If the heart rhythm is disturbed. Violation of the heart rhythm and conduction (cardiac arrhythmias). Possible complications and prognosis

If the frequency and regularity of heartbeats do not correspond to generally accepted norms, you may be diagnosed with cardiac arrhythmia. In essence, this is an organic lesion, which is the result of intoxication, functional failures of the nervous system, or violations of the water-salt balance.

Is cardiac arrhythmia dangerous and how can it be dealt with? We have to study the causes, symptoms and methods of treatment of this disease.

Classification of pathology

Before discussing the essence of pathology, it is necessary to study its varieties. There are several groups of factors that lead our body to a state of arrhythmia. Each type of this disease has its own symptoms. The disease can be based on calcium and magnesium imbalance, industrial and bacterial conditions, bad habits (nicotine, alcohol), oxygen deficiency.

The defeat of the endocrine organs in the future may affect the work of the heart muscle. Side effects from a number of drugs can also cause disease. Types of arrhythmias are based on violations of certain cardiac functions. Four varieties of this disease are known:

• sinus tachycardia.

Sinus bradycardia

A slow heart rate is one of the key symptoms of sinus bradycardia. This pathology affects the sinus node, which serves as an inductor of electrical impulses. The heart rate drops to 50-30 beats/min. Pathology is quite dangerous - it is often found in outwardly "healthy" people undergoing a routine medical examination.

The reasons are different, but most of them lie in the field of congenital genetic anomalies (reduced nodal automatism).

The risk group includes professional athletes. Constant training changes their blood circulation and energy metabolism. However, the reasons for the change in rhythm are very diverse. Let's list them:

• starvation;
• imbalance of the nervous system (vegetative department);
• hypothermia;
• nicotine and lead intoxication;
• infectious diseases (typhoid fever, jaundice, meningitis);
• increased intracranial pressure in tumors and edema of the brain;
• consequences of taking certain drugs (digitalis, beta-blockers, verapamil, quinidine);
• sclerotic changes in the myocardium;
• thyroid dysfunction.

The heart rate increases sharply, exceeding 90 beats / min. The sinus node sets the rhythm, and the heart rate rises to 160 beats. This indicator decreases gradually. Usually a rapid rhythm is a consequence of physical activity, this is a normal phenomenon. Pathology manifests itself in the fact that the patient feels an abnormal heartbeat at rest.

It is not considered an independent disease. Pathology develops against the background of various ailments and an unhealthy lifestyle. This disease is dangerous because the disturbed blood supply is reflected in various systems of our body. We list the main causes of tachycardia:

• vegetative imbalance;
• fever;
• anemia;
• abuse of tea and coffee drinks;
• a number of drugs (calcium channel antagonists, vasoconstrictor anti-cold tablets);
• hyperthyroidism and pheochromocytoma;
• heart failure;
• heart defects and pulmonary pathologies.

With sinus arrhythmia, the sinus node continues to induce impulses, but gives them a variable frequency. A disturbed heart rhythm is developed, which is characterized by slowdowns and accelerations. In this case, the heart rate will fluctuate within the normal range - 60-90 beats. In healthy people, sinus arrhythmia is associated with breathing - the heart rate changes with inhalation / exhalation.

When might sinus arrhythmia be treated? It will not be possible to determine the "fatal line" on your own - for this you need to contact a professional cardiologist. When recording an ECG, the doctor asks the patient to hold their breath. In this case, the respiratory arrhythmia disappears, and only sinus arrhythmia remains. The pathological form of the disease is rare - it is a sign of heart disease.

Paroxysmal tachycardia

Heart contractions in this disease become more frequent / slow down suddenly - in attacks. The correct rhythm is maintained for a long period, but sometimes anomalies occur. The source of failures can be localized in different areas of the heart - the heart rate directly depends on this.

The pulse of adults often accelerates to 220 beats, in children - up to 300. The duration of paroxysms also differs - attacks disappear in a matter of seconds or stretch for hours.

The causes of tachycardia lie in the launch of a focus of increased automatism and pathological circulation of the electrical impulse. The disease can be based on myocardial damage - sclerotic, necrotic, inflammatory and dystrophic. Symptoms may include nausea, dizziness, and weakness.

Here are the main factors that affect the clinical picture:

• condition of the contractile myocardium;
• heart rate;
• the duration of the heartbeat;
• localization of the ectopic driver;
• seizure duration.

Causes of heart failure in atrial fibrillation

We did not mention another form of the disease - atrial fibrillation, also called. The atria in this case flutter, and the ventricles receive 10-15 percent less blood. The state of tachycardia already discussed above sets in. The patient fully learns what cardiac arrhythmia is - heart rate increases to 180 beats.

Irregular heartbeats can take other forms. The pulse drops to 30-60 beats - the doctors state bradycardia. Similar symptoms are fraught with the use of a pacemaker.

We list the main causes of atrial fibrillation:

• hormonal disorders (Hashimoto's thyroiditis, nodular goiter);
• heart failure;
• heart disease or its valves;
• increased blood pressure;
• diabetes mellitus and concomitant obesity;
• pulmonary diseases (bronchial asthma, bronchitis, tuberculosis, chronic pneumonia);
• excessive alcohol consumption;
• a number of medications;
• wearing tight clothing;
• diuretics.

Risk factors

The causes of all forms of pathology are quite similar. Most of them are the result of some diseases, the patient's wrong lifestyle, or are hereditary. After analyzing the sources of heart failure, the doctors deduced the main risk factors.

Here they are:

• genetic predisposition;
• high blood pressure;
• thyroid disease;
• electrolyte disturbances;
• diabetes;
• the use of stimulants.

Most of these factors have been discussed above. Improper nutrition can lead to electrolyte disturbances - calcium, sodium, magnesium and potassium must be present in food.

Forbidden psychostimulants include primarily caffeine and nicotine - thanks to them, extrasystole develops. Subsequently, ventricular fibrillation can cause sudden cardiac death.

How to recognize arrhythmia - symptoms of the disease

Symptoms of tachycardia and bradycardia have a number of minor differences. Cardiac arrhythmia at first develops in a latent form, without showing itself in any way. Subsequently, symptoms are found that indicate arterial hypertension, cardiac ischemia, brain tumors and thyroid pathologies. Here are the main signs of arrhythmia:

• dizziness;
• general weakness;
• dyspnea;
• fast fatiguability;
• darkening in the eyes;
• borderline states of the brain (it seems to the patient that he is about to lose consciousness).

If you have prolonged loss of consciousness, lasting about 5-10 minutes, you can "cut off" bradycardia. Such fainting is not inherent in this form of arrhythmia. The symptoms of tachycardia look a little different and at first look like a general malaise. They look like this:

• dyspnea;
• cardiopalmus;
• fast fatiguability;
• general weakness.

Methods of diagnostic studies

Symptoms of a suspected arrhythmia need to be carefully checked. Alarming signs include not only palpitations, but also sudden fading of the heart, pressure drops, weakness, interspersed with drowsiness.

If you have the above symptoms, it is time to see a doctor and undergo a full diagnosis. You should contact a cardiologist - first of all, he will begin to check the thyroid gland and identify possible heart diseases.

Many methods have been developed to diagnose arrhythmia. Be sure to record an electrocardiogram - it can be short and long. Sometimes doctors provoke an arrhythmia in order to record readings and more accurately determine the source of the problem. Thus, diagnostics is divided into passive and active. Passive methods include:

• Electrocardiography. The electrodes are attached to the patient's chest, arms and legs. The duration of the phases of contraction of the heart muscle is studied, the intervals are fixed.
• echocardiography. It uses an ultrasonic sensor. The doctor receives an image of the heart chambers, observes the movement of the valves and walls, and specifies their dimensions.
• Daily ECG monitoring. This diagnosis is also called the Holter method. The patient carries a portable recorder with him at all times. This happens during the day. Physicians receive information about heart rate during sleep, rest and activity.

In some cases, passive research is not enough. Then doctors induce arrhythmia by artificial means. Several standard tests have been developed for this. Here they are:

First aid

Attacks of arrhythmia can proceed independently and begin suddenly. The attack ends just as unpredictably. If the patient has the first attack, immediately call an ambulance. Often the orderlies drive slowly, so you should worry about the health of the victim. Do this:

• calm the patient, suppress the manifestations of panic;
• create rest conditions for the patient - lay him down or seat him in a comfortable chair;
• try to change the position of the victim's body;
• sometimes you need to induce a gag reflex - do it with two fingers, irritating the larynx.

What happens next is up to the medical staff. Medicines for cardiac arrhythmia will be prescribed by the cardiologist later - when the patient is "pumped out" and a preliminary diagnosis is made.

Seeing the symptoms of arrhythmia, try to interrupt any physical activity.

Permissible use of sedatives:

• motherwort;
• valerian;
• corvalol;
• valocordin (within 40-50 drops);
• elenium.

Complex of therapeutic and preventive measures

It is impossible to give an unambiguous recommendation about which pills will help to cope with cardiac arrhythmia. This disease develops against the background of various lesions of the heart muscle (organic and functional). For example, changes in automatism lead to sinus tachycardia, arrhythmias, or bradycardia. If there are chronic / acute cardiac pathologies, they must be urgently treated.

When a specific form of arrhythmia is identified, secondary prevention is prescribed. This type of treatment is not practiced for bradycardia. But with tachycardia, you will have to drink medicines. You will be prescribed antirhythmic drugs:

• calcium antagonists (Diltiazem, Verapamil);
• adrenergic blockers (Atenolol, Anaprilin, Egilok);
• Sotalex;
• Cardarone;
• Propanorm;
• Allalinin.

It is strictly forbidden to take these substances without a doctor's prescription. Strict supervision is necessary, as misuse of drugs is fraught with consequences. For example, new forms of arrhythmias may arise. So don't take unnecessary risks.

Likely consequences

The main consequences of arrhythmia are heart failure and thromboembolism. Poor contraction of the heart muscle leads to heart failure - internal blood supply is disturbed. Various organs suffer from a lack of oxygen, systemic disorders begin. This leads to a number of serious illnesses and even deaths.

Heart rhythm disturbance or simply arrhythmia is a complex condition in which not only a violation of the heart rate can occur, but also their rhythm and sequence are disturbed.

A normal heart rhythm is very important for the coordinated work of all components of the body. Heart rhythm disturbance code according to ICD 10 - I49, which combines all types of disorders.

The causes of rhythm failures are very different. The feeling of interruption is felt almost immediately after the problem occurs. Indeed, in a normal state, we do not even think about the fact that there is such an important organ as the heart.

One of the most common causes of arrhythmias is stress or emotional stress. This is especially true for people with an unstable psyche and a disease of the nervous system (central and autonomic). It is these people who should be attentive to the surrounding background.

In a healthy person, the heartbeat is even and constant. The heart rate is normally 60-80 beats per minute. In a normal state, all cardiac impulses are formed in the sinus node - the pacemaker.

Then, within 0.05 seconds, they enter the atrioventricular node. During this period of time, the atria contract. After that, along the bundles of His fibers, signals are transmitted to the tissues of the ventricles, which causes their systole.

For reference. All structures of the heart are subject to this mechanism of coordinated work, due to which myocardial contraction and the normal functioning of the valves are carried out.

Rhythm disturbance can occur if any function of the myocardium has failed:

• automatism;
• conductivity;
• excitability;
• contractility.

The heart rate necessary for the body is under the control of the cerebral cortex. However, the myocardium does not always contract with the same rhythm - during sleep, its contraction should be slowed down, during physical activity, on the contrary, it should be accelerated.

This function is provided by the vagus and sinus nerves, which transport signals from the cerebral cortex, as well as pituitary hormones.

Cardiac arrhythmias - what is it?

Arrhythmia, or a violation of the rhythmic contractions of the heart, is a very common pathology characterized by a decrease or increase in the heart rate, as well as its irregularity.

Important. Violation of the heart rhythm is a rather serious pathology, since it can affect the functioning of the whole organism.

Mechanisms of arrhythmia

The factors provoking a pathological change in the heart rhythm are different, and depend on the type of arrhythmia:

• tachycardia or (increase or decrease in the number of contractions, but a constant rhythm) are provoked by a violation of the functioning of the nervous and hormonal regulation, for example, during stress, psychological trauma, intoxication of the body after an infection. They are also caused by cardiac pathologies - the development of tumors, inflammation, dystrophy and heart failure.
• nodal type of contractions - from the atrioventricular node occurs as a result of the transfer of function to a stronger nerve junction. This is a rare type of arrhythmia and, as a rule, occurs in patients of childhood.
• another form of pathology - idioventricular, occurs if the impulse develops in the ventricles and is transmitted from them to the atria;
• extrasystole develops during the formation of additional sources of the excitation site, which have their own location. They arise before natural impulses. They can be single or group. As a rule, such impulses arise due to excessive irritation, dystrophy or inflammation.

  For reference. In young patients, it is associated with past infectious diseases, and in adolescents, with endocrine changes;

• paroxysmal tachycardia develops with excessive excitability of the autonomic nervous system and heart muscle. It is characterized by seizures and an acute failure of the rhythmic contractions of the heart;
• atrial fibrillation of the heart rhythm is associated with a violation of the atrioventricular connections. It is characterized by arbitrary contractions due to a reduced concentration of potassium in the heart muscle, increased excitability of any center. It occurs against the background of tachycardia or bradycardia, has a paroxysmal character.

  For reference. In the course of research, it was found that it can develop as a result of an overdose of drugs from the digitalis group.

• blocking of impulses at various intervals of the conduction apparatus of the heart can be functional or organic, in which case the nerve connection can be broken by a necrotic site, localization of a heart muscle infarction, scars with myocardiosclerosis, or inflammation during an attack of rheumatism in young patients. Such pathologies differ in the degree and nature of the signal break.

Specific variability of cardiac pulsation is found at the acute stage of heart disease: a combination of several pathologies is manifested. To return the correct rhythm, therapy of the leading disease is necessary, taking into account electrolytes, the concentration of enzymes in the blood and the extent of symptoms.

How does a heart rhythm disorder manifest?

The most common complaints of patients with arrhythmia are as follows:

• feelings of failure of rhythmic contractions, pushes or shocks in the chest area;
• in case of violation of connections - a feeling of “stopping” the heart;
• dizziness, darkening in the eyes;
• dyspnea even when relaxed;
• weak condition; in small patients, reduced physical activity is noticeable;
• pain in the heart region - compressive, stabbing, pressing, can be given to the left arm or shoulder blade.

Attention. Failures in the rhythm of the heart significantly change the behavior of a person - he notices problems, tries to listen to the pulse, becomes anxious, there is a fear of dying.

Heart rhythm disorders - classification

Cardiac arrhythmia occurs due to various mechanisms. In accordance with this, several groups of arrhythmias are distinguished:

1. Violation of impulse formation:
   • Failure of the functioning of the sinus node:
     • sinus tachycardia;
     • sinus bradycardia;
     • sinus arrhythmia;
     • pacemaker weakness syndrome;
     • termination of this node.
   • Impulses from additional sources:
     • replacing escape contractions: from the atrioventricular node, from the muscular tissue of the ventricles and mixed;
     • change of pacemaker;
     • accelerated additional cuts.
   • Additional excitation sources independent of the automatic function:
     • extrasystole;
     • paroxysmal tachycardia.
2. Conduction disorder:
   • sinus blockade;
   • intra-atrial blockade;
   • atrioventricular block;
   • intraventricular blockade;
   • ventricular asystole;
   • premature ventricular contraction syndrome.

Causes of heart rhythm disturbance

The formation of arrhythmia is possible if there are malfunctions in the functioning of some body systems:

• Impaired blood supply. If insufficient blood is delivered to the heart, there are problems with the formation of a pulsation, which causes an arrhythmia;
• Myocardial damage or death. As a result, the patency of impulses is disturbed.

In addition to the above, the following diseases contribute to the formation of arrhythmia:

• coronary disease. This disease provokes the formation of arrhythmia, which can lead to death of the heart. There is a gradual narrowing of the blood vessels, eventually the circulation of blood in the heart stops. This leads to necrosis of the myocardium and a heart attack occurs.
• . The walls of the ventricles and atria are stretched. They either become thinner or too thick, as a result of which less blood enters the aorta and the structures of the body do not receive sufficient nutrition.
• Heart valve disease. Malfunctions in the functioning of the valvular apparatus of the heart disrupt the normal functioning of the organ.

Symptoms

The most important manifestations of arrhythmia are as follows:

• the patient is very dizzy;
• the pulsation of the heart has obvious changes;
• oxygen "hunger";
• fainting or pre-fainting states;
• pain in the chest area.

The symptoms of arrhythmia are very similar to those of other diseases. Having found these symptoms in yourself, you must definitely consult a doctor to diagnose the disease and prescribe treatment.

Diagnostics

• type of arrhythmia;
• additional sources of impulses and their location;
• trajectory of excitation waves;
• the degree of conduction disturbance;
• type of blockade of connections;
• connection with pathological processes of the heart muscle.

For reference. To date, the latest method of electrocardiographic research is used - or long-term ECG recording, which allows you to analyze the rhythmic contractions of the heart per day without changing the patient's daily routine.

Also, this diagnostic method can establish side effects from taking medications or the effectiveness of therapy.

To find out the cause of the development of a heart rhythm disorder, examine:

• blood test: determination of enzymatic activity, as well as the concentration of sodium, potassium and proteins;
• ultrasound and dopplerography: help to identify abnormalities in the functioning of the heart chambers, valves, blood circulation of the heart.

Treatment

Therapy for various types of arrhythmia should have a personal approach. Not in all cases it is possible to restore the normal heart rate.

Assistance to the patient consists of the following activities:

• providing rest;
• massaging the eyeballs;
• deep breathing with a delay at the height of inspiration;
• the use of hawthorn tincture (15-20 drops);
• mustard plasters on the projection area of ​​the heart.

Important. Therapy is selected taking into account the type of arrhythmia, the leading disease and the state of the nervous system of patients.

The selection of medicines of various groups is carried out to stop additional sources of impulse occurrence or activation of metabolism in the fibers of the heart muscle, as well as to restore the trajectory of impulse transmission.

In addition, it is necessary to consult with a cardiac surgeon to find out if surgery is required for heart rhythm disturbances, whether an artificial pacemaker should be inserted. It is impossible to postpone a visit to the doctor, since the patient's inaction can lead to the development of heart failure.

You need to visit a cardiologist regularly. Also, the patient needs to learn how to determine his own pulsation and follow all the doctor's recommendations: limit physical activity, get rid of bad habits.

Cardiac arrhythmia in children

For reference. The only similarity between childhood and adult arrhythmias is that the disease can be asymptomatic and only be detected during a routine electrocardiographic study.

The first symptoms of the development of children's arrhythmia are:

• the presence of dyspnea;
• pale skin;
• anxiety for no apparent reason;
• lack of weight;
• poor appetite.

In adolescents, heart rhythm disturbance manifests itself in the form of:

• frequent fainting;
• discomfort in the chest area;
• intolerance to physical activity;
• lethargy;
• excessive fatigue.

Factors provoking the development of children's arrhythmia:

• various heart defects;
• genetic predisposition;
• intoxication of the body with drugs;
• anomalies in the development of the heart;
• inflammation in the body;
• diseases of internal organs;
• impaired functioning of the nervous system.

Attention. In about a quarter of cases in pediatric patients, interruptions in cardiac pulsation are observed, and this process proceeds without any consequences. This is due to the fact that the autonomic nervous system is still being formed and is undergoing changes. This phenomenon is completely normal and cannot be treated.

However, there are quite dangerous forms of arrhythmia in children, such as extrasystole and tachycardia. The seriousness lies in the fact that the kids do not feel any discomfort in their body for a long time.

Very important! The most serious cardiac arrhythmias in children are those caused by myocardial diseases and congenital malformations. The most dangerous arrhythmias are tachycardia, atrial fibrillation and absolute heart block. Lack of timely therapy is fraught with disability and the possibility of death of the child.

The disease is diagnosed using an electrocardiographic study, Holter monitoring, an electrophysiological study through the esophagus. Sometimes testing on simulators is used to assess the functional state of the heart during exercise.

Therapy of pediatric arrhythmia is carried out taking into account the form and stage of the disease. If the doctor has determined that the arrhythmia is temporary, drugs are not prescribed. In this case, the child needs to ensure peace, reduce physical activity and try to avoid emotional stress.

With a more severe type of pathology, medications are prescribed to help eliminate the causes of the development of the disease. Very rarely, surgery is required - to install a pacemaker.

Possible complications

Heart rhythm disturbances can cause the development of the following diseases:

• Stroke. This disease is characterized by necrosis of a part of the brain, which is extremely dangerous for human life. The rate of blood circulation in the atria decreases, due to which blood clots form, and due to their circulation throughout the body, clog the cerebral arteries, which causes a stroke.
• Chronic decompensation of the heart. It manifests itself in the inefficiency of the heart pulsation, as a rule, after a long course of arrhythmia. It is required to constantly monitor the rhythm of heart contractions.

To prevent the development of arrhythmia in young children, it is necessary to control their daily routine, attend scheduled medical examinations. If the disease has developed, the causes should be established and stopped. If there is a suspicion that a person has a heart rhythm disorder, it is necessary to consult a highly qualified doctor.

In adults, preventive measures are:

• stopping smoking and drinking alcohol,
• normal sleep,
• balanced diet,
• balance between work and leisure.

It is also necessary to treat the identified diseases in a timely manner. The heart is the most important organ on which human life depends. If you find any malfunctions in his work, you should consult a doctor.

Arrhythmia is one of the most common cardiac diseases, in which the heart rate increases or decreases under the influence of external adverse factors. These factors include colds, overwork, alcohol intake, and so on. In this case, even healthy people occasionally show symptoms of the disease.
Among cardiovascular diseases, a special place is occupied by rhythm disturbance, which in medical terminology is referred to as “cardiac arrhythmia”. Most often, this disease is not dangerous, but sometimes there may be undesirable consequences in the form of surgery, which improves the patient's quality of life.

In a normal state, the heart contracts rhythmically, with approximately the same frequency, which at rest should be determined in the range from 60 to 90 beats / min. A similar indicator is typical for adults, since children normally have a higher heart rate, approximately 70-140 depending on age (the smaller the child, the higher the heart rate, which in newborns is in the range of 110-140 beats / min.).

Wikipedia notes that "arrhythmia is any heart rhythm that differs from normal sinus rhythm (WHO, 1978)".

Sometimes such a violation can be considered as a variant of the norm, and then they talk about physiological arrhythmia. With its presence, even the army is not contraindicated. In other situations, a rhythm disorder is a pathology that, if not adequately treated, can lead to serious complications.

Video: How the heart works. Cardiac arrhythmia: symptoms, causes and treatment

Normal heart activity

The human heart is divided into four chambers, two of which are filled with arterial blood, and two with venous blood. The upper sections are called the atria, and the lower sections are called the ventricles. The blood flow moves from the veins through the atria to the ventricles and then to the arteries. Promotion of blood in this way occurs due to heart contractions.

The conduction system is responsible for ensuring timely contractions of the heart. Its main driver is the sinus node, located in the upper right corner of the right atrium (more precisely, near the atrial appendage). The electrical impulse generated in this area by a small group of cardiomyocytes is transmitted along the fibers of the left atrium and further along the lower atrioventricular node, passes through the bundle of His and Purkinje fibers to the ventricles. Thus, the atria contract first, and then the ventricles.

A trained heart, for example, in people who love sports, may contract less frequently than in an ordinary person. This is due to the increased mass of the myocardium due to constant sports exercises. This allows the heart to make stronger emissions into the bloodstream. Therefore, in such cases, the heart rate can be 50 beats / min or less, while it will be considered a variant of the norm since it does not cause negative consequences.

In the case of a rhythm disorder, Wikipedia indicates that “the term “arrhythmia” combines various mechanisms, clinical manifestations and prognostic disorders in the formation and conduction of an electrical impulse.”

The reasons

The disease is often associated with cardiac pathologies, which are characterized by a change in the structure of the organ (destruction, ischemia, malnutrition, etc.). Rhythm disorder most often acts as a complication in case of insufficient activity of the heart, coronary disease, cardiac myopathies, congenital and acquired malformations, inflammation of the myocardium.

When exposed to certain drugs, arrhythmia also occurs. In particular, the improper use of cardiac glycosides, diuretics, sympathomimetics, antiarrhythmic drugs with proarrhythmic action can lead to rhythm disturbance of varying severity.

In some cases, the consequences of a simple lack of certain microelements are expressed by the development of arrhythmia. This is most common with hypokalemia, hypomagnesemia, hyperkalemia and hypercalcemia.

It is worth remembering the obvious harm of bad habits such as smoking, drinking alcohol and drugs. Such substances can have a toxic effect on the heart and blood vessels. As a result, undesirable consequences in the form of not only arrhythmias, but also more serious diseases.

Risk factors

Every year, the diagnosis of “arrhythmia” is increasingly being made to patients of various age categories, which is primarily associated with risk factors. Arrhythmia affects adults and children. Identification of a particular cause of the disease is the basis of various diagnostic methods and screening tests. Also, their competent use allows for effective prevention.

• genetic predisposition. Some arrhythmias, like the Wolff-Parkinson-White syndrome, are hereditary diseases. Others are associated with birth defects.
• Pathology of the thyroid gland. This endocrine organ seriously affects the functioning of the heart. The thyroid gland produces hormones that speed up or slow down metabolic processes in the body. Accordingly, with thyrotoxicosis, tachycardia occurs, and with insufficient work of the organ, bradycardia occurs.
• Arterial hypertension. Increased pressure in the vessels threatens coronary heart disease, which in turn is often complicated by rhythm disturbance.
• episodes of hypoglycemia. A temporary decrease in the concentration of glucose in the blood can contribute to the development of arrhythmias. With decompensated diabetes mellitus, hypertension and coronary artery disease occur, and this also leads to a disorder of cardiac activity.
• Excess body weight. Such a condition often causes the development of hypertension, coronary artery disease and other pathological disorders. In addition, increased body weight in itself puts an additional burden on the heart, thereby contributing to a rapid heartbeat.
• Elevated blood cholesterol. This indicator should be especially carefully checked in people 55 years of age and older, when the risk of developing cardiovascular diseases, including arrhythmias, increases.
• Anemia - iron deficiency provokes the development of hypoxia of various tissues, including the heart. This, in turn, leads to rhythm disturbance.
• Hormonal imbalance - with menopause in women, extraordinary contractions and other manifestations of arrhythmia are most often observed.
• Osteochondrosis - a violation of the structure of the spinal column leads to compression of the nerve roots, which in turn contributes to the development of a disorder of autonomic regulation (includes the vagus nerve and the sympathetic nervous system). From this, first of all, cardiac activity suffers.

Symptoms

Arrhythmia manifests itself in various forms, and therefore the clinic depends on the specifics of the course of the disease. Nevertheless, there are common manifestations characteristic of all types of rhythm disturbance:

• Sensation of interruption of cardiac activity.
• Change in heart rate.
• Vegetative disorders (weakness, sensation of heat, cold extremities).
• The appearance of fear and anxiety.

In severe cases, heart pain, pre-syncope and fainting conditions are added to the listed symptoms. It can also be determined by blanching of the skin, high or low blood pressure.

Characteristic features of individual forms of arrhythmia:

• At various times, when even the army is contraindicated, an increase in heart rate is determined. In particular, an increase in heart rate from 150 beats / min is typical for, and when a heart rate is combined from 400 beats / min with loss of consciousness, it is often diagnosed.
• Bradycardia is characterized by a slowing of the rhythm, that is, in adults, a heart rate below 50 beats / min is diagnosed.
• manifested by fading of the heart and extraordinary heart contractions.
• Heart blockades are expressed by severe violations of the general condition of the patient. In particular, convulsions, fainting, lack of pulse are determined.

Video: The first symptoms of heart problems that should not be ignored

Types of arrhythmia

• Disorder of automatism - there are several subgroups: nomotopic, when the pacemaker is the sinus node (respiratory and non-respiratory sinus arrhythmia, sinus bradycardia, sinus node weakness syndrome) and heterotopic, when a different pacemaker is determined than the sinus node (idioventricular, lower atrial and atrioventricular rhythm ).
• An excitability disorder - most often associated with it (it can be ventricular, atrioventricular and supraventricular) and extrasystole (a separate classification is considered by source, number of sources, time of occurrence, frequency and ordering).
• Conduction disorder - options for increasing conductivity (occurs with WPW syndrome), as well as its decrease (typical for blockades of various localizations) are considered.

Depending on the severity of the course of a particular arrhythmia, the army is either contraindicated, or a young man is allowed to line service.

In some cases, mixed arrhythmias occur, when, in addition to extrasystole, a condition such as atrial fibrillation is diagnosed. Or, atrial flutter is combined with ventricular flutter.

Screening and diagnosis

A heart rhythm disorder is dealt with by a cardiologist, who at the reception first of all conducts a patient interview and an external examination. Next, an instrumental examination, laboratory tests, consultations of related specialists are prescribed.

Almost without exception, cardiological patients are prescribed electrocardiography, which in most cases allows you to determine many forms of arrhythmia. Each case has its own ECG signs:

• Sinus tachycardia - other than an increase in heart rate, other rhythm changes are not determined.
• - there is a decrease in heart rate relative to the age norm.
• - the heart rate increases, decreases or remains normal, while the rhythm becomes irregular.
• Sinus node weakness syndrome - there is a constant decrease in the heart rate of the sinus type, sometimes the sinus rhythm disappears, while sinoauricular blockades are periodically recorded. Also on the ECG, tachycardia-bradycardia syndrome can be diagnosed.
• Heterotopic arrhythmias - are manifested by a change in heart rate and rhythm regularity, which are most often non-sinus. With an idioventricular rhythm, the heart rate is 20-40 beats / min, and with an atrioventricular rhythm, 40-60 beats / min.
• Extrasystole - is determined when extraordinary contractions occur on the ECG, which can be single, paired, multiple. Also, this form of arrhythmia is characterized by an incomplete compensatory pause. Depending on the source of excitation, changes can be noted in the atria, the atrioventricular node, and the ventricles.
• Paroxysmal tachycardia - appears suddenly, while the heart rate can reach 150 beats / min and above.
• Heart blockades - are determined by the loss of complexes of the corresponding localization, with a weak severity of the pathology, only a slowdown in the rhythm can be observed.
• - The heart rate is 150-160 beats per minute, while the ventricular complexes do not change, and the rhythm becomes non-sinus.

In addition to electrocardiography, other passive research methods are used. This may be Holter monitoring, ultrasound of the heart (echocardiography). If attacks of arrhythmia occur rarely and they are not recorded on the ECG, then induction tests are used:

• Tests with physical activity - for this, an exercise bike or a treadmill is used, while an ECG is recorded in parallel.
• Tilt table test - often used for frequent and unreasonable pre-syncope and syncope. For this, the patient is fixed on a table, which, after taking indicators in a horizontal position, is transferred to a vertical one and again records the heart rate and blood pressure.
• An electrophysiological study is carried out in order to determine the arrhythmogenic focus, and, if possible, its elimination is also carried out. Often used for atrial fibrillation.

Conservative treatment

In the presence of a severe course of arrhythmia, antiarrhythmic therapy is used. Their reception is possible only with the consent of the attending physician, otherwise undesirable consequences may occur.

Groups of antiarrhythmic drugs used in arrhythmias:

• Drugs that affect the conduction system of the heart. This group includes cardiac glycosides, beta-blockers. Due to this action, the heart rate slows down, so they are more often used for tachycardia and atrial fibrillation.
• Direct antiarrhythmic drugs - affect the permeability of ion channels, which in turn reduces the heart rate. The list of drugs from this group includes amiodarone, allapenin, ritmonorm and others.

• People with a tendency to form blood clots are treated with thrombolytic drugs, including cardiac aspirin, clopidogrel, and other similar drugs prescribed by a doctor. Also, the inclusion of flax seed, garlic, celery, parsley in the diet helps to thin the blood.
• The heart muscle can be strengthened by mildronate, riboxin, ATP. The doctor may prescribe other drugs that are widely used in cardiology practice. Including it is useful to use seeds, nuts, dried fruits, fish.
• If the arrhythmia is a complication of another disease, it is treated first, thereby allowing the elimination of arrhythmia attacks without the use of cardiac drugs.

Long-term treatment of arrhythmia involves careful implementation of medical recommendations, thereby reducing the likelihood of recurrent attacks. In difficult cases, when conservative means cannot achieve the desired effect, they resort to the implantation of a pacemaker or radiofrequency catheter ablation.

Alternative methods of treatment of arrhythmia

An unconventional type of therapy can be used in combination with a conservative therapy regimen. In some cases, when attacks of rhythm disturbance are not very pronounced and there are no other cardiac disorders, they try to treat only herbal preparations. In any case, treatment with folk remedies is previously agreed with the doctor, otherwise there may be disastrous consequences.

• Spring Adonis - among a wide variety of green pharmacy preparations, it has shown its high efficiency, the only thing is that it is used with caution and no more than two weeks, then a break is taken for the same period. For treatment, take a tincture, which is taken 15 drops three times a day. Adonis is a cardiac glycoside, so it is taken in conjunction with diuretics.
• Violet tricolor - also known as "pansies". Dried grass is suitable for use, which in the amount of 2 tsp. brewed with a glass of boiled water. After insisting for several hours, the infusion is ready to receive 2 tbsp. l. up to three times a day. It is important not to overdose the medicine, as nausea and vomiting may develop.
• Oxalis inflorescences - used to treat rhythm disturbances in the form of an infusion, which is prepared from a glass of boiling water and a tablespoon of the plant. The medicine must be infused, it is considered ready for use after cooling.
• Asparagus - few people know, although with the help of its shoots and rhizomes, you can calm the heart and normalize the rhythm. These components should be finely chopped, a tablespoon of the mixture is taken from the total amount and poured with a glass of boiling water. Further, for about three hours, the medicine is infused in heat and then taken in a small amount several times a day. Thus, it can be treated for several months, but with interruptions for 10 days every three weeks of admission.
• Hawthorn is a plant widely recommended in the treatment of cardiovascular diseases. Mostly flowers are taken, but the fruits of the plant can also be used. A glass of boiling water takes a few tablespoons of flowers or fruits. It usually takes 20 minutes to brew, then you can drink it like a tea.

In some cases, it is recommended to take garlic for arrhythmias, but this product is far from suitable for everyone, especially for those who have a stomach ache. Pregnancy is not contraindicated for taking fresh garlic, but everything should be in moderation. Honey can also have a beneficial effect on the heart, but only if there is no allergy.

Folk remedies can be considered mixtures of herbs that have a calming, restorative, vitaminizing effect. Whatever medicine is chosen, it is important to take it with the consent of the attending physician, otherwise side effects may occur.

Complications

In most cases, arrhythmia is not felt or causes minor discomfort, but in the absence of adequate drug exposure, the disease is dangerous not only for health, but also for human life. The risk increases when the arrhythmia is combined with other cardiac diseases. In particular, the following pathologies can develop:

• Decompensated heart failure. The prolonged course of tachycardia or bradycardia in severe cases leads to stagnation of blood in the cavities of the heart. With timely control of heart rate, you can significantly improve your health.
• Stroke. A similar complication is more typical for atrial flutter, which are not able to transfer the necessary portion of blood to the ventricles. If normal blood flow is disturbed in the atria, then the risk of blood clots formation increases, which can enter the general circulation. Often, blood clots enter the cerebral vessels, subsequently causing ischemia of the brain structures.
• Cardiac arrest is the most formidable complication, which often becomes the cause. If medical assistance is not provided in time for this condition, the person dies.

Prevention

There are a number of preventive measures that can prevent the development of arrhythmias or reduce the likelihood of recurrent attacks.

• In the presence of infectious diseases, it is necessary to carry out their treatment with high quality and without delay.
• Concomitant diseases in the form of cardiac pathologies, thyroid diseases and arterial hypertension should be treated in a timely manner.
• Nutrition should be complete and balanced.
• In the presence of enhanced physical training, you need to reduce it, but do not go to the other extreme - physical inactivity.
• It is unacceptable to have a bad habit like smoking, you also need to give up alcohol.
• Stressful situations should be minimized, or even better, completely eliminated.
• Some indicators such as blood glucose, body weight and cholesterol should be constantly monitored.

Which doctor to contact

The arrhythmologist is engaged in the study of the nature of arrhythmia, its diagnosis, treatment and prevention. At the same time, in most clinics there is no separate specialization in arrhythmology, therefore, patients with arrhythmias are seen by a cardiologist.

The functional diagnosis of heart rhythm disorders is carried out by a doctor of the appropriate specialization. With its help, ultrasound, electrocardiography, and, if necessary, Holter monitoring are performed.

The presence of concomitant pathology may require additional consultation of doctors of related specialties. This may be an endocrinologist who treats the thyroid gland, or a gynecologist who helps with the pathological course of menopause. Successful treatment of the underlying disease often allows you to cope with attacks of arrhythmia.

The ineffectiveness of conservative therapy is an indication for referring the patient to a consultation with a cardiac surgeon, who decides on the need for radiofrequency ablation of the pathological focus. An operation to implant a pacemaker may also be performed.

The electrical activity of the heart, which provides a normal rhythm of its contractions, can be influenced by a number of factors. As a result, the heart rhythm may become irregular, abnormally fast, or slow. These abnormal heart rhythms are called arrhythmias.

Most cardiac arrhythmias are rare in young people, but their frequency increases with age. On the causes of arrhythmia in young people.

Atrial fibrillation is the only exception: it is still more of a disease of the elderly. It affects 1% of the population aged 40 to 65 years and 5% of people over 65 years of age. About 50% of patients with atrial fibrillation are 75 years of age or older.

So, let's try to understand in more detail the problem of cardiac arrhythmias, their types, causes, symptoms, methods of treatment and prevention, as well as the prognosis for curing the disease.

Heart rate of a healthy person.

Normally, the heart responds quickly to changes in movement, stress, anxiety, or illness. A timely response is extremely important - it is accompanied by an increase in cardiac output with an increase in tissue demand for oxygen and nutrients.

What are the normal variations of the heart rate?

In a healthy body, the heartbeat is tightly regulated to ensure the efficiency and optimal performance of the heart. A wave of electrical activity travels through the heart, triggering coordinated contractions of the heart muscle, which normally range from 60 to 90 beats per minute.

During sleep or at rest, the heart rate can slow down significantly. This condition - the so-called sinus bradycardia - is most often observed in young athletic people.

Violations of the electrical conduction of the heart can lead to the development of arrhythmia.

Acceleration of the heart rate may be a variant of the norm and is called sinus tachycardia. The opposite of this reaction is a decrease (sometimes significant, especially in young physically trained people) in the heart rate during sleep or rest, called sinus bradycardia. Often, the heart rate slows down to 40 beats per minute. Thus, the heart rate in a healthy person can vary within very significant limits.

An arrhythmia is a condition in which the heart rate is abnormal or the heartbeat becomes irregular.

Slow heart rate

Slow heart rate (bradycardia) can be caused by:

■ Weak sinus syndrome. A pathology characteristic of the elderly, in which there is a dysfunction of the sinus node (the natural pacemaker of the heart). This leads to delayed excitation of the heart muscle, and sometimes to the appearance of pauses in the work of the heart, lasting up to several seconds. These phenomena can be combined with episodes of tachycardia (acceleration of the heart rate).

■ Heart block. Impulses arising in the sinus node periodically do not reach the ventricles of the heart due to violations of the conduction system. The most severe form is complete heart block, when no sinus impulse reaches the ventricles.

■ Taking medication. Some drugs cause a slowdown in the generation of electrical impulses in the sinus node. Such drugs give a good effect in the treatment of a number of diseases (for example, angina pectoris), but their overdose can lead to the development of heart block.

■ Damage to pathways. Coronary artery disease, cardiac surgery, or the use of an ablation catheter in the treatment of tachyarrhythmias can damage the pathways and slow the heart rate.

■ Certain rare heart and thyroid conditions.

Heart rhythm disturbances occur when the normal sequence of contractions of the heart muscle is disturbed. There are several mechanisms of arrhythmia.

■ The heart's own pacemaker (sinoatrial node) is unable to start the electrical system.

■ Pathological foci of electrical activity may occur in the heart muscle, causing additional contractions.

■ There may be a violation of the conduction of the electrical impulse.

Medical causes of cardiac arrhythmias.

Some conditions can provoke arrhythmias. Among them:

■ high blood pressure;

■ ischemic heart disease;

■ congestive heart failure;

■ cardiomyopathy (disease of the heart muscle);

■ excessive alcohol consumption;

■ pulmonary embolism;

■ hyperthyroidism.

In about a third of patients suffering from a common form of arrhythmia - atrial fibrillation, it is not possible to identify any objective cause of heart rhythm disturbances.

Acceleration of the heart rate

An abnormally accelerated heart rate (tachyarrhythmia) is usually associated with a violation of the conduction of electrical impulses through the conduction system of the heart against the background of myocardial pathology or congenital heart disease.

The cause of myocardial dysfunction and the development of tachyarrhythmia can be coronary heart disease, valvular pathology, medication, changes in the chemical composition of the blood and thyroid disease.

In predisposed persons, an attack of tachyarrhythmia can be triggered by excessive consumption of coffee or alcohol.

There are two main types of tachyarrhythmias:

■ Atrial tachyarrhythmias - electrical impulses with an increased frequency enter the atria and cause them to contract at an accelerated pace. If the pulse rate exceeds a certain threshold, the atria lose their ability to contract normally. This type of arrhythmia is called atrial fibrillation. Some or all of the impulses from the atria are transmitted to the ventricles, causing them to also contract at an accelerated rate.

■ Ventricular tachycardia - usually has more serious consequences, as it can disrupt the ability of the ventricles to fully pump blood around the body, which is accompanied by the development of circulatory shock. Ventricular tachycardia can lead to cardiac arrest, which can be caused both directly by tachycardia and ventricular fibrillation caused by it.

We also suggest that you familiarize yourself with a few simple tips for self-help with a strong heartbeat.

arrhythmia symptoms.

Symptoms depend on the type of arrhythmia and include: increased heart rate; increased heart rate; chest discomfort or pain; shortness of breath dizziness and fainting. Many of us know the feeling of "fading" of the heart (extrasystoles). This phenomenon is usually harmless and requires examination only with frequent attacks.

Cardiac arrhythmias may be accompanied by persistent symptoms or have a transient character (in the form of seizures or paroxysms). Often, arrhythmia occurs without pronounced symptoms. However, severe rhythm disturbances can lead to cardiac arrest or the development of circulatory shock.

Diagnosis with a permanent form of arrhythmia is usually not difficult. However, in the paroxysmal course, diagnosis can be difficult due to the fact that many of its symptoms are relatively non-specific and can also be observed in healthy people.

The doctor must determine the timing of the onset of symptoms and their association with certain precipitating factors, such as alcohol use. Diagnosis can be simplified if during an attack it is possible to assess the rhythm and frequency of heart contractions.

Typical symptoms of an arrhythmia may include:

■ Palpitations—a feeling of fluttering or trembling in the region of the heart—is the most common symptom of a tachyarrhythmia. However, it does not always indicate the presence of a disease, since a sharp increase in heart rate can occur in response to many stress factors (for example, anxiety) and is a fairly common reaction. A more significant sign is a sudden acceleration of the heart rate at rest and the same rapid resolution of the attack, especially in combination with other symptoms, such as shortness of breath.

■ Shortness of breath - a feeling of lack of air in combination with tachy- or bradyarrhythmia indicates a violation of the heart's ability to pump blood. Initially, shortness of breath is observed only during physical exertion. In the future, serious disturbances in cardiac function associated with arrhythmia can lead to a decrease in cardiac output even at rest. In such cases, there may be other symptoms of heart failure - for example, paroxysmal nocturnal dyspnea (waking up in the middle of the night from feeling short of breath).

■ Pre-syncope - Dizziness is a fairly common occurrence, not always associated with a violation of cardiac activity, but it can be a symptom of a decrease in blood pressure due to arrhythmia.

In severe cases, there is a short-term shutdown of consciousness (syncope).

■ Chest pain - may occur with arrhythmic paroxysms (most often with tachyarrhythmia). A distinctive feature of such pain is that it occurs only during an attack. Chest pain that occurs under other conditions, such as during exercise or after eating, is likely to have other causes.

■ A decrease in blood pressure due to an arrhythmia can lead to dizziness and fainting. Fainting (syncope) often occurs without any previous symptoms.

■ Cardiac arrest is a serious complication of an arrhythmia, accompanied by a serious impairment of cardiac function. In the absence of emergency medical care, it ends in death.

How does an arrhythmia occur?

Attacks of arrhythmia occur when there is a violation of the conduction of impulses along the conduction system of the heart, its anomalies, as well as the influence of external factors.

Let's look at the conduction system of the heart, and then this mechanism of the onset of an attack will be clear to us.

In order for the chambers of the heart to contract in a coordinated manner, pumping blood, the sinus node generates single electrical impulses, which are then transmitted within the heart through the conduction system.

sinus node.

The sinus node, located in the right ventricle, plays the role of a natural pacemaker of the heart. It is he who regulates the frequency of generation of electrical impulses of the heart. Normally, the heart beats at a speed of 60-80 beats per minute, which corresponds to the pulse rate. This rhythm can change under the influence of nerve impulses or hormones circulating in the blood.

The volume of blood pumped can increase or decrease rapidly in response to changing needs of the body (eg during exercise).

atrioventricular node.

Further, the electrical impulse passes through the atria, reaching the atrioventricular node (AV node). Here it slows down before passing through the conducting pathways of the ventricles, then reaches the tops of the ventricles and spreads throughout the myocardium, causing its contraction.

All components of the conduction system of the heart are capable of generating electrical impulses, but at a lower frequency than in the sinus node.

The flow of electrical impulses generated in the sinus node causes the heart muscle to contract.

Types of arrhythmias.

Arrhythmias can affect both the upper chambers of the heart (atria) and the lower ones (ventricles). There are two main types of arrhythmias: tachycardia, in which the heart rate is too high, and bradycardia, in which it is too low. Specific types of arrhythmias include the following conditions.

• Atrial fibrillation is the most common heart rhythm abnormality, in which a rapid heartbeat is accompanied by a completely irregular rhythm. This condition can be permanent or paroxysmal and is more common in older people.
• Supraventricular tachycardia, a fast but regular heart rate, is more typical in younger people.
• Ventricular fibrillation - in this type of heart rhythm disturbance, an abnormal stimulus comes from the ventricles, which can result in the development of a severe form of arrhythmia that requires emergency treatment.
• Complete heart block - electrical impulses from the atria do not reach the ventricles. In this case, the heart rate drops sharply.
• Wolff-Parkinson-White syndrome is a rare congenital disorder that causes a very fast heart rate.
• Cardiac arrest is the complete inability of the heart muscle to contract.

Diagnosis and treatment of arrhythmias.

Often the first signs of a heart rhythm disorder are detected when listening to the heart with a stethoscope. This is a simple research method, but even it provides the doctor with valuable information.

Diagnosis is usually made by counting the radial artery pulse at the wrist and then listening to the heart. In most patients, the diagnosis is confirmed by electrocardiography (ECG). Since some types of arrhythmias are transient, daily ECG recording using a portable device can be used.

Electrocardiographic study (ECG) allows you to evaluate the conductivity of electrical impulses of the heart, causing its contraction. With persistent forms of arrhythmia, the diagnosis can be made according to the ECG.

In paroxysmal (paroxysmal) forms of arrhythmia, the ECG is of diagnostic value only if it is performed during an attack. If episodes of cardiac arrhythmias are rare or transient, it is almost impossible to detect them with a single ECG study. In such cases, other methods of examination come to the rescue.

In addition, the doctor may order blood tests to check for possible anemia, as well as a chest x-ray.

Recent advances in medicine have made it possible to make the diagnosis and treatment of heart rhythm disorders more effective. After normalization of the heart rhythm, further measures should be aimed at preventing recurrent attacks.

Electrophysiological study.

An alternative method for diagnosing arrhythmia is an electrophysiological study. This method is based on the supply of impulses to various parts of the myocardium using electrodes inserted into the heart through the blood vessels in order to induce an arrhythmia attack and determine its shape.

Such a study is carried out with suspected arrhythmia in complex cases and allows you to clarify the localization of abnormal areas in the heart - sources of arrhythmia.

Clarification of the causes of cardiac arrhythmias

The next step in the diagnosis of arrhythmia is the clarification of causative factors.

For this purpose, they carry out:

■ Laboratory studies - determination of the levels of potassium, magnesium and calcium in the blood. Deviations in the content of these trace elements can lead to arrhythmia. Elucidation of the causes of arrhythmia is also facilitated by the study of the level of thyroid hormones and cardiotropic enzymes.

■ Stress testing - ECG recording during certain physical exercises is an additional method for diagnosing coronary heart disease. This method can also be used to provoke an arrhythmia. When performing these tests, the ECG is recorded while walking on the treadmill.

■ Echocardiography is a method of imaging the heart using ultrasound to identify abnormal heart valves as the cause of an arrhythmia.

■ Coronary angiography - may be performed if coronary heart disease is suspected. Coronary angiography is a test used to diagnose heart conditions that can lead to arrhythmias. This method allows you to assess the blood flow to the heart muscle and the pressure in its cavities.

Identification of paroxysmal arrhythmias.

There are a number of effective methods for detecting paroxysmal arrhythmias:

■ Continuous ECG recording throughout the day using electrodes that are applied to the chest area and connected to a portable recording device worn on the belt.

■ Use of other devices that are worn for a longer period of time and record ECG only when an abnormal heart rhythm develops or the device is activated by the patient during an attack.

■ Even longer monitoring is possible with a device placed on the anterior chest by the patient when symptoms appear suspicious.

Data analysis.

An ECG recorded during an arrhythmia attack may be sent to a cardiac center for immediate interpretation. This is only possible if the patient is able to operate the device during an attack.

It is also possible to implant a miniature device for continuous ECG monitoring under the skin in the chest area. Such a device works continuously for up to 18 months, recording any deviations of the heart rhythm from the norm.

Treatment of cardiac arrhythmias.

Treatment for arrhythmias varies depending on their type. Among the methods of treatment:

• Medical therapy is the most common treatment for tachycardia. For example, the drug of choice for atrial fibrillation is digoxin, which can slow the heart rate. Other drugs used include verapamil and beta-blockers;
• cardioversion - applying a series of electrical discharges to the chest area under anesthesia. This procedure can restore normal heart rhythm in patients with severe supraventricular tachycardia;
• radiofrequency ablation of the AV node with the destruction of the pathological pathway of the impulse;
• installation of a pacemaker - with a heart rate of less than 60 beats per minute and repeated episodes of cardiac arrest, it is necessary to install an artificial pacemaker.

The choice of methods of treatment depends on the form of arrhythmia.

Treatment of bradyarrhythmias.

Severe bradyarrhythmia can lead to a decrease in blood pressure, so in such conditions it is necessary to take measures to prevent cardiogenic shock.

■ For bradyarrhythmia caused by a side effect of a drug, it is often sufficient to stop taking the drug.

■ In severe cases, acceleration of the heart rate can be achieved by the introduction of atropine or isoprenaline.

■ If medications are ineffective, a temporary pacemaker is indicated to restore normal heart rhythm and normalize blood pressure. The pacemaker replenishes the function of the sinus node by generating electrical impulses.

Intermittent episodes of bradyarrhythmias associated with age or chronic disease, are severe, or cause significant discomfort, may require a permanent pacemaker.

This small device delivers electrical impulses to an electrode implanted in the heart muscle, stimulating both ventricles to contract. The pulse rate can be adjusted to maintain a normal heart rate and blood pressure.

Treatment of tachyarrhythmia.

The first priority in the treatment of tachyarrhythmias is the normalization of the heart rhythm.

For this purpose, medications or electrical stimulation (cardioversion) are used:

■ Antiarrhythmic drugs—used to slow the heart rate (eg, digoxin, verapamil, and oral beta-blockers). In severe cases of ventricular tachycardia, intravenous lidocaine or amiodarone may be given.

■ Cardioversion (electrical stimulation) - can be used to stop tachyarrhythmias that are not amenable to medical correction (see below).

■ Catheter ablation - the use of radio frequencies to destroy arrhythmogenic areas of the myocardium.

The pacemaker generates electrical impulses that travel to the heart through an electrode.

The latest models of pacemakers are very small.

The next task after the restoration of sinus rhythm is the prevention of relapse. Preventive measures may include avoiding drugs that provoke arrhythmia, treating the underlying disease, and prescribing anti-arrhythmic anti-arrhythmic therapy.

Cardioversion.

Cardioversion may be used to restore a normal heart rhythm in ventricular tachycardia. This method is often used in the absence of the effect of drug therapy.

In some patients, ventricular tachycardia is not amenable to medical correction. In such cases, the method of pacing (cardioversion) can be used. The relief of arrhythmia and the restoration of a normal heart rhythm is achieved by exposure to an electrical discharge.

Atrial fibrillation.

A contraindication to the use of this method is atrial fibrillation, which creates a risk of blood clots in the chambers of the heart. If an atrial fibrillation attack lasts more than 24 to 48 hours, electrical shock cardioversion may increase the risk of stroke because of the risk of thrombus migration.

Restoration of the heart rhythm.

Under general anesthesia, the doctor applies two plates to the chest area and delivers a high-voltage electrical shock that causes a brief interruption of the abnormal electrical activity of the heart and the restoration of a normal rhythm. This method is also used as part of resuscitation to restore cardiac activity after cardiac arrest.

Defibrillator implantation.

Some patients who have experienced attacks of ventricular tachycardia or atrial fibrillation have a device resembling a pacemaker, an implantable defibrillator, implanted under the skin. It automatically recognizes a tachyarrhythmia and sends an electrical shock to the heart.

catheter ablation.

Electrophysiological studies are often combined with a relatively new medical procedure called catheter ablation.

When an arrhythmogenic area of ​​the heart muscle is detected, a special catheter is inserted into the vein or artery of the arm or inguinal region, which is then passed into the heart to perform ablation (destruction) of the abnormal tissue area using radio frequencies.

The need for continuous pacing.

Catheter ablation can completely eliminate the risk of new attacks of arrhythmia, however, during its implementation, there is some possibility of damage to healthy conductive tissue and the development of heart block. In such cases, it may be necessary to install a permanent pacemaker.

Prevention of cardiac arrhythmias.

To some extent, abnormal heart rhythms can be prevented by heart-healthy measures, such as regular exercise, not smoking, and proper nutrition.

First, you need to pay special attention to nutrition. Reduce in your diet foods that contain a lot of cholesterol, salt, sugar: fatty meat, strong coffee, tea, salinity, spices and seasonings, fatty sour cream, eggs. And if you already have the first signs of arrhythmia, then these products must be completely excluded from your diet.

Eat more vegetables and fruits. Try not to overeat, eat little by little, because when the stomach is clogged with food to the eyeballs, the vagus nerve begins to irritate, which, in turn, inhibits the functions of the heart rhythm driver - the sinus node.

The next, rather important measure for the prevention of heart rhythm disturbances is physical activity. It is worth starting with a simple and easy morning exercise, evening walks with a calm step in the fresh air. Take up swimming. With regular performance of these actions and a gradual increase in loads, you will soon forget about shortness of breath, discomfort in the heart area.

Stress not only exhausts the heart, but also affects the functioning of other vital human organs. Start doing yoga, auto-training. If you feel that your nerves are on edge, then take a sedative based on natural extracts of herbs - mint, motherwort, valerian.

Disease prognosis.

Irregular contractions lead to a decrease in the efficiency of the heart. This can lead to a restriction of blood flow in the heart muscle (ischemia), impaired contractile function of the heart, and a decrease in blood pressure. Mortality in atrial fibrillation is twice as high as in the general population.

stroke risk.

Violation of the contractile function of the heart leads to the fact that part of the blood remains in the atria, this creates conditions for the formation of blood clots. These clots can then travel through the vessels to distant organs, such as the brain, with the development of a stroke.

The average risk of stroke is 5% per year and increases with age, as well as in the presence of arterial hypertension, heart failure, diabetes and coronary heart disease. Patients under the age of 60 who do not have the above risk factors have a low risk of developing a stroke.

In contact with

Violation of the heart rhythm is not an independent disease. Often it manifests itself in the form of symptoms of any pathologies, sometimes minor, and sometimes quite serious.

In such cases, it indicates a disease of the cardiovascular system of the human body. The arrhythmia is not very dangerous and is harmless in nature, but often people have a feeling that their heart stops, and this is very scary.

The mechanism of occurrence of violations

os New mechanisms of cardiac arrhythmia are the following:

• automatism function (changing the functions of nodes);
• impaired conduction (sinoauricular and atrioventricular blockades);
• slow impulse;
• excitation circulation.

Heart rate is the driving process in the human body. Each rhythmic beat is an impetus to life. Already 3 weeks after the child is conceived, his heart produces the first push.

Irregular heart rhythm is a disordered process of the rhythm, sequence and frequency of the beating of the muscles of the heart. The muscles of the heart are the myocardium, which consists of thin filaments of muscle. They are divided into 2 main types:

• contraction (working myocardium);
• conducting myocardium.

This palpitation rhythm disorder syndrome has no specific age restrictions. If we take into account the statistics of attendance at medical institutions, then about 30% of children go to the polyclinic.

Sometimes such a disease can be detected in a child who looks healthy. Heart rhythm disturbances do not endanger life. This disease can be cured and completely get rid of it.

Types of violations

The main types of cardiac arrhythmias are:

• supraventricular;
• ventricular;
• impaired conduction.

The supraventricular (supraventricular) type includes:

• sinus palpitations;
• tachycardia;
• precordial flutter.

The ventricular type includes ventricular flutter and the occurrence of paroxysmal tachycardia, impaired conduction, that is, the occurrence of sinoauricular blockade and blockade of I, II, III degrees.

Causes

Cardiac arrhythmias do not occur on their own.

They are caused by other diseases. Increased heart rate can be triggered by factors such as coronary heart disease, angina pectoris, acute and past myocardial infarction.

Interruptions in the heart occur due to a disease such as arterial hypertension, and especially with frequent crises or its prolonged existence, heart disease, cardiomyopathy (structural change in the myocardium) against the background of other pathologies.

The rhythm of the heart is disturbed not only in connection with heart diseases, but also with diseases that are in no way connected with the heart. These include:

• stomach ulcer;
• cholecystitis;
• acute poisoning;
• inflamed thyroid;
• dehydration;
• fever
• severe hypothermia or the result of sunstroke.

Also, the disease can progress due to alcohol poisoning.

An uneven heart rhythm, causing a disorder of all cardiac activity, can manifest itself against the background of malignant or benign tumors. There are certain risk facts that guarantee a persistent heartbeat disorder, these include:

• excess weight;
• the presence of bad habits;
• age category;
• pathology of the endocrine system.

O obesity is a factor that increases the risk of such a disease, because due to fatty deposits and high levels of cholesterol in the body, the heart does not cope well with its main duty to pump blood through the blood vessels of the whole body.

Bad habits, that is, drinking alcohol, smoking or taking drugs, can often provoke a breakdown associated with a fleeting heartbeat. Age is another risk factor. Often, people who are over 45 years old turn to the clinic on this issue.

Symptoms of the disease

All types of cardiac arrhythmias manifest themselves in different ways. For example, a certain part of patients may not feel any changes in their body, but find out about the presence of this disease after an annual ECG. But most cases are in people who notice certain changes and can describe symptoms.

Many who go to the hospital have a rapid heartbeat, approximately from 150 to 200 per minute, a person feels short of breath, pain in the chest.

The patient, seeking medical help, may complain of a general severe physical condition, the onset of cold sweat, the manifestation of intense pain in the left side of the chest, a significant decrease in blood pressure, general weakness up to loss of consciousness.

If such symptoms occur, you should consult a doctor, and in an emergency, call an ambulance team. The doctor will diagnose and prescribe the necessary course of treatment.

Diagnostics

Of course, with the manifestation of symptoms that indicate a high heart rate, you should consult a specialist. That is the cardiologist. To check the rhythm of the heart, the doctor makes an electrocardiogram, that is, an ECG. It allows you to determine the degree of complexity of the disease.

ECG is the most important way to diagnose a disorder of the cardiac system, but it is done in cases where symptoms are stable. Then Holter monitoring is carried out. It helps to track the work of the heart for several days.

During this time, a person can live in the usual way for him, you just need to indicate in the diary the number of hours of sleep, the level of physical activity and the time of rest.

An experienced doctor knows how to calculate the time, duration and period of occurrence of such disorders, associate them with the level of physical activity, analyze the symptoms and causes of this disease.

If necessary, echocardiography is performed, which is able to identify the disease against which arrhythmia occurred. In addition to the above methods, more innovative methods of diagnosing the body are used. These include:

• endocardinal mapping of the body;
• catheterization;
• esophageal cardiograms.

Conducting a transesophageal electrocardiogram is the newest way to examine a person; such a cardiogram allows you to provoke a heartbeat disorder in a patient.

This procedure is carried out using a thin electrode, which is introduced into the body through the alimentary canal. This provokes another attack. Next, the doctor deciphers all the results that the device displays on the screen.

Catheterization is the passage of a special catheter closer to the heart through the blood vessels with a special tube. This method helps to identify pressure on various parts of the muscles of the heart, extract tissue samples from the body in order to conduct further tests.

If the above methods were not enough, then the doctor has the right to prescribe an additional examination.

How is the treatment carried out?

The course and methods of treatment aimed at recovering the patient differ depending on the type of disease and the reasons that provoked it.

For example, in coronary heart disease, a person who seeks medical help is given Nitroglycerin and drugs that thin the blood (for example, Aspirin cardio, etc.), drugs to normalize high cholesterol (drugs such as Atorvastatin or Rosuvastatin are used) .

If you have hypertension, your doctor may prescribe antihypertensive medications such as Enalapril or Losartan. In acute chronic heart failure, diuretic drugs are prescribed, for example, Lasix, Diacarb, Veroshpiron or Digoxin. If the patient has a disease such as heart disease, he is prescribed a surgical operation.

Regardless of the reasons, any first aid that is an emergency consists of injecting drugs into the human body that restore the rhythm or slow it down. In the first case, the doctor prescribes Pangin, Kordaron or Asparkam, these drugs are administered intravenously.

But blockades must be treated in a different way, for example, Atropine or Eufillin is administered to the patient. If the patient has low blood pressure, then Dopamine or Mezaton must be administered along with adrenaline. These drugs can speed up the heart rate, causing it to contract faster.

Prevention

Of course, it is possible to eliminate the risk of such a disease if certain preventive measures are taken, which are quite simple to follow. To reduce the risk of disruption of the heart system, you should perform daily weak but effective physical activity, for example, exercises in the morning.

Sleep is the key to health, so you need to get enough sleep, for this you need to normalize your daily routine, it is advisable to always go to bed at the same time, so that the body gets used to it, it is imperative to follow this regimen.

It should be remembered that a healthy person's sleep should be at least 8 hours. Walking in the evening has never harmed anyone, so it is advisable to spend more time outdoors. A positive mood significantly affects the overall physical condition, so you need to be less upset and communicate more with friends who give a smile, and enjoy the little things in life.

It would be good to change bad eating habits, replace unhealthy food with nutritious, tasty, and most importantly, healthy. In no case should you overeat, you should give up fatty and high-calorie foods, they will not bring anything useful to the body, but only harm, especially since fatty foods can “linger” not only in the stomach, but also in the blood in the form of cholesterol, which hurts the heart a lot. You should eat more fresh vegetables and fruits, nuts, honey. In addition to healthy food, you can take various vitamins, for example, groups A, B, C.

And the last rule, which is one of the main ones: you need to give up harmful and bad habits, namely, smoking, drinking alcohol or taking drugs. Such habits drastically disrupt the work of the heart, including its rhythmic functions.

So, heart rhythm disturbances are not independent diseases, they arise and develop against the background of other already existing diseases or pathologies. Getting rid of this problem is not difficult at all.

The main thing is that when the first symptoms appear, contact a specialist doctor, he will conduct a complete diagnosis of the patient's body, prescribe the necessary course of treatment and prescribe certain medications, because the treatment depends entirely on the type of violation.

It is worth remembering that if you follow preventive measures, then there is a high probability of avoiding the disease.

To do this, you just need to slightly adjust your lifestyle, including changing your diet and getting rid of bad habits, still do regular morning exercises, get enough sleep and just enjoy life.

If you follow these simple rules, you can stay healthy and cheerful person.