of cardiac arrhythmias.

What are the signs of sinus rhythm on an ECG?

What are the clinical and ECG signs of sinus tachycardia?

What are the clinical and ECG signs of sinus bradycardia?

What are the clinical and ECG signs of sinus arrhythmia?

Define extrasystole.

The mechanism of development of extrasystole.

What are the clinical and ECG signs of different types of extrasystoles?

What is paroxysmal tachycardia?

What is the violation of the conduction function?

Describe sinoauricular blockade.

What is intra-atrial blockade?

What is atrioventricular block?

What degrees of atrioventricular blockade and their manifestations do you know?

What is the blockade of the bundle of His bundle?

What functions of the heart are impaired in atrial fibrillation?

What is the mechanism of atrial fibrillation?

What are the clinical and ECG signs of atrial fibrillation?

situational tasks.

Task 1. The patient complains of palpitations. There is a frequent and rhythmic pulse. On the ECG, the R-R and T-P intervals are shortened, a positive P wave precedes the QRS complex.

Heart rhythm disturbance in medical language is called arrhythmia. Most people understand this term as random abbreviations, but this is not entirely correct. In fact, arrhythmia is a disturbed rhythm, frequency and sequence of heart contractions.

ECG helps to diagnose various types of heart rhythm disorders

This disease is diagnosed using an ECG, on the graph of which the doctor sees a change in the length of the segments or the size of the teeth. Unfortunately, the problem of cardiac arrhythmias is one of the main ones in cardiology practice, since it is often difficult to identify the etiological causes of heart failures, and deep ECG deciphering skills are also required.

All arrhythmias are associated with a violation in the work of the properties of the heart muscle - automatism, excitability, conductivity. Depending on which of the properties of the heart is affected, arrhythmias can be divided into three groups according to the mechanism of occurrence:

arrhythmia associated with a violation of the formation of an electrical signal (sinus tachycardia / bradycardia, sinus arrhythmia);
arrhythmia associated with a failure in the conduction system of the heart;
combined forms of arrhythmias.

Common causes of rhythm disturbance

Based on the results of the ECG, the doctor will be able to identify the cause of the arrhythmia.

The number of factors that cause manifestations of arrhythmia is great, ranging from neuropsychiatric disorders to severe organic damage to the heart. There are main groups of etiological factors:

Organic or functional diseases of the cardiovascular system (myocardial infarction, ischemic heart disease, pericarditis).
Extracardiac factors - disorders of nervous regulation, stressful conditions, hormonal disorders.
Bad habits - alcohol abuse, smoking, drug addiction.
Traumatic lesions, hypothermia or vice versa overheating, oxygen deficiency.
Taking certain types of drugs - diuretics, cardiac glycosides cause arrhythmia as side effects.
Idiopathic (independent) arrhythmias - in this case, there are no changes in the heart, arrhythmia acts as an independent disease.

Arrhythmias due to a failure in the formation of an electrical impulse

sinus arrhythmia

The rhythm of the heart is characterized by a period of acceleration and slowing down. The cause of rhythm disturbance is a change in the tone of n.vagus during inhalation-exhalation, a violation of the formation of an impulse in the node, or a syndrome of autonomic dysfunction.

On the ECG, sinus arrhythmia is recorded as fluctuations in the intervals between the R waves, with an interval of more than 0.15 seconds, the rhythm becomes irregular. Does not require special therapy.

Sinus tachycardia

The diagnosis of sinus tachycardia is made when the heart rate is above 90 beats per minute in a relaxed state (outside of exercise). Sinus rhythm is maintained in the correct form.

On the ECG is detected in the form of an accelerated heart rate. The causes of this condition are divided into extracardiac (hypothyroidism, anemia, fever) and intracardiac (MI, heart failure). Therapy is aimed at the underlying disease that caused this condition.

Sinus bradycardia

Sinus bradycardia is characterized by regular but slow sinus rhythm (less than 65 beats per minute).

On the ECG, it is characterized by a slowing of the rhythm. The extracardiac form of sinus bradycardia is caused by toxic effects on the sinoatrial node or the predominance of the parasympathetic system in the regulation of the rhythm. Occurs with an overdose of β-blockers, cardiac glycosides; viral hepatitis, influenza; hypothyroidism.

Extrasystole

This type of rhythm disturbance is associated with extraordinary contractions of the entire heart muscle or some department, which is caused by a spontaneous electrical impulse from the atria or ventricles. This type of arrhythmia is a rather dangerous condition, especially when it is group, as it can develop into ventricular fibrillation or ventricular tachycardia.

On the ECG, a premature ventricular or atrial complex is recorded with the preservation of a normal further rhythm. If an early extrasystole is fixed, then it can be superimposed on the top of the tooth of the previous complex, due to which deformation and expansion of the latter is possible. At the end of the extrasystole, a compensatory pause always occurs - the next P-QRST cycle is delayed.

Paroxysmal tachycardia

Impulse conduction disorders in paroxysmal tachycardia

The clinical picture is similar to extrasystole, it also starts and ends quickly, the difference is in the heart rate, reaching up to 240 beats per minute in the atrial form and hemodynamic disturbance in the ventricular form.

On the ECG - an altered P wave that precedes the QRS complex, the P-R interval is lengthened, the ST complex is subject to secondary changes. Before an attack on the cardiogram, ventricular or supraventricular extrasystoles, violations of the impulse conduction can be recorded.

Arrhythmias associated with impaired atrioventricular conduction

The second name is blockade. According to the place of origin, they are divided into:

Sinoatrial blockade - impulses from the sinoatrial node do not enter the atria, which is typical for a structural lesion of the heart. Therapy is directed at the underlying disease.
Intra-atrial blockade - detected in heart disease, myocardial inflammation, coronary heart disease, as well as in case of poisoning of some antiarrhythmic drugs.
Atrioventricular (AV) blockade is a delay in the conduction of an impulse from the atrium to the ventricle. Occurs during inflammatory and destructive processes in the heart, myocardial infarction. Increased irritation n.vagus also plays a role in the occurrence of AV blockade;
Intraventricular blockade - occurs in the conduction system of the heart (disturbances in the bundle of His, blockade of the right and left legs of the item of His). This type of blockade does not require special therapy.
Wolff-Parkinson-White syndrome or premature depolarization of the ventricles. It develops in the event of the appearance of additional pathways. It affects men more often than women. A separate syndrome does not require treatment, in some cases, when combined with paroxysmal tachycardia, β-blockers, cardiac glycosides, are prescribed.

On the ECG, these types of arrhythmias are characterized by a loss of ventricular and atrial contractions (PQRS complex), the predominance of P waves, and deformation of the ventricular complexes.

Atrial fibrillation

Atrial fibrillation in frequency of occurrence is after extrasystolic. It is characterized by the fact that excitation and contraction occurs only in certain places of the atria, while in general there is no general excitation. This phenomenon prevents the conduction of an electrical impulse to the AV node. Separate waves reach the ventricles, causing their excitation and chaotic contractions.

On the ECG, it is characterized by two characteristic changes: the absence of the P wave (the atria are not excited, instead of it - atrial waves), and a different interval between the QRS complex.

ventricular fibrillation

This type of arrhythmia is a very severe pathology that accompanies terminal states. The causes of fibrillation are myocardial infarction, electric shock, drug poisoning. If this pathology occurs, minutes count, it is necessary to conduct an emergency electrical defibrillation. With the development of this arrhythmia, a person loses consciousness, turns pale sharply, the pulse on the carotid arteries disappears, the pupils dilate. This occurs due to the cessation of effective blood circulation, i.e. means stop.

On the ECG it is displayed as a wave of one amplitude, on which it is impossible to disassemble the complexes and teeth, the rhythm frequency is 250-300 beats per minute. There is no clear isoline.

Heart disease is very insidious. For a very long period of time, they may not show themselves in any way, and a person will not even suspect that he has a pathology. Arrhythmia is no exception. As a rule, it becomes apparent already at a severe stage. Only monitoring your own blood pressure and heart rate will help you recognize alarming signals in time.

Deciphering ECG indicators for arrhythmias

Arrhythmia is the general name for all those conditions when heart rate, strength, rhythm and sequence are violated. That is, these are all deviations from the normal rhythm of the heart, which is called sinus.

During normal heart rate, the heart rate is 50-100 beats / min, it depends on the physical activity of the person at the moment. The development of arrhythmia is preceded by a variety of reasons. Arrhythmia will be considered such conditions in which the heart rate becomes less than 60 beats per minute or more frequent than 100. Arrhythmia on the ECG is visible in different ways, depending on the type of syndrome.

Important information!

The decoding of the main indicators on the ECG is described below in case an electrocardiogram has been performed, but the cardiologist has not yet deciphered it.

Table-interpretation of indicators on the ECG

An ECG requires mandatory decoding by a cardiologist.

Effect of extrasystoles

These are cuts made prematurely. Electrical impulses do not come from the sinus node. This type most often occurs due to various factors not related to heart disease. The main reasons for this type of arrhythmia include:

unstable psycho-emotional state;
treatment with certain groups of drugs;
smoking abuse;
vegetative disorders.

This is what an extrasystole looks like on an ECG

Extrasystoles- this is just the case when the patient may not feel anything for a long time. Sometimes there may be a kind of push in the heart, or its short-term fading. If such signs are single - it can be even with normal heart function. But if they occur more and more often, this may indicate an exacerbation of diseases - ischemia, myocarditis. The most dangerous are ventricular extrasystoles. This is when the impulse comes from one of the ventricles. This may be the initial symptom of ventricular fibrillation.

How to determine on the ECG. On the ECG, an extraordinary contraction of the heart looks like a tooth different from the others.

Atrial fibrillation

This type is atrial fibrillation. This in itself is a complication that occurs during ischemia. The same type is the most common heart rhythm disorder. Often the cause of this variety is thyroid disease, in violation of its activity.

Atrial fibrillation is characterized by failures of cardiac activity of varying severity, fainting and blackouts in the eyes. Often, these symptoms are accompanied by severe weakness, shortness of breath, chest pain and a feeling of increasing fear. Sometimes attacks begin suddenly and end spontaneously without any intervention. But it is most likely that the attack will be long, several hours, or maybe days, and will require mandatory medical care.

How to determine on the ECG. The ECG may show large or small atrial waves, deformed disordered complexes. One patient has both flutter and atrial fibrillation. In the cardiogram of a healthy person, chaotic waves are absent, the rhythm is even.

sinus arrhythmia

Despite the sinus rhythm, it is distinguished by its irregularity. Heart contractions either slow down or quicken. It is especially noticeable when breathing: on exhalation, the heart rate is almost twice as high, and on inspiration it greatly decreases. The patient feels very tired, dizzy, he may faint. Increased symptoms require close attention and treatment.

The causes of sinus arrhythmia are heart disease, infectious processes involving the myocardium, heart defects. Of the external factors, this type of arrhythmia is most often provoked by hormonal disorders in the body, diseases of the nervous system.

How to determine on the ECG. On the ECG, abnormal cardiac activity is indicated by a difference in PR intervals of at least 10%.

atrial flutter

With this diagnosis, the heart rate increases already to 200-400 contractions, for example, against the background of the correct atrial rhythm.

The reasons here, as a rule, are organic heart disease, heart surgery (especially the first week after the intervention). Often, hypertension, myocardial dystrophy can provoke atrial flutter.

The risk group includes men over 60, smokers, people with a lack of potassium or excessive production of thyroid hormones. An attack of such an arrhythmia can be caused by intense heat, physical overstrain, stress, the use of alcohol or drugs.

Symptoms - a strong increase in heart rate, weakness, a sharp decrease in pressure with the development of a fainting state, dizziness. Along with this, pulsation of the veins in the neck is often observed.

How to determine on the ECG. On the ECG, flutter is indicated by F-waves that occur instead of the P wave. The heart rate is 240-350 beats per minute. There is also atypical flutter, in which these same waves occur at a heart rate of 340-430 beats.

Supraventricular tachycardia

This type of arrhythmia is formed on a fairly small area of atrial tissue. Because of this, inflammation of the heart soon begins. This inflammation is characterized by its periodicity. Periodicity can last days, or even months. Most often it happens that not one area of \u200b\u200bthe heart becomes inflamed, but several.

This arrhythmia implies an increase in heart rate for no apparent reason. The symptoms are quite diverse, but the very first sign is a strong pulsation in the chest. In addition to the signs of other species, sweating, tightness in the throat, increased urination, nausea and vomiting may occur.

How to determine on the ECG. This is noticeable by the increase in the frequency of P waves and QRC complexes, as well as the small intervals between them.

Ventricular tachycardia

Pathology is expressed in the acceleration of the rhythm coming from the ventricles. The heart rate is about 100 beats, but the ventricular impulses can follow each other. The main feature of this species is suddenness. The heart rate begins to increase to 200, the heart can no longer fill with blood normally and, accordingly, much less of it is released into the body. This pathology is difficult for patients, especially with concomitant heart disease.

Persistent gastric tachycardia is manifested in a strong change in systolic pressure. At this point, the patient has reduced pulsation of the veins.

Unstable gastric tachycardia goes unnoticed if at this moment it is not caught on the ECG.

If the heart rate is 220 beats per minute, everything points to ventricular flutter. Here, there may be a decrease in blood pressure, sweating, strong arousal, or, conversely, stupor, fainting. Sometimes there is swelling, difficulty breathing, shortness of breath - all point to acute heart failure.

How to determine. The ECG shows the expansion or deformation of the QRC complexes, their change in amplitude and directions. Noticeable deviation of the electrical axis to the left.

The occurrence of ventricular fibrillation

Here, the impulses coming from the ventricles are chaotic and irregular. Because of this, there is flutter of the ventricles and the absence of their contractions is possible. For this reason, blood cannot be pumped through the body normally. This condition is extremely dangerous, requiring urgent hospitalization, resuscitation with defibrillation. If you do not do all this within 10 minutes after the onset of the attack, then everything can end in death.

If we talk about the symptoms, then they all correspond to circulatory arrest, and, accordingly, clinical death. The patient loses consciousness, he begins to have convulsions, spontaneous urination and defecation, the pupils do not react to light, there is no pulse and breathing, and they are not palpable in the arteries, blueness of the skin may be noted.

Decryption. On an EKG it could be:

large-wave fibrillation (stages 1 and 2) with sufficiently large waves and a frequency of 300-600. This is the best prognosis and indicates that medical intervention will be effective;

small-wave fibrillation (late stage, 3 and 4) - the waves are wider and acquire an uneven amplitude. The heart rate is also uneven - first it increases to 600, and then drops to 400 per minute.

This condition is dangerous due to the occurrence of vascular thromboembolism and abnormal expansion of all parts of the heart.

Features of sinus node dysfunction syndrome

SDSU - failures of the rhythm due to the weakening of the automatism function or its complete cessation. There is a decrease in heart rate, and cardiac arrest may occur.

Symptoms may be absent altogether, or present in full, as in other arrhythmias. With SDSU, fainting is most common, and they can go away on their own - the skin becomes pale and cold, sweating. There may be a violation of the gastrointestinal tract, weakness in the muscles.

Most often, SDSU occurs in people aged 60-70 years, and with an equal degree of probability in men and women. This is a very rare species - 0.03-0.05% of all of them.

heart block

The patient slows down the conduction of the impulse, sometimes there is a complete cessation of it. Blockades can also be persistent and transient. Their causes are heart disease, the use of certain drugs, high blood pressure. The blockade can even be congenital, but this is extremely rare (then the heart rate drops to 40 per minute).

The clinical picture is characterized by the absence of a pulse and heart sounds. In the body there is a very slow blood circulation, there are convulsions and fainting, oxygen starvation of the internal organs. Heart block often ends in the death of the patient.

How to determine. On the ECG, the P wave is always deformed and exceeds the norm in width, height within 0.11 seconds. The PQ interval is extended.

Arrhythmia indicators on the tonometer

When it comes to arrhythmia, the tonometer may give incorrect values. Due to the lack of indication of heartbeat failures, the indicators can be greatly distorted. Now on sale there are good blood pressure monitors that can perfectly recognize arrhythmia. Such devices immediately determine violations of the pulse, the sequence of contractions. As a rule, failures in the work of the heart are expressed by a heart at the bottom of the device monitor. Arrhythmia on the latest blood pressure monitors is displayed as follows:

Arrhythmia indicators on the tonometer

first there are several measurements with pauses between them;
if two of them passed without failures, then the process does not go further;
pulse is displayed on the screen;
at the very bottom of the screen, the arrhythmia indicator lights up.

Do not worry that the device does not identify serious failures from small irritations - all this is perfectly distinguished by a modern device. It is quite possible to trust such a device, and if it reveals signs of arrhythmia, it is urgent to consult a doctor. If the tonometer once showed arrhythmia, then the result may be incorrect, and you need to take another measurement.

How to choose a tonometer

It is very important for a person who periodically has interruptions in the heart rhythm to have a good tonometer on hand that can detect signs of arrhythmia. New generation devices give the result, which is obtained on the basis of data mining. They can work on two principles:

some tonometers give the result by calculating the average value of the last three measurements;
others themselves carry out the required number of measurements and, having processed their indicators, give the final result.

Tonometers of this type are able to determine blood pressure even more accurately. This is a great opportunity to keep pressure, heart rate and heart rate under control at the same time.

Do not worry if sometimes an arrhythmia icon comes out during a normal pressure measurement. An alarm should be caused by a constantly appearing indicator - this means that it is time to visit a doctor. If the sign of atrial fibrillation flashes on the screen, then it is no longer possible to postpone the visit. When choosing a device, you need to focus on the following parameters:

cuff size: it must strictly correspond to the circumference of the arm;
the size of the screen should be sufficient so that all indicators are clearly visible;
arrhythmia indicator should be backlit, in some cases - with sound;
built-in memory can contain up to 90 entries;
averaging function;
a sound signal announcing the end of the measurement process;
blood pressure monitors can be for the whole family - in this case, the indicators of each person are recorded separately;
there are devices powered by both mains and batteries at the same time.

Modern blood pressure monitors are well suited for all people, they are easy to use and do not require any specific skills. They can even be used by patients who have hearing and vision problems. You just need to press the button, and the device does the rest without pain and discomfort in the form of a strong tugging of the forearm.

Pulse count for arrhythmia

People suffering from heart disease should be able to correctly count and evaluate their pulse. This is equally important for both fast and slow heartbeats. Sometimes this is what can prevent a heart attack in time.

To correctly determine the pulse, you need to find the radial artery near the base of the hand near the thumb. It is important to take into account the fact that the indicators of the left and right hands may be slightly different. In order to detect the pulse, you need to lightly press your fingers on your wrist, clasping it from the back. It is the pads of the fingers that will feel the pulse beat.

How to measure the pulse

The standard time is 15 seconds. Then the number of beats produced during this time must be multiplied by 4. The time for counting the pulse during arrhythmia is one minute, it must be counted by squeezing the artery with 3-4 fingers for the best detection of blows. Do not forget that each finger also has a pulsation, so it can be mistaken for a pulse. During the measurement of the pulse, the hand should be as relaxed as possible and placed with the open palm up. On a watch with a second hand, you need to wait for an even value and you can start counting. With different types of arrhythmias, there will be completely different pulse rates. For example, with tachycardia, more than 80 beats, with bradycardia - less than 60, paroxysms are characterized by a very frequent pulse - more than 200, with heart block can reach 250-300.

The appearance of interruptions in cardiac activity against the background of neurological diseases present. It is more pronounced in females. It is characterized by a functional disorder in the rhythmic work of the heart. With a pronounced clinic, appropriate treatment is prescribed. Preparations are selected by a neurologist.

Pulmonary arrhythmia

This definition often denotes a heart rhythm disorder that has developed against the background of a hypertrophied right ventricle. The disease is mainly associated with increased pressure in the pulmonary artery. Also, arrhythmia contributes to the stretching of the walls of the right ventricle. It is difficult to treat due to the chronic process.

Atrial fibrillation

Very rapid and erratic contraction of the atria, in which there is a contraction of more than 300 times per minute. Pathology is extremely dangerous for human life and requires immediate intervention of medical personnel. The risk of developing pathology increases with age, which is facilitated by organic lesions of the myocardium.

Ventricular extrasystole

An important type of arrhythmia for diagnosis, in which there is an untimely contraction of the ventricles. The signal for extraordinary depolarization comes from an additional (ectopic) focus of excitation. To prevent the development of serious complications, it is necessary to carry out timely treatment of ventricular extrasystole.

Atrial fibrillation

This type of arrhythmia is characterized by the appearance of chaotic contractions of the atrial muscles with an increase in heart rate up to 500-600 beats per minute. Pathology can cause a serious lack of blood circulation, because of which a person is threatened with death. It is often a complication of cardiac diseases that have been started or improperly treated.

sinus arrhythmia

Violation of the normal activity of the heart, in which sinus rhythm is maintained. May present with increased, slow, or irregular heartbeats. This type of arrhythmia is divided into pathological sinus arrhythmia and functional, which does not require treatment. The concept is considered general and refers to a number of diseases, each of which is manifested by specific clinical signs.

Sinus bradycardia

Violation of the normal functioning of the sinus node, in which a slow heartbeat develops. In this case, the heart rate is up to 50 beats per minute. In trained people, it is considered as a variant of the norm. If the pathology brings inconvenience to a person, then drug treatment is prescribed.

Paroxysmal tachycardia

An attack of arrhythmia, characterized by the occurrence and termination for no apparent reason. During a heartbeat, the heart rate can reach 300 beats per minute. There are ventricular, atrial and nodal (atrioventricular) forms of the disease. Almost all manifestations of pathology require medical correction.

A form of arrhythmia with a supraventricular location, resulting from the accelerated work of the sinus node. Manifested in adults with a heart rate of 100 beats per minute, in children from 120 beats per minute. Depending on the severity of clinical manifestations, it can be considered physiological and pathological. Treatment of sinus tachycardia is required in violation of the normal lifestyle of a person.

Valvular arrhythmias

It is a clinical definition of cardiac disorders that occur with insufficiency or stenosis of the valvular apparatus. Especially often appear with mitral valve prolapse. Due to the presence of organic pathology, surgical intervention is often required.

Pancreatic arrhythmias

They may appear to patients as one disease, although in fact arrhythmia is a violation of the heart rhythm. Since the pancreas is anatomically close to the heart, some of its diseases cause interruptions in cardiac activity, clinically defined as “pancreatic arrhythmias”. They cannot be ignored, therefore, consultations are held with a cardiologist, followed by the appointment of antiarrhythmic treatment.

Intestinal arrhythmia

In some situations, intestinal diseases are combined with arrhythmias (interruptions in the work of the heart), which significantly complicates the general condition of the patient. In particular, palpitations occur during infectious processes in the intestines, acute poisoning, and after injury. In each case, specific treatment in the form of antiarrhythmic drugs is required.

Intercostal neuralgia

Violation of the heart rhythm, which in neurology can be combined with intercostal neuralgia. In addition to muscle pain, the main clinic is supplemented by heart failures. Therefore, antiarrhythmic drugs are added to the general treatment.

Heterotopic arrhythmias

A group of automatism disorders not associated with the main pacemaker - the sinus node. This includes ventricular, atrial, and junctional rhythms. Excitation of the heart muscle occurs with acceleration or deceleration, which is manifested by the corresponding clinic. Often they take the form of paroxysmal tachycardia, which develops in one or another part of the heart.

Vagal arrhythmia

It is an irregular heart rhythm, directly related to the influence of the parasympathetic nerve (vagus). It develops in 90% of cases in men after taking alcoholic beverages or fatty foods in large quantities. It may not cause significant discomfort and quickly pass after the elimination of the irritating factor. In other cases, therapeutic intervention is required.

Systolic arrhythmia

It is manifested by a disturbed heart rhythm as a result of improper contraction of the ventricles. Belongs to the group of extrasystoles. Depending on the cause, organic and functional types of disorders are distinguished. In the second case, most often the patients are women. In the presence of damage to the heart muscle, they can contribute to the occurrence of more complex conditions (fibrillation, flicker).

Medical arrhythmia

Appears to be an abnormal heart rhythm or heart rate caused by drugs. Most often develops after exceeding the dose of cardiac glycosides and diuretics. With timely assistance, it does not lead to the development of complications.

Ischemic arrhythmia

Interruptions in the work of the heart associated with a lack of oxygen supply to the heart muscle (myocardium). With the disease, an irregular, frequent, or slow heartbeat may be observed. For diagnosis, ECG, coronary angiography are used to identify ischemic areas. In difficult cases, surgery may be required.

supraventricular arrhythmia

Also known as supraventricular extrasystole. Premature impulses originate in the atria. Irregular heartbeats appear, disrupting the normal functioning of the muscular organ. Medical correction is relevant in case of presentation of complaints to patients, reduced ability to work. Without a pronounced clinic, the treatment of pathology is not carried out.

Vascular arrhythmia

It is an additional symptom complex of vegetative-vascular dystonia, characterized by abnormal heart rhythm, its acceleration or deceleration. It is not easy to treat due to the main cause of development - disorders of the nervous system. Therefore, it is often necessary to consult a psychotherapist along with the use of antiarrhythmic drugs.

Hypertensive arrhythmia

Irregular heartbeats, with fast or slow heart rate. Manifested against the background of hypertension. May develop as a result of a hypertensive crisis. This type of arrhythmia is considered a complication of the underlying disease, so timely treatment is necessary.

Respiratory arrhythmia

Mostly diagnosed in teenagers. It is manifested by an increase in the number of heartbeats on a deep breath, while on exhalation, the heart rate decreases. Often there are no clinical manifestations, therefore, pathology is detected during a general examination of the patient. With age, the likelihood of its occurrence may decrease.

cardiac arrhythmia

This type of arrhythmia is a group of heart diseases, including various rhythm disturbances with an increase or decrease in heart rate. A heart impulse against the background of arrhythmia can be formed or conducted in a pathological manner. The form of the disease is diagnosed using an ECG, after which the most appropriate antiarrhythmic agent is prescribed.

ventricular fibrillation

With this pathology, the ventricles contract chaotically with a heart rate of 250 to 500 beats per minute. Cardiac arrest is possible due to the lack of its coordinated work. It develops against the background of various heart diseases, the main of which is myocardial infarction, hypertensive crises, angina pectoris, cardiomyopathy.

Ventricular tachycardia

Frequent contraction of the ventricles of the heart, in which there is a heart rate of 120 times per minute or more. Also known as paroxysmal tachycardia. It can be considered as a physiological state (after physical exertion, against the background of emotional and mental stress) and pathological (it develops at rest). It can be complicated by fibrillation, therefore, in any form, it is necessary to undergo treatment with antiarrhythmic drugs.