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Heart rhythm disturbances. Heart rhythm disturbances Normal heart rhythm

When the sympathetic nerves are stimulated, the heart rate increases. This phenomenon is called tachycardia. When the vagus nerves are excited, the heart rate decreases - bradycardia. The rhythm of the heart can change under the influence of humoral influences, in particular the temperature of the blood flowing to the heart. Local irritation by heat of the area of the right atrium (localization of the leading node) leads to an increase in heart rate; when cooling this area 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.

Heart rate healthy person depends on age.

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 is the volume of blood that comes from the ventricle in one systole. 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 in arterial system 120-160 ml of blood arrives.

Cardiac minute volume is the amount of blood that the heart pumps 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.

Grade functional state body, taking into account their level motor activity

It is known that there is a stage in the development of mechanisms of regulation of the cardiovascular system, which is manifested in the nature of its reaction to the same influence in different periods postnatal development (Frolkis V.V., 1975). In this regard, the dynamics of the features of indicators of autonomic regulation of HR in individuals of primary and secondary school age in formed groups with different levels of motor activity. Features of changes in SR regulation during at different levels motor activity is predominantly determined not by the age of the student, but by the tone of the ANS. This was consistent with the idea that the initial autonomic tone is one of the important characteristics, determining the type of response (Kaznacheev V.P., 1980). Due to this, the features of changes in SR parameters in groups among schoolchildren of different ages, were associated mainly with the fact that in the older school age among persons with regulation unusual for them, persons with sympathicotonia predominate, and at primary school age – with vagotonia.

Since changes in the regulation of SR have common dynamics for individuals with the same ANS tone, regardless of their age, then, therefore, if we take into account the initial ANS tone when analyzing the body’s response to motor activity, there is no need to isolate age groups. Therefore, to analyze changes in the physical activity of the body in schoolchildren in each of the groups with different motor activity, three subgroups of individuals with different initial ANS tone were identified - eutonics, sympathotonics and vagotonics.

In group 1 (with a lower load), it turned out that people with eutonia had no significant changes in FS. Moreover, in 39% of people with eutonia it was characterized by satisfactory adaptation, in 33% - by strained adaptation mechanisms, and in 28% - by unsatisfactory adaptation.

It can be assumed that the muscle load in this group did not have an effect on individuals with eutonia due to its insignificance. However, it should be noted that according to the literature (Iskakova Z.B., 1991; Antropova M.V. et al., 1997), by the end school year Schoolchildren develop tension in their regulatory systems, and since the completion of our research occurred in the middle of the second half of the school year, we can talk about leveling out this tension due to physical activity. This indicated a stabilizing effect of motor activity on the characteristics of autonomic regulation.

In the majority of people with sympathicotonia (73%), the body's physical function significantly improved and began to be characterized by satisfactory adaptation. The same was observed in 50% of individuals with vagotonia. However, 30% of people with vagotonia retained FS, which was characterized by tension in adaptation mechanisms, and in 20%, unsatisfactory adaptation.

The analysis showed that in group 1 (with less load) the proportion of people with different FS changed significantly compared to the beginning of the study. The proportion of people with satisfactory adaptation has increased significantly, and the number of people with strained adaptation mechanisms and unsatisfactory adaptation has significantly decreased. The observed dynamics of physical activity in the group with low muscle load was apparently associated not with the training effect, but with the development of favorable nonspecific adaptive reactions in the body. This is consistent with the studies of a number of authors (Garkavi L. Kh., Kvakina E. B., Ukolova M. A., 1990; Ulyanov V. I., 1995; Fleshner M., 1999).

As a result of the characteristics of the body's physical function in group 2 (with a higher load), it turned out that significant changes in physical function occurred only in individuals with eutonia. The number of eutonics with satisfactory adaptation increased from 30% to 70%. Persons characterized by unsatisfactory adaptation have completely disappeared.

Among persons with sympathicotonia and vagotonia, no significant changes in FS occurred. At the same time, the majority of individuals (74%) with sympathicotonia retained FS, characterized by tension in adaptation mechanisms. The sample of persons with vagotonia consisted of three parts, similar in size: persons with satisfactory adaptation - 31%, with strained adaptation mechanisms - 29%, with unsatisfactory adaptation - 40%.

The lack of improvement in physical activity in individuals with vagotonia and sympathicotonia in group 2 (with a higher load) indicated that they require more careful planning of motor activity depending on the body's physical activity.

Thus, this indicates that the formation of adaptive reactions significantly depended on individual characteristics autonomic regulation and volume of muscle load. Thus, in the group with lower loads, the formation of adaptive reactions depended to a lesser extent on the nature of differentiation of the type of autonomic regulation. At the same time, in the group with a higher load, satisfactory adaptation was formed only in individuals with sufficiently plastic autonomic regulation, and in individuals with a strictly defined type of regulation, adaptive changes were observed to a much lesser extent.

The results obtained develop an understanding of the formation of mechanisms of autonomic regulation of heart rate in ontogenesis and can be used to assess the adequacy of various types of exposure to the individual adaptive capabilities of the body.

Heart rhythm disturbances

Heart rhythm disturbances are a very complex branch of cardiology. The human heart works throughout life. It contracts and relaxes 50 to 150 times per minute. During the systole phase, the heart contracts, ensuring blood flow and delivery of oxygen and nutrients throughout the body. During the diastole phase it rests. Therefore, it is very important that the heart contracts at regular intervals. If the systole period is shortened, the heart does not have time to fully provide the body with blood movement and oxygen. If the diastole period is shortened, the heart does not have time to rest. Heart rhythm disturbance is a disturbance in the frequency, rhythm and sequence of contractions of the heart muscle. Cardiac muscle - the myocardium consists of muscle fibers. There are two types of these fibers: working myocardium or contractile, conducting myocardium that provides contraction, creating an impulse to contract the working myocardium and ensuring the conduction of this impulse. Contractions of the heart muscle are provided by electrical impulses arising in the sinoauricular or sinus node, which is located in the right atrium. Electrical impulses then travel along the conductive fibers of the atria to the atrioventricular node, located in the lower part of the right atrium. The bundle of His originates from the atrioventricular node. It runs in the interventricular septum and is divided into two branches - the right and left bundle branches. The branches of the His bundle, in turn, are divided into small fibers - Purkinje fibers, through which the electrical impulse reaches the muscle fibers. Muscle fibers contract under the influence of an electrical impulse in systole and relax in its absence in diastole. The frequency of the normal (sinus) contraction rhythm is about 50 contractions during sleep, at rest, before physical and psycho-emotional stress, and when exposed to high temperatures.

The endocrine system, through the hormones contained in the blood, and the autonomic nervous system - its sympathetic and parasympathetic divisions - have a regulatory effect on the activity of the sinus node. An electrical impulse in the sinus node occurs due to the difference in the concentrations of electrolytes inside and outside the cell and their movement across the cell membrane. The main participants in this process are potassium, calcium, chlorine and, to a lesser extent, sodium. The causes of heart rhythm disturbances are not fully understood. It is believed that the main two reasons are changes in nervous and endocrine regulation or functional disorders, and abnormalities in the development of the heart, its anatomical structure– organic disorders. Often there are combinations of these underlying causes. An increase in heart rate of more than 100 per minute is called sinus tachycardia. In this case, the full contractions of the heart muscle and the cardiac complexes on the electrocardiogram do not change, an increased rhythm is simply recorded. This can be a healthy person’s reaction to stress or physical activity, but it can also be a symptom of heart failure, various poisonings, diseases thyroid gland. A decrease in heart rate below 60 beats per minute is called sinus bradycardia. Cardiac complexes on the ECG also do not change. This condition can occur in well-trained physically people (athletes). Bradycardia is also accompanied by diseases of the thyroid gland, brain tumors, mushroom poisoning, hypothermia, etc. Disturbances in cardiac conduction and rhythm are very common complications of cardiovascular diseases. The most common heart rhythm disturbances are:

Extrasystole (extraordinary contraction)

Atrial fibrillation (completely irregular rhythm)

Paroxysmal tachycardia (sharp increase in heart rate from 150 to 200 beats per minute).

The classification of rhythm disturbances is very complex. Arrhythmias and blockades can occur anywhere in the conduction system of the heart. Their type depends on the place of occurrence of arrhythmias or blockades.

Extrasystoles or atrial fibrillation are felt by the patient as palpitations, the heart beats faster than usual or there are interruptions in the heart.

If the patient feels fading, cardiac arrest, and at the same time he experiences dizziness and loss of consciousness, most likely the patient has a heart rhythm block or bradycardia (decreased heart rate). If any cardiac arrhythmia is detected in the patient, it is necessary to carry out full examination to clarify the cause of arrhythmia. The main method for diagnosing heart rhythm disorders is an electrocardiogram. An ECG helps determine the type of arrhythmia. But some arrhythmias occur sporadically. Therefore, Holter monitoring is used to diagnose them. This study provides an electrocardiogram recording over several hours or days. At the same time, the patient leads a normal lifestyle and keeps a diary, where he notes the actions he performs hourly (sleep, rest, physical activity). When decrypting ECG data electrocardiograms are compared with diary data. Determine the frequency, duration, time of occurrence of arrhythmias and their connection with physical activity, simultaneously analyze the signs of insufficient blood supply to the heart. Echocardiography allows you to identify diseases that contribute to the development of arrhythmias - valve prolapse, congenital and acquired heart defects, cardiomyopathies, etc. More are used modern methods research:

Endocardial (from the inner cavity of the heart)

Transesophageal electrophysiological research methods

Heart rhythm disturbances: types, causes, signs, treatment

Under normal conditions, the human heart beats smoothly and regularly. The heart rate per minute ranges from 60 to 80 beats. This rhythm is set by the sinus node, which is also called the pacemaker. It contains pacemaker cells, from which excitation is transmitted further to other parts of the heart, namely to the atrioventricular node, and to the His bundle directly in the tissue of the ventricles.

This anatomical and functional division is important from the point of view of the type of a particular disorder, because a block in the conduction of impulses or acceleration of impulses can occur in any of these areas.

Disturbances in heart rhythm and conduction are called arrhythmias and are conditions when the heart rate becomes less than normal (less than 60 per minute) or more than normal (more than 80 per minute). Arrhythmia is also a condition when the rhythm is irregular (irregular, or non-sinus), that is, it comes from any part of the conduction system, but not from the sinus node.

Different types of rhythm disturbances occur in different percentages:

So, according to statistics, the lion's share among rhythm disturbances with the presence of underlying cardiac pathology are atrial and ventricular extrasystole, which occur in 85% of cases in patients with coronary artery disease.
In second place in frequency is the paroxysmal and permanent form of atrial fibrillation, which occurs in 5% of cases in people over 60 years of age and in 10% of cases in people over 80 years of age.

However, disorders of the sinus node are even more common, in particular, tachycardia and bradycardia that occur without heart pathology. Probably every inhabitant of the planet has experienced rapid heartbeat caused by stress or emotions. Therefore, these types of physiological abnormalities statistical significance Dont Have.

Classification

All rhythm and conduction disorders are classified as follows:

Heart rhythm disturbances.
Conduction disorders in the heart.

In the first case, as a rule, there is an acceleration of the heart rate and/or irregular contraction of the heart muscle. In the second, the presence of blockades of varying degrees with or without slowing of the rhythm is noted.

In general, the first group includes disorders of the formation and conduction of impulses:

The cycle of impulses through the heart is normal

In the sinus node, manifested by sinus tachycardia, sinus bradycardia and sinus arrhythmia - tachyarrhythmia or bradyarrhythmia.

According to the tissue of the atria, manifested by atrial extrasystole and paroxysmal atrial tachycardia,

At the atrioventricular junction (AV node), manifested by atrioventricular extrasystole and paroxysmal tachycardia,

Along the fibers of the ventricles of the heart, manifested by ventricular extrasystole and paroxysmal ventricular tachycardia,

In the sinus node and along the tissue of the atria or ventricles, manifested by flutter and fibrillation of the atria and ventricles.

The second group of conduction disorders includes blocks (blockades) in the path of impulses, manifested by sinoatrial block, intraatrial block, atrioventricular block of 1, 2 and 3 degrees and bundle branch block.

Causes of heart rhythm disturbances

Rhythm disturbances can be caused not only by serious heart pathology, but also by the physiological characteristics of the body. For example, sinus tachycardia can develop during fast walking or running, as well as after playing sports or after strong emotions. Respiratory bradyarrhythmia is a variant of the norm and consists of an increase in contractions when inhaling and a decrease in heart rate when exhaling.

However, such rhythm disturbances that are accompanied atrial fibrillation(atrial fibrillation and flutter), extrasystole and paroxysmal types of tachycardia, in the vast majority of cases develop against the background of diseases of the heart or other organs.

Diseases that cause rhythm disturbances

Pathology of cardio-vascular system, flowing in the background:

Coronary heart disease, including angina pectoris, acute and previous myocardial infarction,
Arterial hypertension, especially with frequent crises and long-term,
heart defects,
Cardiomyopathies (structural changes normal anatomy myocardium) due to the above diseases.

Stomach and intestines, such as stomach ulcers, chronic cholecystitis and etc,
Acute poisoning,
Active pathology of the thyroid gland, in particular hyperthyroidism (increased secretion of thyroid hormones into the blood),
Dehydration and disturbances in blood electrolyte composition,
Fever, severe hypothermia,
Alcohol poisoning
Pheochromocytoma is a tumor of the adrenal glands.

In addition, there are risk factors that contribute to the occurrence of rhythm disturbances:

Obesity,
Bad habits,
Age over 45 years,
Concomitant endocrine pathology.

Do cardiac arrhythmias manifest themselves in the same way?

All rhythm and conduction disorders clinically manifest themselves differently in different patients. Some patients do not feel any symptoms and learn about the pathology only after scheduled ECG. This proportion of patients is insignificant, since in most cases patients note obvious symptoms.

Thus, rhythm disturbances accompanied by rapid heartbeat (from 100 to 200 per minute), especially paroxysmal forms, are characterized by a sharp sudden onset and interruptions in the heart, lack of air, pain syndrome in the sternum area.

Some conduction disorders, such as fascicular blocks, do not show any signs and are recognized only on an ECG. Sinoatrial and atrioventricular blockades of the first degree occur with a slight decrease in heart rate (50-55 per minute), which is why clinically they can manifest only slight weakness and increased fatigue.

Blockades of the 2nd and 3rd degrees are manifested by severe bradycardia (less minutes) and are characterized by short-term attacks of loss of consciousness, called MES attacks.

In addition, any of the listed conditions may be accompanied by a general severe condition with cold sweat, intense pain in the left half of the chest, decreased blood pressure, general weakness and loss of consciousness. These symptoms are caused by impaired cardiac hemodynamics and require close attention from an emergency physician or clinic.

How to diagnose pathology?

Establishing a diagnosis of rhythm disturbance is not difficult if the patient presents typical complaints. Before initial examination Doctor, the patient can independently count his pulse and evaluate certain symptoms.

However, the type of rhythm disturbance can only be determined by a doctor after an ECG, since each type has its own signs on the electrocardiogram.

For example, extrasystoles are manifested by altered ventricular complexes, paroxysm of tachycardia - by short intervals between complexes, atrial fibrillation - by an irregular rhythm and heart rate of more than 100 per minute, sinoatrial block - by lengthening of the P wave, reflecting the conduction of the impulse through the atria, atrioventricular block - by lengthening the interval between the atria and ventricular complexes, etc.

In any case, only a cardiologist or therapist can correctly interpret changes in the ECG. Therefore, when the first symptoms of rhythm disturbance appear, the patient should seek medical help as soon as possible.

In addition to an ECG, which can be performed upon the arrival of an ambulance team at the patient’s home, additional examination methods may be needed. They are prescribed in the clinic, if the patient was not hospitalized, or in the cardiology (arrhythmology) department of the hospital, if the patient had indications for hospitalization. In most cases, patients are hospitalized because even a mild heart rhythm disorder can be a precursor to a more serious, life-threatening rhythm disorder. The exception is sinus tachycardia, since it is often stopped with the help of tablet drugs even at the age of prehospital stage, and generally does not pose a threat to life.

From additional methods diagnostics usually indicate the following:

Monitoring blood pressure and ECG throughout the day (Holter),
Tests with physical activity (walking up stairs, walking on a treadmill - treadmill test, cycling - bicycle ergometry),
Transesophageal ECG to clarify the location of the rhythm disturbance,
Transesophageal electrophysiological study (TEPE) in the case when the rhythm disturbance cannot be detected using a standard cardiogram, and it is necessary to stimulate the heart contractions and provoke the rhythm disturbance to find out its exact type.

In some cases, an MRI of the heart may be required, for example, if the patient is suspected of having a heart tumor, myocarditis, or a scar after a myocardial infarction that is not reflected in the cardiogram. A method such as ultrasound of the heart, or echocardioscopy, is a mandatory standard of research for patients with rhythm disturbances of any origin.

Treatment of rhythm disturbances

Treatment for rhythm and conduction disorders varies depending on the type and the cause that caused it.

For example, in the case of coronary heart disease, the patient receives nitroglycerin, blood thinning drugs (thromboAss, aspirin cardio) and drugs to normalize high cholesterol levels in the blood (atorvastatin, rosuvastatin). For hypertension, the prescription of antihypertensive drugs (enalapril, losartan, etc.) is justified. In the presence of chronic heart failure, diuretics (Lasix, Diacarb, Diuver, Veroshpiron) and cardiac glycosides (digoxin) are prescribed. If the patient has a heart defect, he may be indicated surgical correction vice.

Regardless of the cause, emergency care in the presence of rhythm disturbances in the form of atrial fibrillation or paroxysmal tachycardia consists of administering rhythm-restoring (antiarrhythmics) and rhythm-slowing drugs to the patient. The first group includes drugs such as panangin, asparkam, novocainamide, cordarone, strophanthin for intravenous administration.

At ventricular tachycardia Lidocaine is administered intravenously, and in case of extrasystole - betaloc in the form of a solution.

Sinus tachycardia can be stopped by taking anaprilin under the tongue or egilok (Concor, Coronal, etc.) orally in tablet form.

Bradycardia and blockades require completely different treatment. In particular, prednisolone, aminophylline, atropine are administered intravenously to the patient, and in case of low blood pressure, mesaton and dopamine along with adrenaline. These drugs “accelerate” the heart rate and make the heart beat faster and stronger.

Are there possible complications of heart rhythm disturbances?

Heart rhythm disturbances are dangerous not only because blood circulation throughout the body is disrupted due to improper functioning of the heart and decreased cardiac output, but also the development of sometimes dangerous complications.

Most often, patients develop against the background of one or another rhythm disturbance:

Collapse. It manifests itself as a sharp drop in blood pressure (below 100 mmHg), general severe weakness and pallor, pre-syncope or fainting. It can develop both as a result of a direct rhythm disturbance (for example, during an attack of MES), and as a result of the introduction antiarrhythmic drugs, for example, procainamide for atrial fibrillation. In the latter case, this condition is interpreted as drug-induced hypotension.
Arrhythmogenic shock - occurs as a result sharp decline blood flow in the internal organs, in the brain and in the arterioles of the skin. It is characterized by the general severe condition of the patient, lack of consciousness, pallor or cyanosis of the skin, pressure below 60 mmHg, and a rare heartbeat. Without timely assistance, the patient may die.
Ischemic stroke occurs due to increased thrombus formation in the heart cavity, since during paroxysmal tachycardias the blood in the heart “beats”, like in a mixer. The resulting blood clots can settle on the inner surface of the heart (mural thrombi) or spread throughout blood vessels into the brain, blocking their lumen and leading to severe ischemia of the brain substance. It manifests itself as sudden speech disturbances, unsteadiness of gait, complete or partial paralysis of the limbs.
PE (pulmonary embolism) occurs for the same reason as a stroke, only as a result of blockage of a pulmonary artery by blood clots. Clinically manifested by severe shortness of breath and suffocation, as well as bluish discoloration of the skin of the face, neck and chest skin above the level of the nipples. When the pulmonary vessel is completely obstructed, the patient experiences sudden death.
Acute myocardial infarction is caused by the fact that during an attack of tachyarrhythmia the heart beats at a very high frequency, and coronary arteries they are simply not able to provide the necessary blood flow to the heart muscle itself. Oxygen deficiency occurs in the cardiac tissues, and an area of necrosis, or death of myocardial cells, forms. Manifests sharp pain behind the sternum or in chest left.
Ventricular fibrillation, asystole (cardiac arrest) and clinical death. More often they develop with paroxysm of ventricular tachycardia, which turns into ventricular fibrillation. In this case, it is completely lost contractility myocardium, and the vessels do not receive an adequate amount of blood. A few minutes after fibrillation, the heart stops and clinical death develops, which, without timely assistance, turns into biological death.

In a small number of cases, the patient immediately develops a rhythm disturbance, any of the complications and death. This condition is included in the concept of sudden cardiac death.

Forecast

The prognosis for rhythm disturbances in the absence of complications and in the absence of organic heart pathology is favorable. Otherwise, the prognosis is determined by the degree and severity of the underlying pathology and the type of complications.

Heart rhythm disturbance

Heart rhythm and its disorders

One of the most easily determined and important indicators of heart function 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 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 is a decrease in heart rate less than 60 beats/min.

Tachycardia - an increase in heart rate more than 90 beats/min.

Heart rhythm is assessed by comparing the durations of cardiac cycles. 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 option is the presence of arrhythmia, caused by the influence of the respiratory center on the generation of action potentials by the pacemaker. 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

Irregular heart rhythm is called arrhythmia.

Physiological sinus arrhythmia is 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 is 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 conduction system, 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 affecting the heart external factors, such as certain medications, electric current. The effect of electric current is especially dangerous at the end of ventricular systole, 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. In this case, the pumping function of the ventricles weakens or turns off, and blood flow may stop. To restore normal heart rhythm and save a person’s life, they 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 that produces such a current 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 are capable of getting into vascular bed and cause thrombosis of blood vessels.

Normal heart rate in men and women, causes of heart rhythm disturbances by gender

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 closely monitor the health of the heart, especially if there are disturbances in its functioning or there are accompanying illnesses, which 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 the heart muscle contracts and at what intervals this 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(successive contraction and relaxation) take the same period 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. A more accurate number depends on age, level physical activity and other indicators. 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:

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:

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

Bradycardia is a slowing of the heart rate, leading to oxygen starvation and weakness. 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 constant.
Tachycardia is an acceleration of heart rate. An increase in heart rate 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.
Extrasystole is the appearance of extra beats, as a result the interval between beats either increases or decreases. Most common reasons- ischemia, atherosclerotic damage to the heart muscle. Most often occurs in older people.
Atrial fibrillation is a complete rhythm disorder. 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.

Ventricular tachycardia to content

Why do heart rhythm disturbances occur?

Heart rhythm disturbances are:

Temporary - lasts a few minutes, then the heart rate normalizes on its own.
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;
Availability 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:

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.
Coronary artery 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.
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:

Excess weight.
Excessive emotionality.
Serious physical activity.
Chronic stress.

In men

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

Changes in their heart rate are caused by:

Excessive physical activity during sports.
On the contrary - the absence of any physical activity.
Bad habits.
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:

Fatigue;
Dizziness;
Loss of consciousness;
Signs of heart failure;
Impairment, confusion;
Chest pain;
Feeling of shortness of breath, difficulty breathing;
Feeling of panic during an attack.

Diagnostics

Only subjective feelings or the presence of several symptoms is not enough to diagnose accurate diagnosis, determining the type of arrhythmia, its causes and prescribing the correct treatment.

The following methods are used for diagnosis:

Electrocardiography (ECG) is the simplest, fastest and most common examination method. It gives a complete picture of the duration of the heartbeat phases.
Echocardiography allows you to assess the size of the heart chambers, the thickness of the walls, and observe their movement.
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.

Deviations of rhythm to content

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 action involves different kinds massages that help improve blood circulation, reduce or increase 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.

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 early stages, necessary:

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

Cause various diseases and functional failures. This can be a subtle phenomenon or cause serious illness. Heart health should be taken into account if you feel unwell, right action You will need to consult a cardiologist.

Features of the phenomenon

Nature has programmed that the heart rate is set by the sinus node. The pulses travel through a conductive system that branches along the walls of the chambers. The atrioventricular node is located in the system that conducts impulses below the sinus node in the atrium.

The task of the atrioventricular node is to reduce the speed of the impulse when transmitting it to the ventricles. This occurs so that ventricular systole does not coincide in time with the contraction of the atria, but follows immediately after their diastole. If disturbances occur in the creation of heart rhythms for various reasons, then the atrioventricular node is able, in a sense, to take on the mission of setting the heart rhythm. This phenomenon is called atrioventricular nodal rhythm.

In this case, the heart, under the guidance of impulses from the atrioventricular system, contracts 40 ÷ 60 times per minute. Passive impulses work a long period. Atrioventricular nodal rhythm of the heart is detected when six or more beats are observed, defined as the next replacement contractions of the heart. How the impulse emanating from the atrioventricular node is triggered: it passes retrograde movement upward to the atria and a natural downward movement, affecting the ventricles.

The rhythm according to ICD-10 is classified depending on the problems that caused the atrioventricular rhythm: 149.8.

Observations show that circulatory disorders during atrioventricular rhythm occur if the heart beats per minute are less than forty or more than one hundred and forty beats. The negative manifestation is reflected in insufficient blood supply to the heart, kidneys, and brain.

Shapes and types

Atrioventricular rhythm occurs:

Accelerated AV nodal rhythm - contractions per minute within 70 ÷ 130 beats. The violation occurs as a result of:
- glycoside intoxication,
- rheumatic attack,
- heart operations.
The slow rhythm is characterized by a frequency of contractions per minute ranging from 35 to 60 times. This type of atrioventricular rhythm occurs due to disorders:
- negative reaction to taking medications,
- with AV block,
- if ,
- as a result of increased parasympathetic tone.

AV rhythm occurs in the following manifestations:

when atrial excitation occurs first,
the ventricles and atria receive impulses at the same time, and their contraction also occurs at the same time.

About the reasons for the appearance of ectopic and other types of AV nodal rhythm read below.

Causes of atrioventricular nodal rhythm

The atrioventricular node is involved in creating rhythm under the following circumstances:

If sinus rhythm does not enter the atrioventricular node. This may happen due to:
- the sinus node does not cope with its function,
- atrioventricular block;
- arrhythmia with slow sinus rhythm – ,
- if impulses from ectopic foci located in the atrium do not have the opportunity to enter the atrioventricular node.
Atrioventricular rhythm can be caused by the following diseases:
- myocarditis,
- atrial infarction,
- acute myocardial infarction,
Rhythm disturbances can be caused by intoxications resulting from taking medications:
- morphine
- digitalis preparations,
- guanethidine,
- reserpine,
- quinidine,
- strophanthin.

Elena Malysheva’s video will tell you about the reasons for the appearance of AV rhythm in a child:

Symptoms

The manifestation of atrioventricular rhythm coincides with the symptoms of the arrhythmia that initiated the occurrence of this problem. The severity of the condition depends on how severe the manifestations of the underlying disease are.

There are three main signs:

the first heart sound has an amplified tone,
There is a noticeable pulsation in the neck veins,
bradycardia, which has the correct rhythm (number of contractions per minute: 40 ÷ 60 beats).

With prolonged atrioventricular rhythm, heart disease may result in:

acute conditions associated with Morgagni-Edams-Stokes syndrome,
fainting,

Diagnostics

The main method for determining AV rhythms is an electrocardiogram - recording on paper the electrical impulses of the heart. The results of the ECG study indicate a violation of the nodal rhythm or the absence of problems.

Treatment

If sinus bradycardia is observed and the junctional rhythm manifests itself for a short time, then this phenomenon is not treated.

In the case when the rhythm disturbance manifests itself clearly and leads to deterioration of blood circulation, then therapeutic procedures are provided.

Therapeutic

Treatment of rhythm disturbances consists of measures that will convert the atrioventricular rhythm to sinus. They treat major diseases and affect the autonomic system.

Healthy habits always help with heart health:

walks in the open air,
loads should be moderate,
positive thinking.

Medication

The specialist may prescribe medications:

isoprenaline - used intravenous infusion by combining the drug with a glucose solution or
atropine – used intravenously.

Medicines may cause unwanted effects:

angina pectoris
decrease in pressure,
ventricular arrhythmias.

If the patient is not suitable for these medicines, then instead the doctor can use aminophylline intravenously or in tablet form.

If, before treating atrioventricular rhythm, drugs that could cause rhythm disturbances were used, they should be discontinued. This:

digitalis preparations,
guanethidim,
quinidine,
antiarrhythmics
and others.

Operation

For rhythm disturbances caused by serious illnesses heart, an event is required to restore and maintain the correct heart rhythm. To do this, a simple operation is performed to introduce a pacemaker into the patient’s body.

Folk remedies

You can drink infusions and decoctions of herbs. Prescriptions should definitely be discussed with the doctor who is observing the patient.

Recipe No. 1

In a glass of boiling water, infuse herbs and seeds, taken in equal quantities (20 g):

goldenrod grass,
flaxseed (ground),
motherwort grass,
valerian root,
viburnum shoots.

The infusion is drunk in small sips for a month.

Recipe No. 2

Prepare an infusion with components taken in equal quantities (40 g), mixing them with a glass of boiling water:

lemon balm,
motherwort grass,
buckwheat flowers,
goldenrod grass.

The decoction is drunk in small sips for fourteen days. After a week's break, repeat taking the herbal infusion the same way as the first time.

Disease prevention

In order not to create preconditions for rhythm disturbances with replacement of the influence of the main pacemaker on atrioventricular impulses, you should adhere to the following rules:

Use medications with caution:
- reserpine,
- digoxin,
- morphine,
- strophanthin,
- antiarrhythmics.
Promptly treat heart diseases that can cause these disorders,
Carry out therapeutic and preventive measures to prevent:
- Acidosis - a change in the acid-base balance towards an acidic reaction can cause disturbances in the functioning of the heart. It is necessary to treat diseases that initiate an increase in the acidic environment, select the right diet, using consultations with specialists.
- Hyperkalemia – occurs when there is an increased level of potassium cations in the blood. Potassium is a mineral essential for kidney, heart and overall health. If its content significantly exceeds the required norm, it can cause the risk of heart rhythm disturbances and other problems. This occurs if the body does not cope well with eliminating the substance, or the use of potassium in supplements and medications occurs in doses that exceed the need for this substance.
- Hypoxia is a condition when tissues suffer from a lack of oxygen. The cause of the phenomenon should be investigated and the recommendations of a specialist should be followed.

Complications

The consequences of heart rhythm disturbances are determined by the underlying disease that caused these disturbances.

Forecast

If the atrioventricular rhythm operates for a short period during sinus bradycardia or rhythm migration, then we can talk about a good prognosis. It’s another matter if the nodal rhythm is caused by dangerous disorders, for example:

serious heart disease,
atrioventricular block,
during intoxication.

A low nodal rhythm tends to lead to serious manifestations. For example, if a situation of rhythm disturbance leads to heart failure, then this phenomenon is irreversible.

Since atrioventricular rhythm appears as a result of a whole complex of diseases and disorders, the prognosis depends precisely on those primary causes that caused cardiac arrhythmias.

The video below will tell you more about AV block as a cause of junctional rhythm disturbances:

Heart rate is one of the "signs of life" or important indicators health in the human body. It measures the number of times per minute that the heart contracts or beats.

Heart rate varies depending on physical activity, safety threats, and emotional reactions. Resting heart rate refers to the heart rate when a person is relaxing. While a normal heart rate does not guarantee that a person is "free" from health problems - it is a useful guide to identifying a range of health problems.

Briefly about heart rate:

Heart rate measures the number of times the heart beats per minute;

After the age of ten, a person's heart rate should be between 60 and 100 beats per minute while they are resting;

Not only is heart rate important, but an irregular heartbeat can be a sign of a serious health condition;

Monitoring your heart rate can help prevent heart complications.

What is your heart rate?

Heart rate is the number of times the heart beats in a minute. A healthy heart supplies the body with the required amount of blood over a certain period of time within the framework of life activity. For example, being scared or surprised automatically releases adrenaline, a hormone that speeds up the heart rate. This prepares the body to use more oxygen and energy to avoid or face potential danger.

The pulse rate is equal to the heartbeat, since the contractions of the heart cause an increase in blood pressure, which leads to a noticeable impulse. Therefore, pulse is a direct measurement of heart rate.

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Normal heart rate

It is important to determine whether your heart rate is within the normal range. If illness or injury weakens the heart, the organs will not receive enough blood to function properly. National institutions Health officials have published a list of normal heart rhythms.

Over the years, your heart rate becomes slower. The normal heart rate for adults over the age of 10, including older adults, is 60 to 100 beats per minute (bpm). Elite athletes may have heart rates below 60 beats per minute, sometimes reaching as high as 40 beats per minute.

Below is the table normal values heart rate in different age groups:

Heart rate may vary within this normal range. It will increase in response to various changes, including physical exercise, body temperature, emotional stimuli and body position, for example, a sharp rise.

Heart rate increases during exercise, therefore, during fitness classes, it is important not to strain your heart too much. However, the human body needs to increase its heart rate during exercise to provide more oxygen and energy to the rest of the body.

Although the heart rate increases as a result of physical activity, general decline heart rate possible over time. This means the heart works less to get what it needs. nutrients and oxygen to different parts of the body.

Also worth noting is the maximum heart rate - this demonstrates the full capacity of the heart, which is usually achieved through high-intensity exercise. The American Heart Association states that the maximum heart rate during exercise should be approximately 220 bpm minus the person's age.

Because each individual's body will respond differently to activities, the target heart rate is presented as a range known as the "target heart rate zone." The following table shows the appropriate 'zone' for a range of ages - heart rate should fall within this range when training at 50 to 80% intensity, also known as tension.

Abnormal heart rhythms

Heart rate is not the only factor to consider when considering his health, heart rhythm is also important. The heart should beat at a steady rhythm and there should be a regular interval between beats.

It is normal for your heart rate to change throughout the day in response to exercise, anxiety, worry and fear. However, a person should not be bothered by this.

But, if you regularly feel that your heart is losing its usual rhythm - beating too fast or, on the contrary, slowly, consult a doctor about your symptoms. The person may also feel a "missed" beat or may feel like there was an "extra" rhythm (aka, ectopic rhythm– it is common and usually harmless and does not require treatment).

People concerned about palpitations or ectopic beats should talk to a doctor, who can perform an electrocardiogram (ECG) to evaluate the heart rate and rhythm.

Heart rhythm disturbances are called and are conditions when the heart rate becomes less than normal (less than 60 per minute) or more than normal (more than 80 per minute). Arrhythmia is also a condition when the rhythm is irregular (irregular, or non-sinus), that is, it comes from any part of the conduction system, but not from the sinus node.

Different types of rhythm disturbances occur in different percentages:

Thus, according to statistics, the lion's share of rhythm disturbances with the presence of underlying cardiac pathology are atrial and ventricular, which occur in 85% of cases in patients with coronary artery disease.
In second place in frequency is the paroxysmal and permanent form of atrial fibrillation, which occurs in 5% of cases in people over 60 years of age and in 10% of cases in people over 80 years of age.

Nevertheless, Disturbances in the functioning of the sinus node are even more common, in particular, and those that arose without heart pathology. Probably every inhabitant of the planet has experienced stress caused by stress or emotions. Therefore, these types of physiological deviations do not have statistical significance.

Classification

All rhythm and conduction disorders are classified as follows:

Heart rhythm disturbances.
Conduction disorders in the heart.

The second group of conduction disorders includes blocks () on the path of impulses, manifested by intraatrial block, 1, 2 and 3 degrees and bundle branch block.

Causes of heart rhythm disturbances

Rhythm disturbances can be caused not only by serious heart pathology, but also by the physiological characteristics of the body. For example, sinus tachycardia can develop during fast walking or running, as well as after playing sports or after strong emotions. Respiratory bradyarrhythmia is a variant of the norm and consists of an increase in contractions when inhaling and a decrease in heart rate when exhaling.

However, such rhythm disturbances, which are accompanied by atrial fibrillation (atrial fibrillation and flutter), extrasystole and paroxysmal types of tachycardia, in the vast majority of cases develop against the background of diseases of the heart or other organs.

Diseases that cause rhythm disturbances

Pathology of the cardiovascular system occurring against the background of:

, including acute and transferred ones,
, especially with frequent crises and long-term,
(structural changes in the normal anatomy of the myocardium) due to the above diseases.

Non-cardiac diseases:

Stomach and intestines, for example, gastric ulcers, chronic cholecystitis, etc.
Acute poisoning,
Active pathology of the thyroid gland, in particular hyperthyroidism (increased secretion of thyroid hormones into the blood),
Dehydration and disturbances in blood electrolyte composition,
Fever, severe hypothermia,
Alcohol poisoning
Pheochromocytoma is a tumor of the adrenal glands.

In addition, there are risk factors that contribute to the occurrence of rhythm disturbances:

Obesity,
Bad habits,
Age over 45 years,
Concomitant endocrine pathology.

Do cardiac arrhythmias manifest themselves in the same way?

All rhythm and conduction disorders clinically manifest themselves differently in different patients. Some patients do not feel any symptoms and learn about the pathology only after a scheduled ECG. This proportion of patients is insignificant, since in most cases patients note obvious symptoms.

Blockades of the 2nd and 3rd degrees are manifested by severe bradycardia (less than 30-40 per minute) and are characterized by short-term attacks of loss of consciousness, called MES attacks.

How to diagnose pathology?

Establishing a diagnosis of rhythm disturbance is not difficult if the patient presents typical complaints. Before the initial examination by a doctor, the patient can independently count his pulse and evaluate certain symptoms.

However The type of rhythm disturbances can be determined only by a doctor after, since each species has its own signs on the electrocardiogram.
For example, extrasystoles are manifested by altered ventricular complexes, paroxysm of tachycardia - by short intervals between complexes, atrial fibrillation - by an irregular rhythm and heart rate of more than 100 per minute, sinoatrial block - by lengthening of the P wave, reflecting the conduction of the impulse through the atria, atrioventricular block - by lengthening the interval between the atria and ventricular complexes, etc.

In any case, only a cardiologist or therapist can correctly interpret changes in the ECG. Therefore, when the first symptoms of rhythm disturbance appear, the patient should seek medical help as soon as possible.

In addition to an ECG, which can be performed upon the arrival of an ambulance team at the patient’s home, additional examination methods may be needed. They are prescribed in the clinic, if the patient was not hospitalized, or in the cardiology (arrhythmology) department of the hospital, if the patient had indications for hospitalization. In most cases, patients are hospitalized because even a mild heart rhythm disorder can be a precursor to a more serious, life-threatening rhythm disorder. The exception is sinus tachycardia, since it is often treated with tablets at the prehospital stage, and generally does not pose a threat to life.

Additional diagnostic methods usually include the following:

during the day (according to Holter),
Tests with physical activity (walking stairs, walking on a treadmill - treadmill test, cycling - ),
Transesophageal ECG to clarify the location of the rhythm disturbance,
in the case when a rhythm disturbance cannot be registered using a standard cardiogram, and it is necessary to stimulate the heart contractions and provoke a rhythm disturbance in order to find out its exact type.

In some cases, an MRI of the heart may be required, for example, if the patient is suspected of having a heart tumor, myocarditis, or a scar after a myocardial infarction that is not reflected in the cardiogram. A method such as is a mandatory research standard for patients with rhythm disturbances of any origin.

Treatment of rhythm disturbances

Treatment for rhythm and conduction disorders varies depending on the type and the cause that caused it.

For example, in the case of coronary heart disease, the patient receives nitroglycerin (thromboAss, aspirin cardio) and drugs to normalize high cholesterol levels in the blood (atorvastatin, rosuvastatin). For hypertension, the prescription of antihypertensive drugs (enalapril, losartan, etc.) is justified. In the presence of chronic heart failure, diuretics (Lasix, Diacarb, Diuver, Veroshpiron) and cardiac glycosides (digoxin) are prescribed. If a patient has a heart defect, surgical correction of the defect may be indicated.

For ventricular tachycardia, lidocaine is administered intravenously, and for extrasystole, betalocaine is administered in the form of a solution.

Sinus tachycardia can be stopped by taking anaprilin under the tongue or egilok (Concor, Coronal, etc.) orally in tablet form.

Bradycardia and blockades require completely different treatment. In particular, prednisolone, aminophylline, atropine are administered intravenously to the patient, and in case of low blood pressure, mesaton and dopamine along with adrenaline. These drugs “accelerate” the heart rate and make the heart beat faster and stronger.

Are there possible complications of heart rhythm disturbances?

Heart rhythm disturbances are dangerous not only because blood circulation throughout the body is disrupted due to improper functioning of the heart and a decrease in cardiac output, but also due to the development of sometimes dangerous complications.

Most often, patients develop against the background of one or another rhythm disturbance:

Collapse. It manifests itself as a sharp drop in blood pressure (below 100 mmHg), general severe weakness and pallor, pre-syncope or fainting. It can develop both as a result of a direct rhythm disturbance (for example, during an attack of MES), and as a result of the administration of antiarrhythmic drugs, for example, procainamide during atrial fibrillation. In the latter case, this condition is interpreted as drug-induced hypotension.
Arrhythmogenic shock– occurs as a result of a sharp decrease in blood flow in the internal organs, in the brain and in the arterioles of the skin. It is characterized by the general severe condition of the patient, lack of consciousness, pallor or cyanosis of the skin, pressure below 60 mmHg, and a rare heartbeat. Without timely assistance, the patient may die.
occurs due to increased thrombus formation in the heart cavity, since during paroxysmal tachycardias the blood in the heart “beats”, like in a mixer. The resulting blood clots can settle on the inner surface of the heart (mural thrombi) or spread through the blood vessels into the brain, blocking their lumen and leading to severe ischemia of the brain substance. It manifests itself as sudden speech disturbances, unsteadiness of gait, complete or partial paralysis of the limbs.
occurs for the same reason as a stroke, only as a result of blockage of the pulmonary artery by blood clots. Clinically manifested by severe shortness of breath and suffocation, as well as bluish discoloration of the skin of the face, neck and chest skin above the level of the nipples. When the pulmonary vessel is completely obstructed, the patient experiences sudden death.
Acute myocardial infarction due to the fact that during an attack of tachyarrhythmia the heart beats at a very high frequency, and the coronary arteries are simply not able to provide the necessary blood flow to the heart muscle itself. Oxygen deficiency occurs in the cardiac tissues, and an area of necrosis, or death of myocardial cells, forms. It manifests itself as sharp pain behind the sternum or in the chest on the left.
Ventricular fibrillation and clinical death. More often they develop with paroxysm of ventricular tachycardia, which turns into ventricular fibrillation. In this case, the contractility of the myocardium is completely lost, and an adequate amount of blood does not enter the vessels. A few minutes after fibrillation, the heart stops and clinical death develops, which, without timely assistance, turns into biological death.

In a small number of cases, the patient immediately experiences a rhythm disturbance, any of the complications and death. This condition is included in the concept of sudden cardiac death.

Forecast

The prognosis for rhythm disturbances in the absence of complications and in the absence of organic heart pathology is favorable. Otherwise, the prognosis is determined by the degree and severity of the underlying pathology and the type of complications.

Normal rhythm hearts

The human heart is relatively small in size compared to the work it does. It pumps an average of 4.7 liters of blood every minute, or 282 liters every hour, through the vessels, supplying organs and tissues with oxygen. Disturbances in the frequency, rhythm and sequence of excitation and contraction of the heart are called cardiac arrhythmia.

The heart has two upper chambers - the atria, and two lower chambers - the ventricles. The atrium pumps blood to the ventricles, then the right ventricle pumps blood to the lungs, while the left ventricle supplies blood to all organs of the body. Rhythmic contractions of the heart occur due to electrical impulses coming from the “natural stimulator” - the sinoatrial node. Each impulse passes through the atria into the atrioventricular (atrioventricular) node, and then into the ventricles. After the contraction, there is a pause until the next impulse, during which the heart “rests.” The normal heart rate is 60 - 80 beats per minute in a calm state; with increased activity, the heart rate increases.

Cardiac arrhythmia and its signs

Cardiac arrhythmia (Greek: arrhythmia, absence of rhythm, irregularity)

If your heart is beating too fast

In some diseases (coronary heart disease, heart attack, cardiomyopathy, congenital heart disease), the normal activity of the heart may be disrupted. Cardiac arrhythmia occurs. Excessively fast heartbeats are called tachyarrhythmia. One of the types of tachyarrhythmia is ventricular tachycardia, in which electrical impulses arise in the ventricles of the heart.

Ventricular tachycardia is a life-threatening rhythm disorder. With excessively frequent contractions, the ventricles of the heart do not have time to fill with enough blood. As a result, insufficient blood flows to organs, including the brain. In addition to palpitations, you may feel weak, dizzy, and possibly lose consciousness.

Chaotic unstable contractions of muscle fibers are called fibrillation, which, in turn, leads to cardiac arrest. This is the most dangerous complication ventricular tachycardia, which requires immediate resuscitation. Cardiac arrest usually occurs suddenly. To restore normal heart rhythm, immediate defibrillation is necessary - an electrical impulse that restores normal heart rhythm.

Unfortunately, this procedure is not always possible in the first minutes of cardiac arrest. Therefore, an implantable ICD has a built-in defibrillator and pacemaker. A defibrillator uses stimulation or electrical impulses to bring the heart out of ventricular tachycardia or fibrillation.

If the heart beats too slow

In some diseases, the heart beats too slowly. Such heart rhythm disturbances are called bradycardia. With bradycardia, the volume of blood flowing to the organs is insufficient. Dizziness, weakness, feeling of lack of air, fainting occur.

Bradycardia can occur when the sinus node is malfunctioning or during heart block, when the conduction of impulses from the sinus node to the ventricles is impaired. In case of bradycardia, the implantable ICD restores the normal heart rate. The volume of blood flowing to the organs is normalized, and the symptoms of bradycardia are eliminated.

Analysis of heart rate variability is a complex indicator that allows you to assess the functional relationship between the cardiovascular and neurohumoral systems. First of all, the technique is used to assess the functional capabilities of healthy people.

The study of HRV is widely used to examine athletes and astronauts. Nevertheless, this method has shown itself to be effective in early diagnosis. functional disorders of cardio-vascular system. Another advantage of this tool is its simplicity (unlike Holter ECG) and low cost.

Why does rhythm variability appear and what manifestations does it have?

In simple words, heart rate variability is changes in the intervals between systoles that appear due to the influence of external and internal factors.

This indicator is measured by studying the duration of periods of heart contractions over a certain period of time. Typically, electrocardiography data is used for this, namely the distances between the R waves (i.e., the highest peaks on the ECG).

In addition to measuring R-R intervals, it is also used N-N study- intervals between normal contractions.

This is especially important if the patient has an arrhythmia.

It is known that man is an open system. Those. any changes in external or internal environment affect the functioning of organs and cells.

Characteristics of rhythmic heart beats

This is the basis of variability - variability of vital signs under the influence of certain factors.

The heart is a very sensitive organ in this regard.

Its work very much depends on the general condition of the person, especially on the influences of the nervous and endocrine systems.

Sensing changes in the functioning of the body, the nervous system regulates the activity of the heart accordingly.

The sympathetic department increases the heart rate and increases the force of myocardial contractions. In turn, the vagus nerve acts in the opposite way - it reduces the mentioned indicators.

The respiratory system also has a certain influence.

Thus, during inhalation, parasympathetic activity is inhibited and tachycardia occurs. On the contrary, when you exhale, the tone of the sympathetic part of the central nervous system decreases.

This phenomenon is the basis of respiratory arrhythmia.

Thus, HRV analysis allows us to identify changes in cardiac activity, and, consequently, disruptions in the functioning of regulatory systems.

Diagnostic methods

Despite the simplicity of the technique, it is usually used in a hospital setting.

This is due to the fact that strict control over the load on the body is needed. Only in this case can accurate conclusions be drawn about the state of the heart and its reaction to various stimuli.

There are several ways to diagnose variability.

Depending on the duration of registration:

short-term - up to 5 minutes (used for mass or outpatient examinations);
average duration - up to 2 hours (for functional tests);
multi-hour and daily recordings (used during operations and in intensive care units).

Five-minute recordings are most often used.

Depending on the goals, there are:

parallel studies (as a means of medical control, for example, during surgery);
specialized (used to examine the whole organism - in functional diagnostics).
As for the actual methods of analysis, there is also a considerable arsenal. Statistical methods - take direct measurements of the R-R and N-N gaps, and then determine values such as standard deviation intervals or coefficient of variation.

Geometric methods (variation pulsometry) consist in calculating the probabilistic characteristics of the obtained data and constructing graphic histograms.

Correlation rhythmography consists of graphically displaying a sequence of cardiointervals.

In this case, prolapses or, conversely, additional contractions of the heart become clearly visible.

Spectral methods make it possible to determine different frequency indicators of heart rate. This makes it possible to study the impact of regulatory authorities. However, it should be remembered that the presence of arrhythmias can significantly distort the results of this analysis.

Analysis of variability and further tactics of action

It is important to remember that heart rate variability values depend not only on health status, but also on many personal and external factors:

gender (usually higher in women);
age (in older people, some parameters of the cardiac conduction system are reduced);
weight (obesity contributes to decreased variability);
playing sports (a trained person has large reserves of variability);
emotional state (worsens performance).

Also, HRV is negatively affected by sleep disturbances, nutrition, taking certain medications and a polluted environment.

In general, everything that generally disrupts the functioning of the body and, especially, its regulatory systems.

Rate variability is sharply reduced in some acute pathologies:

The rate decreases to a lesser extent in chronic diseases:

overtraining syndrome;
chronic heart failure in the initial stage;
multiple sclerosis;
orthostatic hypertension;
metabolic cardiomyopathies (with diabetes mellitus, infectious and autoimmune diseases);
adaptation disorders.

The use of this technique in fetuses and newborns to assess the risk of sudden death syndrome may be promising.

What to do if you have a decrease in HRV?

Such a conclusion from a diagnostician is far from a death sentence.

First of all, you need to find out the reason for the decline.

Perhaps this is the result of the constant stress in which modern man lives. In this case it is very good remedy There will be proper rest or psychotherapy.

Excess weight indicates the need to adjust your diet and regular physical activity.

Basically, maintaining healthy image life can significantly improve the condition of the body in this regard.

conclusions

Heart rate variability testing is simple and reliable way studying the state of the most important organ systems.

The low cost of the technique allows it to be used for mass screening examinations in order to identify hidden pathologies in the early stages.

Widespread use in sports and astronautics emphasizes the preventive nature of this product, which corresponds to modern trends in medicine.

If you are found to have a violation of this indicator, this does not mean the need for treatment. Try such simple means of correction as sports and recreation. However, heart rate variability can be sharply reduced in some acute pathologies, such as myocardial infarction or stroke.

Indicators of cardiac activity.

Stroke, or systolic, volume of the heart- the amount of blood ejected by the ventricle of the heart into the corresponding vessels with each contraction. In a healthy adult at relative rest, the systolic volume of each ventricle is approximately 70-80 ml .

Thus, when the ventricles contract, 140-160 ml of blood enters the arterial system.

Minute volume- the amount of blood ejected by the ventricle of the heart in 1 minute.

3. Heart rhythm. Indicators of cardiac activity.

The minute volume of the heart is the product of the stroke volume and the heart rate per minute. On average, minute volume is 3-5l/min . Cardiac output can increase due to an increase in stroke volume and heart rate.

Laws of cardiac activity.

Starling's Law– the law of the heart fiber.

Formulated like this: The more a muscle fiber is stretched, the more it contracts. Consequently, the force of heart contraction depends on the initial length of the muscle fibers before the start of their contractions.

Bainbridge reflex(law of heart rate).

This is the viscero-visceral reflex: an increase in the frequency and strength of heart contractions with increased pressure at the mouths of the vena cava. The manifestation of this reflex is associated with the excitation of mechanoreceptors located in the right atrium in the area of the confluence of the vena cava. Mechanoreceptors, represented by the sensitive nerve endings of the vagus nerves, respond to an increase in blood pressure returning to the heart, for example, during muscle work.

Impulses from mechanoreceptors travel along the vagus nerves to medulla to the center of the vagus nerves, as a result of which the activity of the center of the vagus nerves decreases and the influence of the sympathetic nerves on the activity of the heart increases, which causes an increase in heart rate.

Lecture No. 2 Regulation of heart activity.

The heart has automaticity, that is, it contracts under the influence of impulses arising in its special tissue.

However, in the whole organism of animals and humans, the work of the heart is regulated due to neurohumoral influences that change the intensity of heart contractions and adapt its activity to the needs of the body and living conditions.

Nervous regulation.

A heart like everyone else internal organs, innervated by the autonomic nervous system.

Parasympathetic nerves are fibers vagus nerve, which innervate the formations of the conduction system, as well as the myocardium of the atria and ventricles.

The central neurons of the sympathetic nerves lie in the lateral horns of the spinal cord at the level of the I-IV thoracic vertebrae; the processes of these neurons are directed to the heart, where they innervate the myocardium of the ventricles and atria, forming the conduction system.

The centers of the nerves innervating the heart are always in a state of moderate excitement.

Due to this, nerve impulses constantly flow to the heart. The tone of neurons is maintained by impulses coming from the central nervous system from receptors located in the vascular system. These receptors are located in the form of a cluster of cells and are called the reflexogenic zone of the cardiovascular system.

The most important reflexogenic zones are located in the area of the carotid sinus, in the area of the aortic arch.

The vagus and sympathetic nerves have opposite effects on the activity of the heart in 5 directions:

1. chronotropic (changes heart rate);

2. inotropic (changes the strength of heart contractions);

3. bathmotropic (influences excitability);

4. dromotropic (changes the ability to conduct);

tonotropic (regulates tone and intensity metabolic processes).

The parasympathetic nervous system has a negative effect in all five directions, and the sympathetic nervous system has a positive effect.

Thus, with stimulation of the vagus nerves there is a decrease in the frequency and strength of heart contractions, a decrease in the excitability and conductivity of the myocardium, and a decrease in the intensity of metabolic processes in the heart muscle.

When the sympathetic nerves are stimulated there is an increase in the frequency and strength of heart contractions, an increase in the excitability and conductivity of the myocardium, and stimulation of metabolic processes.

Correct heart rhythm

How does heart rate occur?

Heartbeat depends on the impulses that arise in the sinus node or drivers of the heart. This group of cells is located at the junction of the superior vena cava with the right atrium and is capable of creating rhythmic impulses that spread under other cells.

Usually sinus node creates impulses with a frequency of 60-100 per minute, while suppressing the abilities of other pacemakers. Normal frequency own heart rhythm is calculated: 118.1 - (0.57*age). It is very important that the heart contracts at regular intervals.

Violation of the interval leads either to a reduction in the systole period ( heart contractions), and then it does not supply the organs with blood and oxygen, or it leads to a reduction in the diastole period ( relaxation of the heart), and then the organ does not rest and works poorly.

The heart rhythm is regulated by hormones entering the blood, that is, by the work of the endocrine system and the autonomic nervous system.

The difference in the concentration of electrolytes inside and outside the cells, as well as their movement, creates the electrical impulse of the heart.

Heart rhythm disturbance goes in the form:

acceleration (tachycardia);
slowing down (bradycardia);
the appearance of extra beats (extrasystole);
complete rhythm disturbance (atrial fibrillation).

Why is the heart rhythm disrupted?

Causes of rhythm disturbances there may be any heart disease that eventually leads to sick sinus syndrome– a set of symptoms that can disappear, appear, or even relate to another disease.

These include:

dizziness,
fatigue,
fainting,
disturbances of consciousness,
heart failure.

The heart rhythm is affected by the following: factors:

lack of oxygen (hypoxia);
high blood pressure;
myocardial infarction;
inflammatory diseases (rheumatism) and heart defects;
congenital anomalies of the sinus node;
use of stimulant drugs;
endocrine diseases;
use of certain medications;
overeating, alcohol abuse, smoking;
stress and strong emotions;
anemia;
heart failure;
cardiac ischemia;
physical exercise.

Sinus tachycardia- acceleration of the generation of impulses in the sinus node.

Any nervous and physical stress naturally causes increased activity of the heart, since the body reflexively prepares to protect itself from stress and danger, for which it intensively supplies the musculoskeletal system with blood (due to increased heart function). However, such a reaction to “danger” may be pathological, and then excessive tachycardia occurs with every mental irritation, that is, increased release of adrenaline and other hormones of the pituitary gland and thyroid gland into the blood.

Tachycardia may occur with an increase in body temperature, a drop in blood pressure, certain infectious diseases (typhoid fever, tuberculosis, subacute tonsillitis), shock, and blood loss.

Sinus tachycardia unlike tachycardias that occur in other parts of the heart, very often it does not lead to excessive stress on the body and does not occur in the form of an attack.

Sinus bradycardia– slowing down the production of impulses – is very often a congenital condition, and is also observed in athletes or people doing heavy physical work.

Along with a slowing of the rhythm (up to 60 beats per minute), they noticed low blood pressure and a lengthening of the interval between the beginning of atrial systole and the beginning of ventricular systole ( distance Р-R- electrocardiograms).

Heart rhythm and arrhythmia

However, bradycardia can be pathological - as a result of irritation of the vagus nerve, exhaustion of the nervous system. This deviation occurs with brain tumors, meningitis, tumors hearts, compensatory in case of increased blood pressure, vomiting, middle ear disease, attacks of cholelithiasis, decreased thyroid function, depression, postpartum period, atherosclerosis.

Sinus arrhythmia is often determined by an increase in heart rate during inhalation and a slower rate during exhalation.

This is a complete disturbance of the rhythm of the sinus node, determined by simply palpating the pulse. For example, with complete relaxation, the pulse slows down and respiratory arrhythmia occurs - which is typical for childhood and adolescence. There is also respiratory arrhythmia during the period of recovery after infectious diseases.

How to cope with rhythm disturbances?

When found heart rate(usually it beats unnoticed by us), especially if the violation affects general condition, you need to see a doctor:

if there are obvious interruptions in the functioning of the heart, unnecessary shocks, increased heart rate for no reason;
if the heart rate drops to 50 beats per minute, and then sharply rises to 100 or higher;
if, without any physical or nervous stress, the heartbeat accelerates above 100 beats per minute.

Unpleasant symptoms, Related arrhythmias, can be reduced if you treat heart rhythm disturbances more calmly:

If you notice an increase in your heart rate, there is no need to worry.
It’s better to talk about abstract topics with the person who is nearby, read a book, and switch your attention.
Avoid coffee, tea and other drinks that stimulate the heart.
Eat more vegetables and fruits, which contain potassium - a heart electrolyte.
Eat more nuts, beans, bran and beans - they contain magnesium, which helps with tachycardia.
You need to normalize your sleep with medicinal herbs(infusion of three-leaf watch, peppermint and valerian - 30 g each in a collection, a spoonful of the mixture per glass of boiling water), which should be taken 30 minutes before bedtime.

Heart rate is normal in adults

Systolic or stroke volume (SV, SV) is the volume of blood that the heart ejects into the aorta during systole; at rest, about 70 ml of blood.

Minute volume of blood circulation (MCV) is the amount of blood ejected by a ventricle of the heart per minute.

The IOC of the left and right ventricles is the same. IOC (l/min) = CO (l) x HR (bpm). On average 4.5-5 liters.

Heart rate (HR). Resting heart rate is about 70 beats/min (in adults).

Regulation of heart function.

Intracardiac (intracardiac) regulatory mechanisms

Heterometric self-regulation is an increase in contraction force in response to an increase in the diastolic length of muscle fibers.

Frank-Starling law: the force of myocardial contraction in systole is directly proportional to its filling in diastole.

2. Homeometric self-regulation - an increase in contractility parameters without changing the initial length of the muscle fiber.

a) Anrep effect (force-velocity relationship).

As pressure in the aorta or pulmonary artery increases, the force of myocardial contraction increases.

The rate of shortening of myocardial fibers is inversely proportional to the force of contraction.

b) Bowditch ladder (chronoinotropic dependence).

Increased force of contraction of the heart muscle with increased heart rate

Extracardiac (extracardiac) mechanisms regulating cardiac activity

Nervous mechanisms

A. Influence of the autonomic nervous system

The sympathetic nervous system has effects: positive chronotropic ( increase in heart rate ), inotropic(increased strength of heart contractions), dromotropic(increased conductivity) and positive bathmotropic(increased excitability) effects.

The mediator is norepinephrine. Adrenergic receptors α and b-types.

The parasympathetic nervous system has effects: negative chronotropic, inotropic, dromotropic, bathmotropic. Mediator – acetylcholine, M-cholinergic receptors.

B. Reflex effects on the heart.

1. Baroreceptor reflex: when pressure in the aorta decreases and carotid sinus there is an increase in heart rate.

Chemoreceptor reflexes. When there is a lack of oxygen, the heart rate increases.

3. Goltz reflex. When the mechanoreceptors of the peritoneum or abdominal organs are irritated, bradycardia is observed.

4. Danini-Aschner reflex. When pressing on the eyeballs, bradycardia is observed.

Humoral regulation of heart function.

Adrenal medulla hormones (adrenaline, norepinephrine) - the effect on the myocardium is similar to sympathetic stimulation.

Adrenal cortex hormones (corticosteroids) have a positive inotropic effect.

Hormones of the thyroid gland cortex (thyroid hormones) are positive chronotropic.

Ions: calcium increases the excitability of myocardial cells, potassium increases myocardial excitability and conductivity.

A decrease in pH leads to depression of cardiac activity.

Functional groups of blood vessels:

1. Shock-absorbing (elastic) vessels(aorta with its sections, pulmonary artery) transform the rhythmic release of blood into them from the heart into uniform blood flow.

They have a well-defined layer of elastic fibers.

2. Resistive vessels(resistance vessels) (small arteries and arterioles, precapillary sphincter vessels) create resistance to blood flow, regulate the volume of blood flow in various parts systems. The walls of these vessels contain a thick layer of smooth muscle fibers.

Precapillary sphincter vessels - regulate blood flow exchange in the capillary bed.

Contraction of smooth muscle cells of the sphincters can lead to blockage of the lumen of small vessels.

3.Exchange vessels(capillaries) in which exchange takes place between blood and tissues.

4. Shunt vessels(arteriovenous anastomoses), regulate organ blood flow.

5. Capacitive vessels(veins), have high extensibility, deposit blood: veins of the liver, spleen, skin.

Return vessels(medium and large veins).

Heart rhythm disturbances: types, causes, signs, treatment

Classification

Causes of heart rhythm disturbances

Diseases that cause rhythm disturbances

Do cardiac arrhythmias manifest themselves in the same way?

How to diagnose pathology?

Treatment of rhythm disturbances

Are there possible complications of heart rhythm disturbances?

Forecast

Heart rhythm disturbance

Heart rhythm and its disorders

Arrhythmia

Normal heart rate in men and women, causes of heart rhythm disturbances by gender

What is heart rate?

Heart rate: what is normal?

Heart rhythm disturbances: what are they?

Why do heart rhythm disturbances occur?

Among women

In men

Symptoms that accompany arrhythmia

Diagnostics

Treatment and prevention

Features of the phenomenon

Shapes and types

Causes of atrioventricular nodal rhythm

Symptoms

Diagnostics

Treatment

Therapeutic

Medication

Operation

Folk remedies

Recipe No. 1

Recipe No. 2

Disease prevention

Complications

Forecast

Briefly about heart rate:

What is your heart rate?

Normal heart rate

Abnormal heart rhythms

Classification

Causes of heart rhythm disturbances

Diseases that cause rhythm disturbances

Do cardiac arrhythmias manifest themselves in the same way?

How to diagnose pathology?

Treatment of rhythm disturbances

Are there possible complications of heart rhythm disturbances?

Forecast

Cardiac arrhythmia and its signs

Why does rhythm variability appear and what manifestations does it have?

Characteristics of rhythmic heart beats

Diagnostic methods

Analysis of variability and further tactics of action

What to do if you have a decrease in HRV?

conclusions

Indicators of cardiac activity.

3. Heart rhythm. Indicators of cardiac activity.

Correct heart rhythm

How does heart rate occur?

Why is the heart rhythm disrupted?

Heart rhythm and arrhythmia

How to cope with rhythm disturbances?

Heart rate is normal in adults

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