Cardiac arrhythmia is a pathological condition in which violations of the frequency, rhythm and sequence of excitation and contraction of the heart occur. Arrhythmia - any heart rhythm that differs from the normal sinus rhythm. With arrhythmia, the normal contractile activity of the heart is disturbed, which can lead to a number of serious complications. The term "arrhythmia" combines various violations in the mechanism, clinical manifestations and prognostic value of the formation and conduct of an electrical impulse.
The most common causes of heart rhythm and conduction disturbances:
Cardiac reasons:
Ischemic heart disease;
heart failure;
cardiomyopathy;
heart defects (acquired, congenital);
myocarditis;
mitral valve prolapse.
Medicinal effects:
cardiac glycosides;
antiarrhythmic drugs (proarrhythmic effect);
diuretics;
sympathomimetics.
Electrolyte disturbances
Toxic effects:
smoking;
alcohol;
thyrotoxicosis.
Idiopathic arrhythmias
At the heart of cardiac arrhythmias is a change in the conditions for the formation of excitation of the heart muscle or an anomaly in its distribution. Arrhythmias can be caused by both functional disorders and severe organic heart damage. In some cases, the cause of heart rhythm disturbances are congenital features of the cardiac conduction system. A certain role in the occurrence of arrhythmia is played by the state of the nervous system. For example, mental, emotional stress causes changes in pace, and often in the rhythm of heart contractions, including healthy people. Arrhythmia often occurs in people with diseases of the central and autonomic nervous system.
Various diseases, accompanied by a violation of the anatomical structure of the heart or the metabolic processes occurring in it, cause types of arrhythmia that are different in duration and nature, and only a doctor can establish a diagnosis, the conclusions of which are based on clinical electrocardiographic data.
Symptoms of Arrhythmias
Quite often, patients do not feel the presence of arrhythmias. In these cases, arrhythmia is detected during a routine medical examination. However, many patients experience various sensations in the chest, which most often include:
feeling of palpitations and interruptions in the chest;
very frequent heartbeats;
extremely slow heartbeat ("freezing" of the heart);
chest pain
dizziness;
loss of consciousness or feeling close to fainting.
Classification of Arrhythmias
1. Disorders of automatism:
a) nomotopic (pacemaker - in the sinus node):
sinus tachycardia;
sinus bradycardia;
sinus arrhythmia;
Sinus node weakness syndrome (SSSU).
b) heterotopic (pacemaker - outside the sinus node):
lower atrial rhythm;
atrioventricular rhythm;
idioventricular rhythm.
2. Disorders of excitability:
a) extrasystole:
by source: atrial, atrioventricular, ventricular;
by the number of sources: monotopic, polytopic;
by time of occurrence: early, interpolated, late;
in frequency: single (up to 5 per minute), multiple (more than 5 per minute), paired, group;
by ordering: disordered, allorhythmias (bigeminia, trigeminia, quadrigeminia).
b) paroxysmal tachycardia (atrial, AV, ventricular)
3. Conductivity disorders :
a) an increase in conductivity (WPW syndrome); b) a decrease in conduction (blockade: sinoauricular, intraatrial, AB, blockade of the bundle of the bundle).
ECG is the main diagnostic method for arrhythmias. However, it is not always possible to detect arrhythmia when a resting ECG is taken. In such cases, a daily ECG monitoring (Holter monitoring) is performed at the K + 31 clinic. Part of arrhythmias is provoked by physical activity, in such cases, stress tests (treadmill) are used to diagnose them.
Complications
A number of rhythm disturbances can lead to the development of severe complications. With the wrong rhythm of contractions in the heart, blood flow slows down, which leads to the formation of blood clots in the atria. In the absence of adequate therapy, these blood clots can spread with blood flow through the body, leading to blockage of the arteries of the brain (stroke), intestinal arteries, and lower limbs. The prolonged existence of uncorrectable arrhythmias often leads to the development of heart failure.
Arrhythmia Treatment
if arrhythmia is the result of a disease (for example, thyrotoxicosis), our doctors treat the underlying disease;
antiarrhythmic drugs are prescribed (affecting the conduction system of the heart, as well as various ion channels).
To prevent the development of complications, dynamic monitoring by a cardiologist of a patient is recommended even during remission.
