Arrhythmias. Heart rhythm disturbances Changes in myocardial contractility and nutrition

ECG interpretation- the job of a knowledgeable doctor. With this method functional diagnostics estimated:

• heart rate - the state of the generators of electrical impulses and the state of the heart system conducting these impulses
• condition of the heart muscle itself (myocardium), the presence or absence of inflammation, damage, thickening, oxygen starvation, electrolyte imbalance

However, modern patients often have access to their medical documents, in particular, to electrocardiography films on which medical reports are written. With their diversity, these records can reach even the most balanced but ignorant person. After all, the patient often does not know for certain how dangerous to life and health is what is written on the back of the ECG film by the hand of a functional diagnostician, and there are still several days before an appointment with a therapist or cardiologist.

To reduce the intensity of passions, we immediately warn readers that with not a single serious diagnosis (myocardial infarction, acute rhythm disturbances), a functional diagnostician will not let a patient leave the office, but, at a minimum, will send him for a consultation with a fellow specialist right there. About the rest of the “open secrets” in this article. In all unclear cases of pathological changes in the ECG, ECG monitoring, 24-hour monitoring (Holter), ECHO cardioscopy (ultrasound of the heart) and stress tests (treadmill, bicycle ergometry) are prescribed.

Numbers and Latin letters in ECG interpretation

PQ- (0.12-0.2 s) – atrioventricular conduction time. Most often it lengthens against the background of AV blockade. Shortened in CLC and WPW syndromes.

P – (0.1s) height 0.25-2.5 mm describes atrial contractions. May indicate their hypertrophy.

QRS – (0.06-0.1s) -ventricular complex

QT – (no more than 0.45 s) lengthens with oxygen starvation (myocardial ischemia, infarction) and the threat of rhythm disturbances.

RR - the distance between the apices of the ventricular complexes reflects the regularity of heart contractions and makes it possible to calculate heart rate.

The interpretation of the ECG in children is presented in Fig. 3

Heart Rate Description Options

Sinus rhythm

This is the most common inscription found on an ECG. And, if nothing else is added and the frequency (HR) is indicated from 60 to 90 beats per minute (for example, HR 68`) - this is the best option, indicating that the heart works like a clock. This is the rhythm set by the sinus node (the main pacemaker that generates electrical impulses that cause the heart to contract). At the same time, sinus rhythm implies well-being, both in the state of this node and the health of the conduction system of the heart. Denies the absence of other records pathological changes heart muscle and means that the ECG is normal. In addition to sinus rhythm, there may be atrial, atrioventricular or ventricular, indicating that the rhythm is set by cells in these parts of the heart and is considered pathological.

Sinus arrhythmia

This is a normal variant in young people and children. This is a rhythm in which impulses leave the sinus node, but the intervals between heart contractions are different. This may be due to physiological changes (respiratory arrhythmia, when heart contractions slow down during exhalation). Approximately 30% sinus arrhythmia require observation by a cardiologist, as they are at risk of developing more serious rhythm disturbances. These are arrhythmias after rheumatic fever. Against the background of myocarditis or after it, against the background of infectious diseases, heart defects and in persons with a family history of arrhythmias.

Sinus bradycardia

These are rhythmic contractions of the heart with a frequency of less than 50 per minute. In healthy people, bradycardia occurs, for example, during sleep. Bradycardia also often occurs in professional athletes. Pathological bradycardia may indicate sick sinus syndrome. In this case, bradycardia is more pronounced (heart rate from 45 to 35 beats per minute on average) and is observed at any time of the day. When bradycardia causes pauses in heart contractions of up to 3 seconds during the day and about 5 seconds at night, leads to disturbances in the supply of oxygen to tissues and is manifested, for example, by fainting, an operation is indicated to install a cardiac pacemaker, which replaces the sinus node, imposing a normal rhythm of contractions on the heart.

Sinus tachycardia

Heart rate more than 90 per minute is divided into physiological and pathological. In healthy people, sinus tachycardia is accompanied by physical and emotional stress, drinking coffee, sometimes strong tea or alcohol (especially energy drinks). It is short-lived and after an episode of tachycardia, the heart rate returns to normal within a short period of time after stopping the load. At pathological tachycardia palpitations bother the patient at rest. Its causes include fever, infections, blood loss, dehydration, anemia,. The underlying disease is treated. Sinus tachycardia stop only in case of heart attack or acute coronary syndrome.

Extarsystole

These are rhythm disturbances in which foci outside the sinus rhythm give extraordinary cardiac contractions, after which there is a pause of twice the length, called compensatory. In general, the patient perceives heartbeats as uneven, rapid or slow, and sometimes chaotic. The most worrying thing is the dips in heart rate. May occur in the form of tremors, tingling, feelings of fear and emptiness in the stomach.

Not all extrasystoles are dangerous to health. Most of them do not lead to significant circulatory disorders and do not threaten either life or health. They can be functional (against the background panic attacks, cardioneurosis, hormonal imbalances), organic (for ischemic heart disease, heart defects, myocardial dystrophy or cardiopathy, myocarditis). Intoxication and heart surgery can also lead to them. Depending on the place of occurrence, extrasystoles are divided into atrial, ventricular and anthrioventricular (arising in the node at the border between the atria and ventricles).

• Single extrasystoles most often rare (less than 5 per hour). They are usually functional and do not interfere with normal blood supply.
• Paired extrasystoles two each accompany a certain number of normal contractions. Such rhythm disturbances often indicate pathology and require further examination (Holter monitoring).
• Allorhythmias - more complex types extrasystoles. If every second contraction is an extrasystole, this is bigymenia, if every third contraction is trigymenia, every fourth is quadrigymenia.

It is customary to divide ventricular extrasystoles into five classes (according to Lown). They are assessed at daily ECG monitoring, since the results of a regular ECG may not show anything in a few minutes.

• Class 1 - single rare extrasystoles with a frequency of up to 60 per hour, emanating from one focus (monotopic)
• 2 – frequent monotopic more than 5 per minute
• 3 – frequent polymorphic ( different shapes) polytopic (from different foci)
• 4a – paired, 4b – group (trigymenia), episodes of paroxysmal tachycardia
• 5 – early extrasystoles

The higher the class, the more serious the violations, although today even classes 3 and 4 do not always require drug treatment. In general, if there are less than 200 ventricular extrasystoles per day, they should be classified as functional and not worry about them. For more frequent cases, ECHO CS is indicated, and sometimes cardiac MRI is indicated. It is not the extrasystole that is treated, but the disease that leads to it.

Paroxysmal tachycardia

In general, a paroxysm is an attack. A paroxysmal increase in rhythm can last from several minutes to several days. In this case, the intervals between heart contractions will be the same, and the rhythm will increase over 100 per minute (on average from 120 to 250). There are supraventricular and ventricular forms of tachycardia. This pathology is based on abnormal circulation of electrical impulses in the conduction system of the heart. This pathology can be treated. Home remedies to relieve an attack:

• holding your breath
• increased forced cough
• immersing face in cold water

WPW syndrome

Wolff-Parkinson-White syndrome is a type of paroxysmal supraventricular tachycardia. Named after the authors who described it. The appearance of tachycardia is based on the presence of additional nerve bundle, through which a faster impulse passes than from the main pacemaker.

As a result, an extraordinary contraction of the heart muscle occurs. The syndrome requires conservative or surgical treatment (in case of ineffectiveness or intolerance of antiarrhythmic tablets, during episodes of atrial fibrillation, and with concomitant heart defects).

CLC – syndrome (Clerk-Levi-Christesco)

is similar in mechanism to WPW and is characterized by earlier excitation of the ventricles than normal due to an additional bundle along which the nerve impulse travels. The congenital syndrome is manifested by attacks of rapid heartbeat.

Atrial fibrillation

It can be in the form of an attack or permanent shape. It manifests itself in the form of atrial flutter or fibrillation.

Atrial fibrillation

Atrial fibrillation

When flickering, the heart contracts completely irregularly (the intervals between contractions of very different durations). This is explained by the fact that the rhythm is not set by the sinus node, but by other cells of the atria.

The resulting frequency is from 350 to 700 beats per minute. There is simply no full contraction of the atria; contracting muscle fibers do not effectively fill the ventricles with blood.

As a result, the heart’s output of blood deteriorates and organs and tissues suffer from oxygen starvation. Another name for atrial fibrillation is atrial fibrillation. Not all atrial contractions reach the ventricles of the heart, so the heart rate (and pulse) will be either below normal (bradysystole with a frequency of less than 60), or normal (normosystole from 60 to 90), or above normal (tachysystole more than 90 beats per minute ).

An attack of atrial fibrillation is difficult to miss.

• It usually starts with a strong beat of the heart.
• It develops as a series of absolutely irregular heartbeats with a high or normal frequency.
• The condition is accompanied by weakness, sweating, dizziness.
• The fear of death is very pronounced.
• There may be shortness of breath, general agitation.
• Sometimes observed.
• The attack ends with normalization of the rhythm and the urge to urinate, during which a large amount of urine is released.

To stop an attack, they use reflex methods, drugs in the form of tablets or injections, or resort to cardioversion (stimulating the heart with an electric defibrillator). If an attack of atrial fibrillation is not eliminated within two days, the risks of thrombotic complications (pulmonary embolism, stroke) increase.

With a constant form of heartbeat flicker (when the rhythm is not restored either against the background of drugs or against the background of electrical stimulation of the heart), they become a more familiar companion to patients and are felt only during tachysystole (rapid, irregular heartbeats). The main task when detecting ECG signs tachysystole of a permanent form of atrial fibrillation is a slowdown of the rhythm to normosystole without attempts to make it rhythmic.

Examples of recordings on ECG films:

• atrial fibrillation, tachysystolic variant, heart rate 160 b'.
• Atrial fibrillation, normosystolic variant, heart rate 64 b'.

Atrial fibrillation can develop in the course of coronary heart disease, against the background of thyrotoxicosis, organic heart defects, diabetes mellitus, sick sinus syndrome, and intoxication (most often with alcohol).

Atrial flutter

These are frequent (more than 200 per minute) regular contractions of the atria and equally regular, but less frequent contractions of the ventricles. In general, flutter is more common in the acute form and is better tolerated than flicker, since circulatory disorders are less pronounced. Fluttering develops when:

• organic heart diseases (cardiomyopathies, heart failure)
• after heart surgery
• against the background of obstructive pulmonary diseases
• in healthy people it almost never occurs

Clinically, flutter is manifested by rapid rhythmic heartbeat and pulse, swelling of the neck veins, shortness of breath, sweating and weakness.

Conduction disorders

Normally, having formed in the sinus node, electrical excitation travels through the conduction system, experiencing a physiological delay of a split second in the atrioventricular node. On its way, the impulse stimulates the atria and ventricles, which pump blood, to contract. If in any part of the conduction system the impulse is delayed longer than the prescribed time, then excitation to the underlying sections will come later, and, therefore, the normal pumping work of the heart muscle will be disrupted. Conduction disturbances are called blockades. They can occur as functional disorders, but more often they are the result of drug or alcohol intoxication and organic heart disease. Depending on the level at which they arise, several types are distinguished.

Sinoatrial blockade

When the exit of an impulse from the sinus node is difficult. In essence, this leads to sick sinus syndrome, slowing of contractions to severe bradycardia, impaired blood supply to the periphery, shortness of breath, weakness, dizziness and loss of consciousness. The second degree of this blockade is called Samoilov-Wenckebach syndrome.

Atrioventricular block (AV block)

This is a delay of excitation in the atrioventricular node longer than the prescribed 0.09 seconds. There are three degrees of this type of blockade. The higher the degree, the less often the ventricles contract, the more severe the circulatory disorders.

• In the first, the delay allows each atrial contraction to maintain an adequate number of ventricular contractions.
• The second degree leaves some of the atrial contractions without ventricular contractions. It is described, depending on the prolongation of the PQ interval and the loss of ventricular complexes, as Mobitz 1, 2 or 3.
• The third degree is also called complete transverse blockade. The atria and ventricles begin to contract without interconnection.

In this case, the ventricles do not stop because they obey the pacemakers from the underlying parts of the heart. If the first degree of blockade may not manifest itself in any way and can be detected only with an ECG, then the second is already characterized by sensations of periodic cardiac arrest, weakness, and fatigue. With complete blockades, brain symptoms are added to the manifestations (dizziness, spots in the eyes). Morgagni-Adams-Stokes attacks may develop (when the ventricles escape from all pacemakers) with loss of consciousness and even convulsions.

Impaired conduction within the ventricles

In the ventricles, the electrical signal propagates to the muscle cells through such elements of the conduction system as the trunk of the His bundle, its legs (left and right) and branches of the legs. Blockades can occur at any of these levels, which is also reflected in the ECG. In this case, instead of being simultaneously covered by excitation, one of the ventricles is delayed, since the signal to it bypasses the blocked area.

In addition to the place of origin, a distinction is made between complete or incomplete blockade, as well as permanent and non-permanent blockade. The causes of intraventricular blocks are similar to other conduction disorders (ischemic heart disease, myocarditis and endocarditis, cardiomyopathies, heart defects, arterial hypertension, fibrosis, heart tumors). Also affected are the use of antiarthmic drugs, an increase in potassium in the blood plasma, acidosis, and oxygen starvation.

• The most common is blockade of the anterosuperior branch of the left bundle branch (ALBBB).
• In second place is right leg block (RBBB). This blockade is usually not accompanied by heart disease.
• Left bundle branch block more typical for myocardial lesions. In this case, complete blockade (PBBB) is worse than incomplete blockade (LBBB). It sometimes has to be distinguished from WPW syndrome.
• Block of the posteroinferior branch of the left bundle branch may occur in persons with a narrow and elongated or deformed chest. Among pathological conditions, it is more typical for overload of the right ventricle (with pulmonary embolism or heart defects).

The clinical picture of blockades at the levels of the His bundle is not pronounced. The picture of the underlying cardiac pathology comes first.

• Bailey's syndrome is a two-bundle block (of the right bundle branch and the posterior branch of the left bundle branch).

Myocardial hypertrophy

With chronic overload (pressure, volume), the heart muscle in certain areas begins to thicken, and the chambers of the heart begin to stretch. On the ECG, such changes are usually described as hypertrophy.

• (LVH) – typical for arterial hypertension, cardiomyopathy, a number of heart defects. But even normally, athletes, obese patients and people engaged in heavy physical labor may experience signs of LVH.
• Right ventricular hypertrophy- an undoubted sign of increased pressure in the pulmonary blood flow system. Chronic cor pulmonale, obstructive pulmonary diseases, cardiac defects (pulmonary stenosis, tetralogy of Fallot, ventricular septal defect) lead to RVH.
• Left atrial hypertrophy (LAH)) – with mitral and aortic stenosis or insufficiency hypertension, cardiomyopathy, after.
• Right atrial hypertrophy (RAH)– with cor pulmonale, tricuspid valve defects, chest deformities, pulmonary pathologies and pulmonary embolism.
• Indirect signs of ventricular hypertrophy is a deviation electrical axis heart (EOC) to the right or left. The left type of EOS is its deviation to the left, that is, LVH, the right type is RVH.
• Systolic overload- This is also evidence of hypertrophy of the heart. Less commonly, this is evidence of ischemia (in the presence of angina pain).

Changes in myocardial contractility and nutrition

Early ventricular repolarization syndrome

More often just an option norms, especially for athletes and people with congenital high body weight. Sometimes associated with myocardial hypertrophy. Refers to the peculiarities of the passage of electrolytes (potassium) through the membranes of cardiocytes and the characteristics of the proteins from which the membranes are built. It is considered a risk factor for sudden cardiac arrest, but does not provide clinical results and most often remains without consequences.

Moderate or severe diffuse changes in the myocardium

This is evidence of a malnutrition of the myocardium as a result of dystrophy, inflammation () or. Also reversible diffuse changes accompanied by disturbances in water and electrolyte balance (with vomiting or diarrhea), taking medications (diuretics), and heavy physical activity.

Nonspecific ST changes

This is a sign of deterioration in myocardial nutrition without severe oxygen starvation, for example, in case of disturbances in the balance of electrolytes or against the background of dyshormonal conditions.

Acute ischemia, ischemic changes, T wave changes, ST depression, low T

This describes reversible changes associated with oxygen starvation of the myocardium (ischemia). This can be either stable angina or unstable, acute coronary syndrome. In addition to the presence of the changes themselves, their location is also described (for example, subendocardial ischemia). Distinctive feature such changes are their reversibility. In any case, such changes require comparison of this ECG with old films, and if a heart attack is suspected, troponin rapid tests for myocardial damage or coronary angiography. Depending on the type of coronary heart disease, anti-ischemic treatment is selected.

Advanced heart attack

It is usually described:

• by stages: acute (up to 3 days), acute (up to 3 weeks), subacute (up to 3 months), cicatricial (all life after a heart attack)
• by volume: transmural (large focal), subendocardial (small focal)
• by location of heart attacks: there are anterior and anterior septal, basal, lateral, inferior (posterior diaphragmatic), circular apical, posterobasal and right ventricular.

In any case, a heart attack is a reason for immediate hospitalization.

The whole variety of syndromes and specific changes on the ECG, the difference in indicators for adults and children, the abundance of reasons leading to the same type of ECG changes do not allow a non-specialist to interpret even the finished conclusion of a functional diagnostician. It is much wiser, having the ECG result in hand, to visit a cardiologist in a timely manner and receive competent recommendations for further diagnosis or treatment of your problem, significantly reducing the risks of emergency cardiac conditions.

One of the most easily identified and important indicators The work of the heart is the frequency and rhythm of its contractions. These measures reflect the number of action potentials generated by the cardiac pacemaker and the contraction of the heart. In this case, in a healthy person, the number of action potentials generated and the number of heart contractions per minute (heart rate per minute) coincide. Heart rate (HR) depends on age. In one-year-old children, the heart rate at rest is about 120, at the age of 5 years - about 100, in young people - up to 90 beats / min. In adults, the normal heart rate at rest is 60-80 beats/min. In trained athletes, the lower limit of normal heart rate can reach 45 contractions per minute.

To characterize deviations of heart rate from the norm, the following terms are used:

Bradycardia - decrease in heart rate less than 60 beats/min.

Tachycardia- increased heart rate more than 90 beats/min.

Heart rhythm is assessed by comparing durations. The heart rhythm is considered correct when the duration of cardiac cycles following each other does not differ by more than 10%. In a healthy person, the normal variant is the presence of arrhythmia due to the influence of the pacemaker on the generation of action potentials. A sign of respiratory arrhythmia is a cyclical, gradual decrease in the duration of cardiac cycles during inhalation and an increase during exhalation. The difference between short and long cycles during respiratory arrhythmia can reach 0.15 s. Respiratory arrhythmia is usually more pronounced in young people and people with increased lability of the tone of the autonomic nervous system.

Arrhythmia

Violation of correctness heart rate called arrhythmia.

Physiological sinus arrhythmia- the occurrence of electrical impulses in pacemaker cells at slightly varying intervals of time. Normal heart rhythm is characterized by rhythm and consistency. However, due to the high sensitivity of the cells of the sinoatrial node to nervous and humoral influences, there are slight fluctuations in the duration of successive electrical impulses.

Physiological respiratory arrhythmia - a type of physiological sinus arrhythmia, manifested by an increase in heart rate during inspiration and a decrease during exhalation. It is characteristic of childhood and adolescence (juvenile respiratory arrhythmia) even with normal average breathing. In an adult, this type of arrhythmia is detected only with deep breathing. This arrhythmia is caused by increased tone sympathetic division the autonomic nervous system during inhalation and the parasympathetic nervous system during exhalation.

The causes of arrhythmias, as a rule, are disturbances in the processes of generation and conduction of excitation in the heart, the development of ischemic and other pathological processes in the heart. Some arrhythmias are fatal to humans.

One of the simplest types of arrhythmia is extrasystole - an extraordinary contraction that occurs after a shortened time interval after the previous contraction. After the extrasystole, an extended period of time (compensatory pause) may follow before a new contraction of the heart. The causes of extrasystoles can be extraordinary excitation in the pacemaker of the heart, then it is called atrial, or excitation of cells in an ectopic (pathological) focus of excitation, usually occurring in the ventricular myocardium. Individual extrasystoles do not pose a great threat to humans. More dangerous are group extrasystoles (two or more following each other).

Extrasystole can occur when the heart is exposed to external factors, such as certain medications or electric current. The effect of electric current at the end of the ventricles is especially dangerous, when myocardial excitability is increased for 30 ms. In this case, even a relatively weak electric current can cause excitation of the myocardium, provoke a circular movement of excitation waves throughout the myocardium, which can lead to desynchronization of muscle fiber contraction and ventricular fibrillation. This weakens or shuts down the ventricles and blood flow may stop. Recovery normal rhythm heart and saving a person’s life resort to passing a short-term high-voltage electric current through the chest and heart, which often helps restore the processes of generating action potentials in the pacemaker, starting and synchronizing myocardial contraction. The device with which such a current is obtained is called a defibrillator, and the procedure for influencing the heart is called defibrillation.

One of the dangerous forms of arrhythmia is atrial fibrillation, manifested by atrial fibrillation or flutter. Such arrhythmic contraction of the atria is caused as a result of the appearance of multiple foci of excitation in it and the continuous circulation of action potentials throughout their myocardium. The synchronicity of contraction of the atria myocardium is sharply disrupted and their pumping function is reduced. The rhythm of ventricular contraction is disrupted, and the duration of cardiac cycles continuously changes. Atrial fibrillation is dangerous not only because of the disruption of the pumping function of the heart, but also because, due to hemodynamic disturbances, blood clots can form in the atrial blood. They or their fragments can enter the vascular bed and cause thrombosis blood vessels.

Lower atrial rhythm is one of the main types of cardiac arrhythmias, which cause certain negative changes in the patient’s condition, in particular discomfort, disruption of the usual lifestyle and significant limitation in active movement. Occurring with an uneven rhythm in the activity of the sinus node, the lower atrial rhythm is an abnormal contraction of the myocardium.

Features of the violation

This type of cardiac arrhythmia is considered one of the most common in people with any cardiac pathology. And identifying the so-called “replacement rhythm” is quite simple, since its long duration is shorter, which can be easily heard by a professional when conducting an appropriate examination.

Since the etiology of this cardiac pathology presupposes the presence of causes provoking this condition physiological nature, as well as objective reasons that can become provoking factors, to completely get rid of this type of cardiac arrhythmia, identifying the disease and treating it will not be enough. It is necessary to identify those predisposing factors that could cause the manifestation of the lower atrial rhythm.

The danger of this condition lies in the possibility of further worsening of symptoms, as well as in significantly limiting the capabilities of the sick person. There is also a danger to life, and this is especially true in the case of additional serious diseases.

Read on to find out what it is and whether ectopic, accelerated, transient lower atrial heart rhythm is dangerous.

Classification of lower atrial rhythm

There is a certain classification of this pathological condition of cardiac muscle contractions. In accordance with it, there are several main types of lower atrial rhythm:

• ectopic rhythm, which is caused by automatism observed in any part of the myocardium. This type of rhythm manifests itself as a replacement rhythm, and its frequency is significantly lower in comparison with the sinus rhythm of a healthy heart;
• transient lower atrial rhythm, characterized by the occurrence of complete or incomplete blockade of the right side of the heart. The manifestation of this type is fickle, transient;
• an accelerated rhythm most often manifests itself in vagotonia, when inflammatory or age-related changes in heart.

Read below about the reasons for the appearance of lower atrial rhythm.

Causes

Most often, lower atrial rhythm is detected in people who are elderly: by this time they already have a number of chronic diseases, which can also cause the onset of various types of cardiac pathologies. The most common provoking causes of this type of arrhythmia include diseases such as:

However, when the disease is detected, this pathology can be diagnosed as congenital; V in this case the disease can no longer be completely cured.

Symptoms

With lower atrial rhythm, manifestations characteristic of any type of cardiac pathology are especially frequent. Symptoms of lower atrial rhythm include the following:

• pain with deep breathing or sudden movements;
• acute pain when receiving heavy physical activity;
• the occurrence of noticeable disturbances in the heart rhythm and discomfort from this condition.

Abnormal rhythm and heart rate are the most common reason for visits to a cardiologist, as this causes a deterioration in the patient’s general condition.

Diagnostics

Identification of this pathological condition begins with determining the patient’s subjective manifestations. Symptoms characteristic of lower atrial rhythm usually become the first manifestations of the disease, on the basis of which a preliminary diagnosis can be made by a cardiologist.

Subsequent studies of the lower atrial rhythm are based on an ECG. With this procedure it becomes possible definition the presence of disturbances in heart rate and heart rhythm. The doctor also prescribes general and biochemical analysis blood, with the help of which it becomes possible to determine the presence of serious disorders in the functioning of thyroid gland, as well as the entire endocrine system in general.

The doctor may order a test for a more detailed examination. general analysis urine, its data helps determine the etiology of the disease, and will also make it possible to more correctly carry out treatment in each case.

Treatment

Treatment of lower atrial rhythm can be carried out in several main directions.

Elimination of the root cause of the disease is mandatory drug treatment and preventive measures will help to completely stop the pathological process and normalize the patient’s condition.

Therapeutic

The most important point in obtaining excellent results with treatment of this disease is to eliminate the causes that provoked the appearance of the lower atrial rhythm. Since many serious diseases can provoke this pathological condition, you should first eliminate the root cause of heart pathology. The definitive cure of chronic diseases is considered an important condition success in curing lower atrial rhythm.

• It is also important to follow a certain diet, which significantly limits the consumption of fatty, sweet and overly salty foods, and excludes the consumption of alcoholic beverages and foods that contain preservatives.
• Additional use of physiotherapy in combination with acupuncture sessions will help eliminate the unpleasant manifestations of this cardiac pathology.

Medication

As a treatment, when a lower atrial rhythm is detected, a cardiologist prescribes the use of antiarrhythmic drugs that stabilize the frequency and rhythm of heart contractions, as well as the speed of impulses that are transmitted from the heart.

Purpose of a certain medication carried out by a doctor, taking into account the specifics of the patient’s disease and the presence of chronic diseases.

Surgical

In the absence of significant effectiveness of drug and therapeutic treatment methods, surgical intervention may be prescribed to help eliminate the problem. However, the operation requires a long recovery period.

Prevention

Following a diet that limits the consumption of fatty, canned and excessively sweet or salty foods, as well as following the advice of a cardiologist, allows you to avoid disturbances in the functioning of the cardiac system, therefore, as preventive measures The following measures may be recommended:

• compliance with the prescribed diet;
• maintaining an active lifestyle;
• elimination of factors that provoke abnormalities in the functioning of the heart;
• regular examinations for the purpose of prevention by a cardiologist.

Complications

In the absence of the necessary treatment, complications may occur that negatively affect the condition of the cardiac system as a whole. Relapses of the disease are likely - this is possible with incompletely cured diseases that provoked the disease.

Deterioration of the patient's condition, severe arrhythmia and increased symptoms of lower atrial rhythm (chest pain, weakness and lack of stability during physical activity) are the main manifestations of insufficient treatment of this pathological condition.

Forecast

The survival rate when this cardiac pathology is detected is quite high. The main condition is its timely diagnosis.

With the correct treatment regimen and the absence of advanced chronic diseases that can worsen the patient’s condition, the survival rate is about 89-96%. This is a high indicator and can become an incentive to begin timely and adequate treatment when diagnosing lower atrial heart rhythm.

The following video will tell you about some methods of treating various types of arrhythmias at home. But remember: self-medication can be dangerous:

Types of atrial rhythm abnormalities and methods for their treatment

This type of heart defect manifests itself against the background of problems in the sinus node. If its activity is weakened or completely stopped, then an ectopic rhythm occurs. This type of contraction is due to automatic processes that occur under the influence of disturbances in other parts of the heart. In simple words One can characterize such rhythm as a process of a substitutive nature. The dependence of the frequency of ectopic rhythms is directly related to the distance of rhythms in other cardiac regions.

Types of atrial arrhythmia

Since the manifestations of ectopic rhythms are a direct derivative of disturbances in the functioning of the sinus node, their occurrence occurs under the influence of changes in the rhythm of cardiac impulses or myocardial rhythm. The following diseases are common causes of ectopic rhythm:

• Cardiac ischemia.
• Inflammatory processes.
• Diabetes.
• High pressure in the heart area.
• Rheumatism.
• Neurocircular dystonia.
• Sclerosis and its manifestations.

Other heart defects, such as hypertension, can also trigger the development of the disease. A strange pattern of occurrence of ectopic right atrial rhythms appears in people with excellent health. The disease is transient, but there are cases of congenital pathology.

Among the features of the ectopic rhythm, a characteristic heart rate is noted. In people with this defect, during diagnosis they reveal increased performance heartbeats.

With routine pressure measurements, it is easy to confuse ectopic atrial rhythm with an increase in the number of heart contractions due to high temperature, inflammatory diseases, or normal tachycardia.

If the arrhythmia does not go away long time, talk about the persistence of the violation. Paroxysmal disturbances of accelerated atrial rhythm are noted as a separate item. A feature of this type of disease is its sudden development, the pulse can reach a minute.

A feature of such ectopic rhythms is the sudden onset of an attack and unexpected termination. Most often occurs with atrial tachycardia.

On the cardiogram, such contractions are reflected at regular intervals, but some forms of ectopia look different. The question: is this normal or pathological can be answered by studying different types deviations.

There are two types of uneven changes in the intervals between atrial rhythms:

• Extrasystole is an extraordinary atrial contraction against the background of a normal heart rhythm. The patient can physically feel a pause in the rhythm that occurs against the background of myocarditis, nervous breakdown or bad habits. There are cases of manifestations of causeless extrasystole. A healthy person can feel up to 1500 extrasystoles per day without harm to health, and there is no need to seek medical help.

• Atrial fibrillation is one of the cyclic stages of the heart. There may be no symptoms at all. The atrium muscles stop contracting rhythmically, and chaotic flicker occurs. The ventricles, under the influence of flickering, are knocked out of rhythm.

The danger of developing an atrial rhythm exists regardless of age and can occur in a child. Knowing that this abnormality can occur over a period of days or months will make it easier to identify. Although medicine treats such deviations as a temporary manifestation of an illness.

IN childhood the appearance of ectopic atrial rhythm may occur under the influence of a virus. This is the most dangerous form illness, usually the patient is in serious condition, and exacerbations of atrial heart rhythm in children can occur even with a change in body position.

Symptoms of atrial rhythm

External manifestations of the disease appear only against the background of arrhythmia and another complication. The ectopic rhythm itself does not have characteristic symptoms. Although it is possible to pay attention to long-term disturbances in the rhythm of heart contractions. If you discover such a deviation, you should immediately consult a doctor.

Among the indirect symptoms indicating heart problems are:

• Frequent attacks of shortness of breath.
• Dizziness.
• Chest pain.
• Increased feeling of anxiety and panic.

Important! A characteristic sign of the onset of an attack of ectopic rhythm is the patient’s desire to take a body position in which the discomfort will go away.

In cases where the attack does not go away for a long time, it may begin copious discharge sweat, blurred vision, bloating, hands will begin to shake.

There are deviations in heart rate that cause problems with the digestive system, sudden vomiting and the desire to urinate. Urges to empty bladder occur every minute, regardless of the amount of liquid drunk. As soon as the attack stops, the urge will stop and your overall health will improve.

An attack of extrasystole can occur at night and be provoked by a dream. As soon as it is completed, the heart may freeze, after which its operation will return to normal. Symptoms may occur during sleep elevated temperature and burning sensation in the throat.

Diagnostic techniques

Identification is made based on data obtained during the anamnesis. After this, the patient is sent to an electrocardiogram to detail the obtained data. Based on the patient’s internal feelings, one can draw conclusions about the nature of the disease.

With the help of an ECG, the features of the disease are revealed; with ectopic heart rhythm, they are of a specific nature. Characteristic signs manifested by changes in readings on the “P” wave, can be positive and negative depending on the lesion.

The presence of atrial rhythm on an ECG can be determined based on the following indicators:

1. The compensatory pause does not have a full form.
2. The P-Q interval is shorter than it should be.
3. The “P” wave configuration is uncharacteristic.
4. The ventricular complex is excessively narrow.

Treatment of ectopic rhythm

To select an appropriate treatment, an accurate diagnosis of the abnormality must be established. Inferior atrial rhythm can affect heart disease to varying degrees, causing treatment tactics to change.

Sedatives are prescribed to combat vegetative-vascular disorders. Increased heart rate suggests the use of beta-blockers. To stop extrasystoles, Panalgin and Potassium chloride are used.

Manifestations of atrial fibrillation are determined by the prescription of drugs that stop the manifestation of arrhythmia during attacks. Controlling the contraction of cardiac impulses with medications depends on age group patient.

Massage of the carotid sinus located nearby carotid artery, is necessary after diagnosing the supraventricular form of heart rhythm disorder. To carry out the massage, apply gentle pressure in the neck area on the carotid artery for 20 seconds. Remove development unpleasant symptoms will help at the time of attack rotational movements parades on eyeballs.

If the attacks are not stopped by massage of the carotid artery and pressure on eyeballs, a specialist may prescribe medication treatment.

Important! Repetition of attacks 4 times in a row or more, severe deterioration of the patient’s condition can lead to serious consequences. Therefore, to restore normal heart function, the doctor uses electromagnetic therapy.

Although the extrasystole defect can be irregular, the appearance of ectopic arrhythmia is a dangerous form of development of heart damage, as it entails serious complications. To avoid becoming a victim of unforeseen attacks that result in an abnormal heart rhythm, you should regularly undergo examinations and diagnostics of the functioning of the cardiovascular system. Adherence to this approach allows you to avoid the development of dangerous diseases.

What does atrial rhythm mean on an ECG?

Atrial rhythm is a condition in which the function of sinus contraction is weakened. In this case, the lower atrial center acts as a source of impulses. There is a weakened heart rate, with heart beats ranging from 90–160 per minute. This article explains how atrial rhythm is determined on an ECG.

What are we talking about?

Many people who are diagnosed with atrial rhythm do not understand what this means. A healthy person has a single path for the transmission of electrical impulses that cause sequential excitation of all parts of the heart. Due to this, a productive contraction occurs, leading to a satisfactory blood release into the arteries.

This route originates in the right atrium. After which it passes to the most distant ventricular tissues through the conduction system. However, for various reasons, the sinus node loses the ability to generate electricity necessary to release impulses to distant sections.

There is a change in the process of transmission of cardiac excitation. A replacement contraction is formed. It turns out that the impulse arises out of place. For information, atrial rhythm is the appearance of much-needed excitation anywhere in the heart, only in the non-location of the sinus node.

How does atrial rhythm occur?

Outside the border of the sinus node, an extraneous impulse appears, exciting the heart before the signal emanating from the main one. This situation indicates an advance of the secondary atrial contraction. Based on the reentry theory, there is no parallel excitation. This is influenced by local blocking of nerve impulses. During activation, this area experiences an extra extraordinary contraction, which disrupts the main cardiac impulse.

Diagnostics allows you to determine the presence of pathologies of the heart muscle

According to some theories, the endocrine, vegetative nature of the formation of the precardiac impulse is assumed. Typically, this situation occurs in a child in adolescence or in an adult suffering from hormonal changes, which may occur due to age or pathological manifestations.

In addition, there is a theory of the occurrence of an impulse formed by the atria as a result of hypoxic, inflammatory processes occurring in the myocardium. This pathology can occur with regular inflammatory diseases. It has been noted that in children suffering from influenza and tonsillitis, the likelihood of myocarditis with further changes in atrial contraction increases.

The heart, which is the main muscle of the body, has a special property. It has the ability to contract regardless of the nerve impulse emanating from the main organ of the central nervous system. Since it is he who controls the activity of the neurohumoral system. The correct route originates in the region of the right atrium. Then spread along the septum occurs. Impulses that do not pass along this route are called ectopic.

Types of atrial contraction

Based on the unevenness of the intervals, atrial rhythm is of the following types:

• Extrasystole is characterized by extraordinary contractions that occur during normal heart rhythm. This condition does not always have a clinical picture. It happens that a healthy person, for one reason or another, experiences extrasystole. In this case, sometimes there is no need to contact a cardiologist. It manifests itself as fear, tingling in the area of ​​the heart and stomach.
• With atrial fibrillation, heartbeats can reach up to 600 per minute. The atrial muscles are characterized by a lack of rhythm, flickering appears, with characteristic chaotic behavior. As a result, the ventricles of the heart completely go out of rhythm. This condition is quite serious and can lead to a heart attack. With this pathology, the patient suffers from shortness of breath, panic, dizziness, sweating, and fear of death. Loss of consciousness may occur.
• When the pacemaker migrates, the source of contraction seems to move through the atria. There is a manifestation of successive impulses emanating from different atrial sections. The patient experiences tremors, fear, and stomach emptiness.
• Atrial flutter is characterized by frequent regular atrial contractions and systematic ventricular contractions. At this state more than 200 beats per minute occur. It is more easily tolerated by the patient than flickering, since it has a less pronounced circulatory disorder. Manifested by rapid heartbeat, swollen neck veins, excessive sweating, lack of strength.

The ECG results are deciphered by a cardiologist who, based on obvious signs, confirms or denies the presence of extrasystoles

How to distinguish atrial rhythm from sinus rhythm

The atrial rhythm is slow, replacing. It occurs during suppression of the sinus node. Usually, with this arrangement, the heart contracts less than normal. In addition, there are accelerated impulses, during which the pathological activity of the center of atrial automation increases. In this situation, the heart rate is higher than the heart rate.

Based on where the activity of the ectopic center occurs, left atrial and right atrial contractions are distinguished. To alleviate the patient’s condition, electrocardiography does not necessarily have to determine which atrium is producing the pathological impulse. The doctor will need to diagnose the altered contractions.

The atrial rhythm on the replacement type ECG has following signs:

• correct contraction of the ventricles at regular intervals;
• contraction frequency varies from 45 to 60 per minute;
• each ventricular complex has a deformed, negative wave;
• intervals are characterized by shortness or normal duration;
• the ventricular complex is not changed.

Accelerated atrial rhythm has the following signs on the ECG:

• cardiac impulses range from 120 to 130 per minute;
• each ventricular contraction has a deformed, biphasic, negative, jagged wave;
• intervals are lengthened;
• the ventricular complex is unchanged.

Atrial extrasystole is determined by a premature, extraordinary contraction. Ventricular extrasystole is characterized by a change in the contractile complex followed by a compensatory pause.

Features of atrial and ventricular rhythm that should be differentiated from each other

Signs on ECG

On an electrocardiogram, the doctor judges the atrial rhythm by the presence of deformation of the P wave. Diagnostics records the disturbed amplitude and its direction in comparison with the normal impulse. Usually this tooth is shortened. Right atrial contraction appears negative on the ECG. The left atrial rhythm has a positive wave and a rather bizarre shape. It looks like a shield with a sword.

If the patient suffers from migration of the driving rhythm, then the electrocardiogram shows a changed wave shape and a longer P Q segment. Moreover, this change is cyclical. Atrial fibrillation is characterized by the complete absence of a wave. Which is explained by the inferiority of systole.

However, the ECG shows an F wave, characterized by uneven amplitude. Using these waves, ectopic contractions are determined. There are cases when the atrial rhythm is asymptomatic, appearing only on the ECG. However, if a patient has this pathology, he requires specialist supervision.

Atrial rhythm

The heart, being one of the main muscles in the human body, has a number of special properties. It can contract regardless of nerve impulses coming from the brain and taking part in the control of the neurohumoral system. The correct route for transmitting information in the heart muscle begins in the area of ​​the right atrium (sinus node), continues in the area of ​​the atrioventricular node and then spreads across the entire area of ​​the septum. All other contractions that do not follow this route are considered an ectopic rhythm.

How do atrial rhythms appear?

An ectopic impulse, appearing outside the sinus node, is formed and excites the heart muscle before the signal is transmitted from the main pacemaker. Such situations allow us to say that an accelerated atrial rhythm appears due to the “advanced” of the main rhythm by a secondary contraction of the ectopic type.

The theoretical basis for the ectopic rhythm is the re-entry theory, according to which a certain area of ​​the atrium is not excited in parallel with others due to the fact that there is a local blocking of the propagation of the nerve impulse. At the time of its activation, this area experiences an additional contraction - thus, it goes out of turn and thereby disrupts the overall rhythm of the heart.

Some theories suggest the autonomic and endocrine nature of the occurrence of atrial rhythms. As a rule, such phenomena occur in children during puberty or in adults with certain hormonal changes (age-related or resulting from pathologies).

There is also a version of the following type: hypoxic and inflammatory processes in the myocardium during cardiopathy and inflammatory diseases can cause atrial rhythms. Thus, in children who suffer from a sore throat or flu, there is a risk of myocarditis with a subsequent change in atrial rhythm.

The heart, being one of the main muscles in the human body, is endowed with special properties. It can contract regardless of the nerve impulses coming from the brain that control neurohumoral system. The correct route for receiving information in the heart muscle begins in the area of ​​the right atrium (sinus node), passes in the area of ​​the atrioventricular node and then spreads along the septum. All other beats that do not follow this route are called ectopic rhythm.

Etiology of atrial rhythm

As noted above, the reasons for changes in atrial rhythm are changes that take place in the sinus node. All changes are divided into ischemic, inflammatory and sclerotic. Non-sinus rhythms that appear as a result of such changes appear in the following forms:

1. Supraventricular ectopic rhythm;
2. Ventricular rhythm;
3. Atrial rhythm.

Accelerated atrial rhythm is formed, as a rule, in people who suffer from rheumatic diseases, various heart diseases, dystonia, diabetes, coronary disease or hypertension. In some cases, atrial rhythm can appear even in healthy adults and children, and can also be congenital in nature.

Impulses can come from different departments heart, since the source of emerging impulses moves through the atrium. IN medical practice This phenomenon is called migrating rhythm. When measuring such an atrial rhythm, the amplitude on the ECG changes according to the source of the location of the impulses.

Clinical picture

Atrial rhythm has a direct relationship with the specific disease that caused it. This means that there are no specific symptoms. Clinical picture directly caused by the pathological picture in the patient’s body. This rule applies only to short-term attacks of rhythm disturbance. With prolonged attacks, the following symptoms are possible:

• Initially there is a feeling of anxiety and fear. A person tries to take the most comfortable position that would stop further development attack.
• The next stage is accompanied by severe tremor (shaking) in the limbs, and in some cases, dizziness.
• The next step is the appearance of pronounced symptoms - increased sweating, dyspeptic disorders, manifested in the form of bloating and nausea, frequent urge to urination.

Short attacks may be accompanied by an increase in heart rate and shortness of breath, after which the heart stops for a moment and a noticeable jolt is felt. A similar impulse in the heart indicates that sinus rhythm has been restored - this can also be confirmed by minor painful sensations in the chest and heart area.

The change in atrial rhythm resembles paroxysmal tachycardia. Patients themselves can determine that they have an abnormal heart rhythm. If the heart rate is high, these changes will not be noticeable. An ECG examination helps to accurately determine this condition. In the case of atrial fibrillation, patients may complain of chest pain characteristic of angina pectoris.

Long-term attacks of atrial rhythm disturbance are dangerous for a person - at this moment, blood clots can form in the heart muscle, which, if they enter the blood vessels, can cause a heart attack or stroke. The danger also lies in the fact that when the disease is latent, patients may ignore the above symptoms, and therefore are not able to determine its further development.

Diagnosis of atrial rhythm

The main method for studying atrial rhythm is ECG. A cardiogram allows you to accurately determine where the rhythm disturbance occurs, as well as accurately determine the nature of such a rhythm. An ECG allows you to determine the following types of atrial escape rhythm:

• Left atrial rhythm: aVL is negative, aVF, PII, III are positive, PI, in some cases, smoothed. PV1/PV2 are positive and PV5-6 are negative. According to Mirovski et al., the P wave in left atrial rhythm consists of two parts: the first has a low-voltage and dome-shaped rise (affected by depolarization of the left atrium), the second part is characterized by a narrow and high peak (the right atrium is depolarized).
• Right atrial rhythm: characterized by a negative P wave in the area of ​​the third standard branch, in the first and second - positive. This phenomenon is characteristic of a mid-lateral right atrial rhythm. The lower rhythm of this form is characterized by the indication of the P wave, negative in the second and third branches, as well as aVF, smoothed in the 5-6 thoracic.

• The lower atrial rhythm is characterized by a shortening of the PQ interval, in which its value is less than 0.12 seconds, and the P wave is negative in branches II, III and aVF.

The following conclusion can be drawn: based on electrocardiogram data, the doctor can determine a change in atrial rhythm based on changes in the P wave, which has a different physiological norm amplitude and polarity.

Note that to determine the right atrial rhythm, a specialist must have extensive experience, since ECG data with such a rhythm are blurry and difficult to differentiate. In view of this, Holter monitoring can be used to form the most complete and accurate picture of cardiac activity.

Treatment of pathology

Since the change in rhythm is directly determined by the presence of pathologies in the human body (in particular, circulatory system and heart), treatment is aimed at identifying and eliminating the underlying causes. So, for vegetative-vascular disorders they can prescribe sedatives, in case of strengthening of the vagus, drugs based on atropine or belladonna are prescribed. If there is a predisposition to tachycardia, beta-blockers are used - the most popular are isoptin and cordarone. In case of polytopic extrasystoles and ventricular fibrillation, potassium preparations, panangin, and lidocaine are used.

In situations where the above methods do not allow you to get rid of diseases that cause changes in heart rhythm, the doctor may prescribe the use of special therapy - preventive procedures aimed at promoting health, as well as the use of electrical pulse therapy.

Heart rhythm and factors influencing it. The heart rhythm, i.e. the number of contractions per minute, depends mainly on the functional state of the vagus and sympathetic nerves. When the sympathetic nerves are stimulated, the heart rate increases. This phenomenon is called tachycardia. When excited vagus nerves heart rate decreases - bradycardia.

The state of the cerebral cortex also affects the heart rhythm: with increased inhibition, the heart rhythm slows down, with increased excitatory process it is stimulated.

The rhythm of the heart can change under the influence of humoral influences, in particular the temperature of the blood flowing to the heart. Experiments have shown that local irritation of the region of the right atrium with heat (localization of the leading node) leads to an increase in heart rate; when cooling this region of the heart, the opposite effect is observed. Local irritation by heat or cold of other parts of the heart does not affect the heart rate. However, it can change the speed of excitations through the conduction system of the heart and affect the strength of heart contractions.

The heart rate in a healthy person depends on age. These data are presented in the table.

What are the indicators of cardiac activity?

Indicators of cardiac activity. Indicators of cardiac performance are systolic and cardiac output.

Systolic, or stroke, volume of the heart- this is the amount of blood that the heart releases into the corresponding vessels with each contraction. The size of the systolic volume depends on the size of the heart, the condition of the myocardium and the body. In a healthy adult at relative rest, the systolic volume of each ventricle is approximately 70-80 ml. Thus, when the ventricles contract, 120-160 ml of blood enters the arterial system.

Minute volume of the heart- this is the amount of blood that the heart ejects into the pulmonary trunk and aorta in 1 minute. The minute volume of the heart is the product of the systolic volume and the heart rate per minute. On average, the minute volume is 3-5 liters.

Systolic and cardiac output characterizes the activity of the entire circulatory system.

4. External manifestations of heart activity.

How can you determine the work of the heart without special equipment?

There is data by which the doctor judges the work of the heart by external manifestations its activities, which include the apical impulse, heart sounds. More details about this data:

Apex impulse. During ventricular systole, the heart performs a rotational movement, turning from left to right. The apex of the heart rises and presses on the chest in the area of ​​the fifth intercostal space. During systole, the heart becomes very dense, so pressure of the apex of the heart on the intercostal space can be seen (bulging, protrusion), especially in thin subjects. The apical impulse can be felt (palpated) and thereby determined its boundaries and strength.

Heart sounds- These are sound phenomena that occur in the beating heart. There are two tones: I-systolic and II-diastolic.

Systolic tone. The atrioventricular valves are mainly involved in the origin of this tone. During ventricular systole, the atrioventricular valves close, and vibrations of their valves and the tendon threads attached to them cause the first sound. In addition, sound phenomena that occur during contraction of the ventricular muscles take part in the origin of the first tone. According to its sound characteristics, the first tone is drawn-out and low.

Diastolic tone occurs at the beginning of ventricular diastole during the protodiastolic phase, when the semilunar valves close. The vibration of the valve flaps is the source of sound phenomena. According to the sound characteristics, tone II is short and high.

Also, the work of the heart can be judged by the electrical phenomena that occur in it. They are called cardiac biopotentials and are obtained using an electrocardiograph. They are called electrocardiograms.

Diseases of the heart and cardiovascular system are one of the largest groups of diseases that quite often lead to death.

A person with a heart disorder - depending on its type - can live for several decades, or can die almost instantly.

Therefore, it is necessary to carefully monitor your heart health, especially if there are disturbances in its functioning or there are concomitant diseases that can affect the functioning of this vital organ.

What is heart rate?

Heart rhythm is the main characteristic of the heart, one of the important indicators of the organ’s functioning, by which the presence of pathology can be determined. It indicates how often it contracts and at what intervals it occurs. Heart rhythm is characterized by the frequency of heart contractions per unit time, as well as the duration of the break between contractions.

If the heart muscle contracts evenly, each cardiac cycle (sequential contraction and relaxation) takes the same amount of time - the rhythm is normal. If the duration of several cycles is not the same, there are rhythm disturbances.

The heart rhythm is set by cells in the sinus node (this part of the heart is called the Keith-Fluck node) - pacemakers that generate impulses.

The impulses are then transmitted to muscle cells, causing them to contract and subsequently relax. Since the heart is formed by muscle cells that have a high ability to contract, impulses affect the entire organ, causing it to contract rhythmically and pump blood.

Heart rate: what is normal?

Typically, the heart muscle contracts at a frequency of 60 to 100 beats per minute - depending on the state of the body, the influence of internal and external factors.

A normal heart rate is between 60 and 90 beats per minute. The more precise number depends on age, level of physical activity and other factors. If a person’s heart rate is 91 beats per minute, this is not a reason to call an ambulance. But exceeding the healthy heart rate by at least 5 units is a reason to consult a doctor and undergo additional examination.

In women, the heart rate is on average 7-8 units higher than in men.

The norms for a healthy heartbeat in children are higher - on average about 120 times per minute. This is due to the fact that the child’s blood volume is small, and the cells need more nutrients and oxygen.

Therefore, the heart needs to work faster in order to deliver oxygen to the cells in a timely manner.

The normal heart rate depending on gender in adults is shown in the table below:

Age, years	Men, normal (beats per minute)	Women, normal (beats per minute)
20-30	60-65	60-70
30-40	65-70	70-75
40-50	70-75	75-80
50-60	75-78	80-83
60-70	78-80	83-85
70 and older	80	85

As you can see, with age, the heart rate increases (on average, by 5 beats every 10 years). This is due to a decrease in the elasticity of the heart muscle and a deterioration in the condition of blood vessels.

Heart rhythm disturbances: what are they?

An important indicator is the interval between contractions. It should be the same. Otherwise, we can talk about a heart rhythm disorder.

The interval between beats at rest is assessed: during physical or emotional stress, the heart contracts more often, so the interval between beats is shortened - but again it should be uniform.

If the interval is uneven, the duration of one of the periods is reduced:

1. Systole– period of contraction of the heart muscle. As a result, the volume of transported oxygen decreases, and organs and tissues suffer from oxygen starvation.
2. Diastole– a period of her relaxation. As a result, the heart muscle does not rest and is regularly overexerted, resulting in chronic diseases of the organ.

Heart failures occur frequently. If everything is fine, a person does not hear or feel his heart beating. If there is a violation, a person feels a pulsation or experiences discomfort - a feeling of lack of air, dizziness, etc. Often, these ailments are not paid attention to and they find out about the disturbance in heart rhythm during a routine examination or examination.

An abnormal heart rhythm is called arrhythmia. There are several types of it:

1. Bradycardia– slowing down the heart rate, leading to oxygen starvation and weaknesses. Occurs by natural reasons when a person is weakened after illness, during prolonged relaxation. If bradycardia is caused by reasons not related to health problems and occurs sporadically, it is not dangerous. But it may indicate pathological changes in the structure of the heart if it is permanent.
2. Tachycardia– acceleration of heart rate. An increase in heart rate of 20-25 units during intense physical activity is normal. But tachycardia at rest is dangerous because it causes increased impact on blood vessels and the heart muscle wears out faster.
3. Extrasystole– the appearance of extra blows, as a result, the interval between blows either increases or decreases. The most common causes are ischemia and atherosclerotic damage to the heart muscle. Most often occurs in older people.
4. Atrial fibrillation- complete rhythm disturbance. It occurs when the heart muscle does not contract completely, but only twitches slightly. This type of arrhythmia indicates serious heart problems and requires careful and immediate examination and treatment. Often occurs with lung diseases.

Why do heart rhythm disturbances occur?

Heart rhythm disturbances are:

1. Temporary- lasts several minutes, then the heart rate normalizes on its own.
2. Permanent– when they are associated with the presence of pathology and disease of the heart itself or other organs.

Most often, heart rhythm disturbances are caused by:

• Hypertension;
• Chronic diseases of the cardiovascular system;
• Damage to the heart muscle;
• Constant stress;
• Presence of mental disorders and diseases;
• Diabetes;
• Poor circulation, decreased vascular tone, varicose veins veins;
• Obesity;
• Bad habits (smoking, alcoholism, abuse of caffeine and other substances that cause spasms of blood vessels and affect heart rate);
• Some medications.

Heart diseases that affect the occurrence of arrhythmia:

1. Cardiomyopathy. With it, the walls of the atria and ventricles can thicken or, on the contrary, become too thin, as a result of which the volume of blood that is pumped per contraction decreases.
2. Ischemic disease occurs when some of the small blood vessels become severely narrowed. As a result, part of the heart muscle does not receive oxygen and dies. The consequence of this disorder is ventricular arrhythmia.
3. Heart valve diseases. Because of them, the volume of blood pumped changes, which also affects the number of contractions necessary to maintain life.

Thyroid diseases are a risk factor for the development of arrhythmia. Patients with thyroid dysfunction need to be examined by a cardiologist from time to time.

Among women

Tachycardia in a woman occurs during pregnancy and menopause. If it is not accompanied by other symptoms, there is no reason to see a doctor.

Causes of poor heart health and heart rate disorders also include:

1. Excessive emotionality.
2. Serious physical activity.
3. Chronic stress.

In men

Representatives of the stronger sex are less attentive to their health.

Changes in their heart rate are caused by:

1. Excessive physical activity during sports.
2. On the contrary - the absence of any physical activity.
3. Bad habits.
4. Poor nutrition, excess fatty foods.

In women, arrhythmia usually occurs after 50 years, in men a little earlier - after 45 years.

In children, heart rhythm disturbances occur due to congenital or inflammatory heart diseases, severe poisoning and intoxication, and disorders of the nervous system.

Symptoms that accompany arrhythmia

The presence of heart disease leads to a gradual weakening of the heart muscle and the sinus node itself, which produces impulses.

This is accompanied by characteristic symptoms:

Diagnostics

Only subjective feelings or the presence of several symptoms is not enough to make an accurate diagnosis, determine the type of arrhythmia, its causes and prescribe the correct treatment.

The following methods are used for diagnosis:

1. Electrocardiography (ECG) is the simplest, fastest and most common examination method. It gives a complete picture of the duration of the heartbeat phases.
2. Echocardiography allows you to assess the size of the heart chambers, the thickness of the walls, and observe their movement.
3. Monitoring using the Holter method, when a special sensor is installed on the patient’s arm. During the day, it constantly records your heart rate - at rest, while performing everyday activities.

Treatment and prevention

Arrhythmia is mainly treated with medication. For this purpose, antiarrhythmic drugs and medications are prescribed to maintain and improve the functioning of the heart muscle. . Treatment of concomitant diseases is mandatory.

Reflex effects include various types of massage that help improve blood circulation, reduce or increase the heart rate.

In case of serious disorders, I use the installation of pacemakers and pacemakers. They take on those functions that the damaged sinus node cannot cope with.

Check out pacemakers

It is extremely rare, but physiotherapeutic treatment is used. It is effective if the arrhythmia is caused not by physiological disorders, but by the consequences of stress and disturbances in the functioning of the nervous system.

To prevent the risk of arrhythmia and get rid of it in the early stages, you need to:

1. Normalize your rest schedule - get enough sleep regularly, avoid serious physical activity, but do not completely give up physical activity.
2. To be less nervous, you can take light soothing teas.
3. Avoid tea, coffee, alcohol and cigarettes.
4. Review your diet - give up baked goods, fatty and sweet foods, eat more vegetables and light protein foods.
5. Eat foods rich in magnesium and potassium (microelements necessary for the health of the nervous and cardiovascular systems) - legumes, apricots, bananas.
6. Control your weight and gradually get rid of extra pounds.
7. Regularly undergo preventive examinations, monitor blood pressure and pulse parameters.

Video: Atrial flutter. Heart rhythm disturbance