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

Greek term arrhythmia translated (a - negative particle and rhythmos - rhythm) not rhythm or rhythm disturbance. In medicine, the concept of arrhythmia means changes in the physiological activity of the heart, various in nature and origin, associated with heart rhythm. The state of the body in which a change in physiological frequency, periodicity, a change in the source of the rhythm occurs, and an impulse is pathologically conducted is called cardiac arrhythmia.

When the heart is functioning properly, a person does not notice its contractions. The heart contains pacemaker cells that independently generate electrical impulses. The impulse generated by these cells is transmitted through the myocardial conduction system to the heart muscle. As a result, the heart muscle contracts. Normally, the automatic generator of these impulses is the sinoatrial node. Anatomically, it is located in the right atrium, at the confluence of the vena cava. Normal heart rhythm is controlled by the sinus node, but the rhythm and outgoing contractions are called sinus.

Having formed in the sinus node, the impulse travels through the atria, causing them to contract. The impulse then passes through the underlying pacemaker, called the atrioventricular (AV) node, to the ventricles. And it goes along the bundles of His and Purkinje fibers, which are the conduction system of the ventricles. The ventricles contract. Then the heart rests and is restored to its original state. So the cycles of contraction (systole) and relaxation (diastole) are automatically repeated again and again, forming a physiological rhythm. Normally, the heart contracts from the right atrium to the left atrium, followed by contraction of the ventricles. The transmission of impulse and the contraction wave proceed in a certain direction, sequence and at a certain speed. The heart contracts rhythmically, with a certain physiological frequency and force. In an adult healthy person in a state of physical and emotional rest, the heart rate (HR) (pulse) is 60-80 beats per minute. The rhythm is sinus. The contractions are uniform and constant. The pulse is well filled.

Violation of the origin of the impulse and disruption of its transmission lead to cardiac arrhythmia and diseases associated with rhythm disturbances.

Causes

Possible causes of cardiac arrhythmia

Diseases associated with changes in the rhythmic functioning of the heart are polyethylological. The cause of rhythm disruption, and therefore cardiac arrhythmia, can be damage to the regulatory mechanisms of the heart, myocardial pathology and pathology of the system of pathways conducting the electrical cardiac impulse. Or a combination of these factors. Let's look at some of them.

Pathological organic damage to the nervous and endocrine systems, diseases of internal organs are accompanied by dysregulation of the heart. Such cardiac arrhythmias in painful conditions of other organs are caused by a neuro-reflex effect.

With myocardial pathology of any origin, cardiac arrhythmia is possible as a result of changes in the functions of heart cells. Often cardiac ischemia, myocarditis of any etiology, myocardial dystrophy, cardiosclerosis are combined with arrhythmia, atrial fibrillation or heart block.

Organic irreversible changes in the myocardium in the area of ​​the sinoatrial node and fibers of the conduction system most often lead to arrhythmia of severe clinical course. There are also congenital anomalies of the pacemaker nodes and the conduction system, leading to arrhythmias of various pathogenesis.

Arrhythmia is caused by pathological changes in the myocardium, as a result of which the function of the sinoatrial node changes, the activity of lower-order pacemakers increases, and the conduction of the excitation wave along the paths of the conduction system and myocardial fibers is disrupted.

Exposure to toxic chemicals can cause rhythm disruption and cause cardiac arrhythmia for the duration of this toxic factor. After eliminating the toxic effect, the rhythm is restored if no irreversible changes occur in the myocardium.

Changes in the electrolyte composition in myocardial cells can provoke the appearance of arrhythmia with impaired excitability and conductivity. Such electrolyte shifts in myocardial cells are possible with cardiosclerosis or renal pathology.

A decrease in blood oxygen saturation, with “cor pulmonale,” leads to arrhythmia and complicates the patient’s condition.

Classification

Cardiac arrhythmia is classified according to etiology, mechanism, localization of disorders and clinical course. .

Classification of arrhythmias by etiology: Based on the causes of occurrence, they distinguish between dysregulatory, otherwise functional, organic, polyetiological and idiopathic, i.e. unknown etiology.

When classified according to the mechanism and symptomatic manifestations of cardiac arrhythmia, the following are distinguished:

conduction disorders; impulse formation disorders; as well as combined arrhythmias.

The following disorders in the formation of an impulse are distinguished: Nomotopic and heterotopic. Heterotropic arrhythmias are also called ectopic.

Let's consider nomotopic rhythm disturbances; they are divided into sinus bradycardia, sinus tachycardia and sinus arrhythmia. The group of nomotropic disorders also includes migration of the source of the pacemaker.

Heterotopic (ectopic) rhythm disturbances. This group of arrhythmias includes: extrasystole, paroxysmal tachycardia, non-paroxysmal tachycardia and accelerated ectopic rhythms, atrial fibrillation, atrial flutter, fibrillation and flutter (fibrillation) of the ventricles.

Extrasystole is divided, in turn, according to the location of the source of excitation into supraventricular and ventricular. And in quantity it can be single, paired or allorhythmic.

Accelerated ectopic rhythms are localized supraventricular and ventricular. The group of paroxysmal arrhythmias or tachycardias, depending on the location of formation, is divided into: supraventricular and ventricular; and they are distinguished by duration; constant and recurrent paroxysmal. Recurrent paroxysmal has three forms of clinical course: chronic, continuously relapsing, unstable.

Atrial fibrillation (atrial fibrillation) is divided into paroxysmal (paroxysmal) and persistent (permanent) based on its timing. According to heart rate - tachysystolic, normosystolic, bradysystolic;

Atrial flutter has an attack-like (paroxysm) or persistent (permanent) course; and according to the shape of the ECG complex, regular and irregular shapes.

Arrhythmias with conduction disturbances are classified as follows:

• Incomplete and complete sinoatrial block.
• Incomplete and complete intraatrial block;
• Atrioventricular block: 1, 2 and 3 (complete) degrees;
• Intraventricular blockades or blockades of the legs and branches of the His bundle, altered conduction through the ventricles.
• Ventricular asystole
• Intraventricular blockade can be: a) mono-, bi- and trifascicular; focal, aborization; b) incomplete, complete);

Combined arrhythmias are arrhythmias caused by impaired conduction and excitability of the myocardium.

• This is sick sinus syndrome, when the functioning of the main pacemaker, the sinus node, is disrupted.
• Slipping (escaping) contractions (complexes) and rhythms. Their sources are second- or third-order pacemakers during prolonged diastole.
• Syndrome of premature excitation of the ventricles (Wolff-Parkinson-White syndrome WPW) excitation spreads from the atria to the ventricles both in the usual, normal way and in an abnormal way, bypassing the atrioventricular connection.
• Shortened PQ or CLC (Clerk-Levy-Cristescu) syndrome is an atypical form of WPW syndrome.
• Long QT syndrome. The pathogenesis has not been identified, but there is an assumption that increased tone of the sympathetic nervous system leads to prolongation of the QT interval on the ECG. An extended QT interval is characteristic of a slow process of myocardial repolarization (diastole).
• Parasystoles. With such an arrhythmia, the myocardium contracts when two centers of pacemakers work.

Symptoms

The clinical manifestation of arrhythmia is characterized by attacks of palpitations, interruptions in the rhythmic functioning of the heart, shortness of breath, pre-syncope and fainting states.

Palpitations are a subjective symptom. There are people who periodically feel normal heart contractions, while others do not feel pathological rhythm disturbances. Therefore, the sensation of a heartbeat itself is not a sign of cardiac pathology.

Interruptions or arrhythmia of the heart are felt as uneven pauses between heart beats. Patients usually complain of periodic “failures” and missed heartbeats. Patients complain that the heart sometimes “stumbles,” “turns over,” or “somersaults” in the chest. The feeling that the heart is stopping appears when one cardiac impulse is lost. The loss of several impulses leads to dizziness. Loss of consciousness (with Morgagni-Adams-Stokes syndrome) occurs when 6-8 contractions are missed.

Shortness of breath - difficulty breathing, rapid breathing, feeling of lack of air. With increased physical activity, shortness of breath also occurs, but it is not a symptom of the disease. Only the disproportion between the amount of load and the shortness of breath that it causes is a signal of illness. The appearance of shortness of breath during arrhythmias is a sign of circulatory failure.

Symptoms of arrhythmia of various origins.

Sinus arrhythmia is characterized by irregular but regular rhythmic contractions, a gradual increase and decrease in rhythm. Sinus rhythm is preserved.

Sinus arrhythmia is also observed in young people, associated with breathing. It is called respiratory arrhythmia and is considered physiological. It is caused by increased activity of the vagus nerve at the beginning of exhalation.

Sinus tachycardia is a feeling of rapid heartbeat, more than 90 beats per minute, in sinus rhythm. During physical or emotional stress, the pulse quickens, but remains uniform, i.e. rhythmic. This is normal. The body's reaction in the form of sinus tachycardia to stress.

The opposite condition of sinus tachycardia is sinus bradycardia. This is a decrease in heart rate to 50-30 beats per minute. Bradycardia also occurs in healthy people, and is often observed in people trained for physical activity. Bradycardia is a low heart rate, unstable hemodynamic conditions (for example, heart rate 65 per minute in combination with hypotension). When the pulse drops below 40, weakness and fainting appear.

Migration (movement) of the supraventricular pacemaker. With this type of arrhythmia, the source of the rhythm moves; the impulse is generated not in the sinus node, but in the underlying pacemaker, which has a slower conduction speed, which leads to a slowdown in the pulse. When the source of rhythm returns to the sinus node, the pulse quickens. Symptomatically - a slight arrhythmia.

Extrasystolic contractions are characterized by premature excitation in relation to the main rhythm. The entire heart or a section of it contracts. Many patients have no clinical symptomatic manifestations of arrhythmia. In the presence of a clinic, patients are concerned about interruptions in the functioning of the heart at rest or during physical activity. Sometimes interruptions are accompanied by acute short-term pain in the area of ​​the 5th - 6th rib on the left.

Paroxysmal tachycardia is a paroxysmal, sudden, often sharp increase in heart rate up to 140-150 or more per minute. The rhythm of contractions instantly changes from normal to very fast. The attack ends just as suddenly. Sometimes weakness, dizziness, and nausea occur during an attack. The longer the attack, the greater the heart rate, the brighter the clinic.

It is necessary to distinguish between supraventricular and ventricular. Supraventricular paroxysmal arrhythmia occurs more often in young people, the pulse is above 160, often 200-220. The rhythm is strictly regular or there is a periodic loss of the pulse wave. Ventricular paroxysmal arrhythmia is more common in the elderly. The pulse usually increases to 160, rarely 180-200, some rhythm irregularity is noted, the clinical picture is more pronounced.

Atrial fibrillation is indicated by chaotic, irregular, uncoordinated contractions of individual parts of the atria with a frequency of 350 to 600 per minute. Such atrial contractions cause complete, absolute arrhythmia. Arrhythmias take 2nd place and account for 40% of all rhythm disturbances. It is observed 10 times more often than attacks of paroxysmal arrhythmia and 20 times more often than attacks of atrial flutter. In 94-97% of cases it occurs in people over 40 years of age. Often accompanies cardiosclerosis and mitral heart disease. ventricular contractions. According to the frequency of atrial fibrillation among

The condition of atrial flutter is characterized by a regularly coordinated atrial rhythm with a rate of more than 150 per minute. The patient is bothered by constant or paroxysmal heartbeat.

Sinoauricular blocks. There is a disruption in the mechanism of impulse transmission from the sinoatrial node to the atria, which leads to loss of heart contractions. The clinic depends on the frequency and number of such prolapses. The course is asymptomatic or there are interruptions, weakness, dizziness to Morgagni-Adams-Stokes syndrome.

Weakness of the sinus node. The cells that generate sinus rhythm are affected. Characterized by increasing bradycardia turning into attacks of paroxysmal rhythm disturbances. After an attack of tachycardia, asystole for a few seconds and again bradycardia with the correct sinus rhythm. Such attacks exhaust the patient.

Intraatrial blocks. This pathology is usually associated with organic changes. Clinical arrhythmias are practically not observed.

Atrioventricular blockade. Characterized by slow conduction or complete absence of conduction of impulses between the atria and ventricles. Divided into three degrees. Clinical manifestations and prognosis are directly related to the location of the blockade. The lower the blockade, the more severe the disease and the more unfavorable the prognosis. Subjective sensations, such as a slow pulse, interruptions appear in the second degree. The third degree is a complete blockade. There is a sharp increase in the stroke volume of the heart, systolic pressure rises, diastolic pressure decreases or remains normal, and pulse pressure increases. Slow pulse. The size of the heart increases, more to the left. Venous pulsation is often detected due to atrial contraction. Severe complications are possible. Heart failure progresses. Physical activity increases hemodynamic disturbances. Heart failure with such arrhythmia is explained by a low, insufficient heart rate.

Often, when an incomplete blockade transitions to a complete one, Morgagni-Adams-Stokes Syndrome occurs. This is the symptomatic picture. Pallor suddenly appears, the pulse cannot be detected, loss of consciousness occurs, and heart sounds are not heard. Then the patient turns blue and convulsions appear. Involuntary urination and defecation are possible. At 1-2 minutes, the attack most often ends, because the idioventricular pacemaker of the ventricles is switched on.

Complications

Complications of cardiac arrhythmia are associated with the appearance of hemodynamic disturbances, the addition of circulatory failure, impaired cerebral circulation, thromboembolism, the appearance of conditions such as clinical death, caused by a decrease in cardiac arrhythmia of its propulsive work. .

Diagnostics

Diagnosis of arrhythmia is based on the patient’s complaints, medical history and objective examination. Among the special methods of examining the patient, depending on the complexity of the diagnosis, an ECG is performed; daily ECG monitoring, stress tests, functional tests, electrical cardiac stimulation through the esophagus, ECHO-CG, coronary angiography. A consultation with a psychotherapist is necessary to rule out neurosis.

Treatment

Treatment of arrhythmia is related to the cause that led to the disruption of the normal heart rhythm. Treatment of arrhythmia by a cardiologist is being developed, and all patients with cardiac arrhythmia are subject to consultation or observation. Often a special diagnostic examination in a hospital is required. All arrhythmic pathological disorders require conservative drug treatment. In all cases, it is necessary to treat the disease that provokes cardiac arrhythmias with the use of antiarrhythmic drugs. If signs of hemodynamic disturbances appear, compensatory symptomatic therapy with medications is carried out. In complex cases of organic damage with pronounced signs of circulatory failure, implantation of an artificial pacemaker is recommended. The state of “clinical death” (the patient is unconscious, does not breathe independently and/or does not have independent circulation) requires urgent pulmonary-cardiac resuscitation measures (resuscitation). When treating arrhythmia, an individual regimen of exercise and rest is prescribed, exercise therapy is recommended, and sometimes sedatives are used.

Forecast

With proper treatment of arrhythmia without significant organic damage to the myocardium, the prognosis is favorable. The prognosis is questionable in case of irreversible organic changes in the heart muscle, with increasing symptoms of complications.

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

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

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

What is heart rate?

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

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

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

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

Heart rate: what is normal?

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

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

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

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

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

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

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

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

Heart rhythm disturbances: what are they?

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

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

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

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

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

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

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

Why do heart rhythm disturbances occur?

Heart rhythm disturbances are:

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

Most often, heart rhythm disturbances are caused by:

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

Heart diseases that affect the occurrence of arrhythmia:

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

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

Among women

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

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

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

In men

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

Changes in their heart rate are caused by:

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

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

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

Symptoms that accompany arrhythmia

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

This is accompanied by characteristic symptoms:

Diagnostics

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

The following methods are used for diagnosis:

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

Treatment and prevention

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

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

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

Check out pacemakers

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

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

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

Video: Atrial flutter. Heart rhythm disturbance

Heart rhythm disturbances are a very complex branch of cardiology. People who have no idea about the structure of the heart and its conduction system will find it difficult to understand the mechanisms of arrhythmia. No need! For this purpose, there is a whole section of cardiology that deals only with heart rhythm disturbances (arrhythmology), and the doctor who treats them is an arrhythmologist. Everyone must do their job.

Arrhythmias are very common in our lives, and every person should know what arrhythmia is, how and under what circumstances it occurs, how it manifests itself and why it is dangerous.

As simply as possible, without delving into the physiological mechanisms of arrhythmias, we will consider their most common types. What is arrhythmia

There is a special node in the heart - the sinus node. It sets the rhythm for the whole heart. The correct (normal) heart rhythm is called sinus rhythm. The heart rate in normal (sinus) rhythm is 60-90 beats per minute. All rhythm disturbances (arrhythmias) are irregular (non-sinus) rhythms, with an increased (more than 90 beats per minute) or decreased (less than 60 beats per minute) heart rate. In other words, this is any deviation from the norm.

If the heart beats faster than 100 beats per minute, this is a disorder called tachycardia (increased heart rate). If the heart beats less frequently, for example, 55 beats per minute, this is bradycardia (rare heartbeats).

In young children, the heart rate is not 60-90 beats per minute, as in adults, but 140 or more, so for children 140 beats per minute is the norm.

Classification of arrhythmias. What are the types of arrhythmias?

1. Sinus tachycardia - increased heart rate to 120-200 beats per minute while maintaining a normal rhythm (the heart beats faster, but the rhythm is correct).

Sinus tachycardia is a normal response of the heart to physical activity, stress, and drinking coffee. It is temporary and is not accompanied by unpleasant sensations. The restoration of normal heart rate occurs immediately after the cessation of the factors that caused it.

Doctors are only concerned about tachycardia that persists at rest, accompanied by a feeling of lack of air, shortness of breath, and a feeling of palpitations. The causes of such tachycardia may be diseases that manifest themselves in heart rhythm disturbances or are accompanied by them: hyperthyroidism (thyroid disease), fever (increased body temperature), acute vascular insufficiency, anemia (anemia), some forms of vegetative-vascular dystonia, use of medications (caffeine, aminophylline).

Tachycardia reflects the functioning of the cardiovascular system in response to a decrease in the contractility of the heart, which is caused by heart diseases such as chronic heart failure, myocardial infarction (death of a section of the heart muscle), a severe attack of angina in patients with coronary heart disease, acute myocarditis (inflammation of the heart). muscles), cardiomyopathy (changes in the shape and size of the heart).

2. Sinus bradycardia - slowing the heart rate to less than 60 beats per minute.

In healthy people, it indicates good fitness of the cardiovascular system and is often found in athletes (in response to stress, the heart does not start beating strongly because it is accustomed to the stress).

Causes of bradycardia not related to heart disease: hypothyroidism, increased intracranial pressure, overdose of cardiac glycosides (drugs for the treatment of heart failure), infectious diseases (influenza, viral hepatitis, sepsis, etc.), hypothermia (lowered body temperature); hypercalcemia (increased calcium in the blood), hyperkalemia (increased potassium in the blood).

The causes of bradycardia associated with heart disease: myocardial infarction, atherosclerosis (deposition of atherosclerotic plaques on the vessel wall, which, when growing, narrow the lumen of the vessel and lead to circulatory disorders), post-infarction cardiosclerosis (a scar on the heart that interferes with its full functioning).

3. Paroxysmal ventricular tachycardia - a sudden onset and suddenly ending attack of increased heart rate from 150 to 180 beats per minute.

This type of arrhythmia occurs in people with the following heart diseases: myocardial infarction, post-infarction aneurysm (formation of a vascular “bag” of blood at the site of a heart attack after scarring), cardiomyopathies, heart defects (changes in the structure of the heart that interfere with its normal functioning).

Paroxysmal ventricular tachycardia occurs 2 times more often in women than in men and often causes a decrease in blood pressure and loss of consciousness.

4. Extrasystole - extraordinary contractions of the heart. It may be asymptomatic, but more often patients feel a jolt or a sinking heart.

Causes of extrasystole not related to heart disease: stress and, as a consequence, vascular reaction; emotional stress, overwork; abuse of coffee, smoking, alcohol, often during alcohol withdrawal due to chronic alcoholism (withdrawal syndrome); drug use.

Causes of extrasystole associated with heart disease: coronary heart disease, acute myocardial infarction; mitral stenosis (narrowing of the mitral valve of the heart), rheumatic carditis (heart disease due to rheumatism), thyrotoxicosis (thyroid disease), intoxication with cardiac glycosides.

5. Ventricular fibrillation is a serious condition in which the heart contracts chaotically, incoherently, and has no rhythm. As a rule, ventricular fibrillation of the heart, a complication after extensive myocardial infarction, is the cause of death

Causes of rhythm disturbances (arrhythmias)

1. Cardiovascular diseases:

• coronary heart disease (myocardial infarction, angina pectoris, post-infarction cardiosclerosis) - ventricular arrhythmias and sudden cardiac arrest occur more often due to damage to the heart muscle and a decrease in the ability of the heart to contract:
• heart failure - there is an increase in the parts of the heart, loss of elasticity of the heart muscle, it ceases to contract adequately, blood stagnates inside the heart, or a turbulence in its flow occurs, resulting in arrhythmia;
• cardiomyopathy - when the walls of the heart are stretched, thinned or thickened, the contractile function of the heart decreases (it cannot cope with its work), which leads to the development of arrhythmia;
• acquired heart defects - disorders of the structure and structure of the heart (usually after rheumatism), which affect its functioning and contribute to the development of arrhythmia;
• congenital heart defects - congenital disorders of the structure and structure of the heart that affect its functioning and contribute to the development of arrhythmia;
• myocarditis is an inflammatory disease of the heart muscle, which sharply reduces the function of the heart (prevents it from contracting) and can cause various arrhythmias; mitral valve prolapse - an obstruction in the mitral valve that prevents blood from flowing from the left atrium to the left ventricle (normally), blood from the ventricle is thrown back into the atrium (where it came from, but this should not happen), all these disorders can trigger the occurrence of arrhythmia .

2. Medicines. An overdose of cardiac glycosides, antiarrhythmic drugs, diuretics, beta blockers (drugs for regulating blood pressure and heart rate) leads to heart rhythm disturbances (arrhythmias).

3. Electrolyte disturbances (impaired water-salt balance in the body): hypokalemia, hyperkalemia, hypomagnesemia (decreased magnesium in the blood), hypercalcemia (increased calcium in the blood).

4. Toxic effects on the heart: smoking, alcohol, bioactive supplements, herbal treatment, working with toxic substances (poisons).

Clinical manifestations (symptoms and signs) of arrhythmia

Arrhythmias may not manifest themselves for a long time, and the patient may not suspect that he has an arrhythmia until the doctor identifies the disease during a routine medical examination or an electrocardiogram.

But often arrhythmias are not so “quiet” and make themselves known, significantly preventing a person from living his usual life. They can manifest themselves in the form of “turning over”, “transfusion” and “freezing” of the heart, but more often it is a feeling of interruptions in the heart, increased heartbeat, “fluttering” of the heart, extremely fast or, conversely, slow heartbeat, dizziness, shortness of breath, chest pain a cell of a pressing nature, a feeling of “failure” of the ground under your feet, nausea and (or) vomiting (especially when the normal rhythm changes to arrhythmia, and vice versa, when it is restored from arrhythmia to a normal heart rhythm), loss of consciousness.

Such diverse manifestations of arrhythmia do not always indicate the complexity of the rhythm disorder. People with minor rhythm disturbances may lose consciousness, but patients who have truly life-threatening rhythm disturbances do not show any complaints. Everything is very individual.

Risk factors for arrhythmia development

Age - with age, the heart muscle, our pump, weakens and can fail at any moment, and the diseases that we have “accumulated” over our lives will aggravate the situation.

Genetics - in people with congenital anomalies (malformations) of the development of the heart and its conduction system, arrhythmias are much more common.

Heart diseases - myocardial infarction and the scar on the heart that forms after it, coronary heart disease with vascular damage and rheumatism with damage to the heart valves are fertile ground for the development of arrhythmia.

Arterial hypertension (systematic increase in blood pressure) - increases the risk of developing coronary heart disease and contributes to the development of left ventricular hypertrophy (increase in size), which also increases the risk of developing arrhythmia.

Obesity is a direct risk factor for the development of coronary heart disease with all the ensuing consequences.

Diabetes mellitus - an uncontrolled increase in blood glucose can easily trigger the development of arrhythmia; coronary heart disease and arterial hypertension, which contribute to the development of arrhythmia, are faithful companions of diabetes mellitus.

Taking medications - uncontrolled use of diuretics and laxatives leads to disruption of the water-salt balance in the body and can cause arrhythmia.

Electrolyte disturbances - potassium, magnesium and sodium form the basis of the contractile mechanism of the heart, therefore, an imbalance in them (imbalance) can lead to arrhythmia.

Coffee, smoking and drugs are the cause of the development of extrasystole; amphetamine and cocaine provoke ventricular fibrillation and sudden cardiac arrest.

Alcohol abuse - risk of developing ventricular fibrillation; Chronic alcoholism leads to the development of cardiomyopathy (enlargement of the heart), followed by a decrease in the contractile function of the heart and the addition of arrhythmia. Complications of arrhythmia

A person with arrhythmia automatically falls into the risk group for the development of myocardial infarction and stroke, since the heart contracts incorrectly, the blood stagnates, blood clots (clots) form, which are carried throughout the body with the blood flow, and in the vessel where the blood clot gets stuck, it happens catastrophe. If a blood clot gets into the coronary (heart) vessels, there will be a heart attack, if it gets into the vessels of the brain, there will be a stroke. In third place, after the vessels of the heart and brain, are the vessels of the lower extremities.

Arrhythmia can cause the development of diseases such as myocardial infarction, cerebral stroke, pulmonary embolism, intestinal vascular thrombosis, vascular thrombosis of the extremities with subsequent amputation, and also lead to sudden cardiac arrest. Diagnosis of arrhythmia ECG (electrocardiogram) - records the electrical activity of the heart, evaluates the rhythm, heart rate and condition of the heart parts.

Ultrasound or echocardiography (echocardiography) - obtains an image of the heart. This method allows you to see all sizes, shapes and abnormalities of the heart; determine how the valves and parts of the heart work; recognize scars after myocardial infarction; assess the contractile function of the heart.

Daily Holter monitoring is the recording of an ECG during the day, which is possible thanks to a sensor attached to the patient. He wears it 24 hours, and an ECG is recorded during daily activities and during night sleep. After 24 hours, the rhythm, episodes of arrhythmia, at what time they occurred and what they are associated with are assessed.

EPI and mapping (electrophysiological study) is the most accurate and informative method for determining arrhythmia. Its essence is that the thinnest catheters are inserted into the cavity of the heart, recognizing the area of ​​the heart from which incorrect impulses emanate. In this case, thermal radiofrequency exposure is used, which allows not only to identify, but also to eliminate the source of arrhythmia.

Treatment of heart rhythm disturbances (arrhythmias)

Under no circumstances should you treat arrhythmia yourself! The recommendations that can be found on the Internet regarding self-medication of arrhythmia are illiteracy, obvious negligence and disregard for the patient and his life. Arrhythmia is a disruption of the heart, the most important motor in the human body, and its inept treatment, namely self-medication, can lead to death.

Arrhythmia should be treated by a doctor after conducting a special examination and determining the type of arrhythmia: from which part of the heart and under the influence of what causes this condition arose.

The goal of treating arrhythmia is to restore the correct (sinus) rhythm of the heart, reduce the manifestations of arrhythmia, eliminate its consequences and prevent complications.

There are two types of treatment for arrhythmia: medication and surgery.

Drug treatment of arrhythmia

Provides for the prescription and use of antiarrhythmic drugs. Their range is quite large. In cardiological practice, there are four classes of antiarrhythmic drugs.

1. Antiarrhythmic drugs: verapamil, adenosine, digoxin - used to eliminate atrial arrhythmias; lidocaine, disopyramide, mixletine - for ventricular arrhythmias; amiodarone, propafenone, flecainide - for both atrial and ventricular arrhythmias.

Amiodarone (cordarone) is the most commonly used and well-proven drug for the treatment of almost all types of arrhythmias. It is prescribed for arrhythmias in patients with myocardial infarction and heart failure. When administered intravenously, antiarrhythmic activity occurs within the first 10 minutes after administration. Usually, for the first two weeks after the onset of arrhythmia, cordarone is used orally to saturate the heart, and then the dose is reduced to a maintenance dose and continued thereafter. Contraindications for use: bradycardia (slow pulse, 50 beats per minute or less), bronchial asthma, heart block (atrioventricular), thyroid disease and pregnancy.

2. Beta-blockers are a group of drugs that have an antiarrhythmic and pronounced hypotensive (lowering blood pressure) effect. Beta blockers reduce heart rate and prevent the development of heart failure. Contraindications to the use of beta blockers are chronic respiratory diseases and bronchial asthma, since their use can cause an attack of suffocation.

3. Cardiac glycosides - increase myocardial contractility, improve blood circulation and reduce the load on the heart (digoxin, digitoxin, strophanthin, korglykon).

4. Metabolic drugs - help improve metabolism, nourish the heart muscle and protect the myocardium from ischemic effects.

Surgical treatment of arrhythmia Radiofrequency ablation is a procedure that allows, using small punctures, to completely cure arrhythmia. A special catheter is used in the heart to cauterize the area (source) of the arrhythmia and restore the correct heart rhythm.

Installation of an electrical pacemaker (ECS), a device that eliminates cardiac arrhythmia. The main function of the pacemaker is to impose a certain (desired) heart rate on the patient’s heart to maintain the correct heart rhythm. For example, if a patient has bradycardia (slow pulse) with a heart rate of 40 beats per minute, then when setting the pacemaker, the correct rhythm is set with a frequency of 80 beats per minute.

ditch per minute. There are one-, two- and three-chamber pacemakers. Single-chamber pacemakers are activated on demand. When bradycardia appears against the background of normal rhythm and heart rate (heart rate is 40-50 beats per minute), the pacemaker is turned on with the desired heart rate. Dual-chamber pacemakers automatically control heart rate. Three-chamber pacemakers are used to treat arrhythmias that threaten the patient’s life (ventricular arrhythmias) and are a reliable prevention of sudden death.

There is a so-called cardioverter - defibrillator. It instantly turns on and stimulates the heart, in other words, it resuscitates the heart when life-threatening arrhythmias develop.

Atrial fibrillation or atrial fibrillation

Atrial fibrillation (AF) is a heart rhythm disorder accompanied by an increase in heart rate to 350-700 beats per minute. At the same time, the heart rhythm is absolutely erratic and there is no way to accurately calculate the pulse. AF most often develops after 60 years and accounts for 40% of all hospitalizations for arrhythmias.

Causes of MA: heart disease (myocardial infarction, arterial hypertension, heart failure, cardiosclerosis, myocarditis, rheumatic heart disease); diseases of other organs (thyrotoxicosis; intoxication with narcotic substances; overdose of cardiac glycosides; acute alcohol poisoning and chronic alcoholism; uncontrolled use of diuretics; hypokalemia - decrease in potassium content in the blood; complication of severe poisoning and overdose of diuretics; stress and neuropsychic stress) .

Forms of MA according to the nature of the clinical course: paroxysmal - a first-time attack that lasts up to five days, usually less than a day; persistent - a condition when attacks are periodically repeated, the attack lasts more than seven days, but with effective treatment it is relieved immediately after the occurrence, after 3-5 hours; chronic (permanent) - erratic contractions of the heart over a long period of time.

• Based on the speed of heart contractions, the following variants of MA are distinguished: normosystolic - abnormal heart rhythm at a normal pace (60-90 beats per minute);
• tachysystolic - abnormal heart rhythm at a fast pace (90 or more beats per minute), patients tolerate this form of arrhythmia the worst;
• Bradysystolic - abnormal heart rhythm at a slow pace (60 or less beats per minute).

1. Fibrillation (atrial fibrillation). Normally, impulses from the atria enter the ventricles of the heart, and they contract, during which blood is pushed out of the heart. Fibrillation (atrial fibrillation) is a contraction not of the entire atrium, but only of its sections, and the remaining impulses do not reach the ventricles, but only jerk them and force them to contract in the wrong way. As a result, there is no complete transmission of the impulse from the atrium to the ventricles and proper contraction of the heart is impossible.

2. Atrial flutter - rapid contractions of the atria in the correct rhythm, but very fast (200-400 beats per minute). In this case, contraction of both the atria and ventricles suffers. The atria do not have time to relax because they work at a very fast pace. They become overfilled with blood and do not have time to give it to the ventricles. Because of this “greedy” relationship of the atria to the blood, the ventricles of the heart suffer, which cannot receive enough blood to push it out of the heart and give it to all the organs and tissues of the body.

Symptoms and complaints of patients with atrial fibrillation

Some patients may not feel the arrhythmia and still feel fine. Others feel a rapid heartbeat, “interruptions” in the heart, shortness of breath, which worsens with minimal physical activity. Chest pain may not always be present. Some patients feel pulsation in the neck veins. All this is accompanied by weakness, sweating, a feeling of fear and frequent urination. With a very high heart rate (200-300 or more beats per minute), dizziness and fainting are observed. All these symptoms disappear almost immediately after normal rhythm is restored. When the rhythm changes (from the correct rhythm to an arrhythmia and from an arrhythmia to the correct rhythm), nausea and vomiting may occur. Patients suffering from a permanent (chronic) form of MA stop noticing it. Complaints appear only with increased blood pressure, stress and physical activity, because the heart rate changes and arrhythmia reminds itself.

Complications of atrial fibrillation

Thromboembolism and stroke. In the presence of intracardiac thrombi, LA acts as a powerful provocateur of the development of thromboembolism in various organs. In AF, blood clots travel from the heart into the blood vessels of the brain and cause a stroke. Every seventh stroke develops in patients with MA.

Heart failure. MA in people suffering from mitral stenosis (narrowing of the mitral valve of the heart) and hypertrophic cardiomyopathy (thickening of the walls of the heart), against the background of heart failure, can lead to the development of cardiac asthma (an attack of suffocation) and pulmonary edema.

Dilated cardiomyopathy. MA against the background of heart failure provokes it and quickly leads to the development of dilated cardiomyopathy (enlargement of the cavities of the heart).

Arrhythmogenic shock. MA in the setting of heart failure can cause the development of arrhythmogenic shock (a sharp decrease in blood pressure, loss of consciousness and cardiac arrest).

Heart failure. AF (atrial fibrillation) can progress to ventricular fibrillation and cause cardiac arrest.

Diagnosis of atrial fibrillation is similar to that described above (ECG, echocardiography or ultrasound of the heart, Holter 24-hour monitoring, EPI and mapping, and also includes a conversation with the patient (they find out the probable causes of the arrhythmia, how long the person has been suffering from atrial fibrillation, how often and under what conditions the arrhythmia manifests itself) ), its examination (listen to erratic heartbeats and determine the pulse rate) and transesophageal electrophysiological study - a method of examining the heart that makes it possible to determine the source and mechanism of development of AF).

Treatment of atrial fibrillation

Only a doctor should prescribe medicine, select doses and restore rhythm!

The goals of drug treatment for AF are: restoration of the correct (sinus) rhythm of the heart, prevention of relapses (repeats) of an attack of AF, control of the heart rate and maintenance of the correct heart rhythm, prevention of thromboembolism. In case of AF, it is first necessary to treat the diseases that led to the development of arrhythmia.

Drug treatment of AF (atrial fibrillation) is similar to that described above and includes: antiarrhythmic drugs, beta blockers, anticoagulant therapy, metabolic drugs,

Surgical treatment of AF (atrial fibrillation):

• Radiofrequency ablation. In case of frequently recurring attacks or a chronic form of MA, they “cauterize” (using a special electrode) the area of ​​the heart responsible for conducting the impulse, thereby causing a complete blockade in the heart. After this, a pacemaker is installed, which sets the heart to the correct rhythm.
• Radiofrequency isolation of pulmonary veins. This is a method of radical elimination of MA (effectiveness is about 60%). The focus of “incorrect” excitation, located at the mouth of the pulmonary veins, is isolated from the atria.

Every year, new methods of surgical treatment of arrhythmias are developed, antiarrhythmic drugs are improved, and the number of side effects is reduced; Research continues to develop a universal antiarrhythmic drug. But all this does not give us the right not to be treated on time and correctly.

The longer an arrhythmia lasts, the more likely it is that it will remain for life. Do you need such travel companions? Get rid of them before it's too late...

Attention! All information in the article is provided for informational purposes only and cannot be taken as a guide to self-medication.

Treatment of diseases of the cardiovascular system requires consultation with a cardiologist, a thorough examination, prescription of appropriate treatment and subsequent monitoring of the therapy.

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Causes of the disease

The causes of arrhythmia can be very different. They are caused by various diseases or special conditions of the body.

The main causes of the disease include the following factors:

• cardiac ischemia;
• heart injuries;
• myocarditis;
• heart failure;
• heart defects;
• strong feelings;
• overwork;
• anemia.

Irregular heart rhythm always symbolizes any diseases or health-related problems, therefore, you should not neglect them. The presence of arrhythmia is a reason to consult a doctor for examination.

Types of arrhythmia

The form of arrhythmia is influenced by the heart rate. In this regard, the following types of arrhythmia are noted:

• tachycardia;
• bradycardia;
• extrasystole;
• atrial fibrillation;
• heart block.

Tachycardia

Tachycardia is the most common type of heart rhythm disorder. It manifests itself by rapid heartbeat. Heart rate exceeds 90 beats per minute.

In some cases Aach tachycardia can also appear in healthy people. It occurs:

• under stress;
• after physical activity;
• after taking certain medications;
• when drinking strong tea, coffee, alcohol.

Tachycardia is often diagnosed in preschool children. This does not apply to pathological phenomena. It proceeds favorably and belongs to the physiological norm.

Pathological tachycardia carries many dangers. An increase in heart rate affects a decrease in the volume of blood ejected, as a result of which blood pressure decreases and the blood supply to all vital organs deteriorates.

Tachycardia, in turn, is divided into two more subtypes:

1. Ectopic tachycardia.

Sinus tachycardia most often occurs in people with a healthy heart, but suffering from vegetative-vascular dystonia. Sometimes it indicates the presence of heart failure.

The cause of the ectopic form of tachycardia is severe heart disease, such as myocardial infarction and myocarditis.

If with tachycardia the heart rate increases, then with bradycardia, on the contrary, the heart begins to beat more slowly. The person becomes weak and dizzy, and there is a risk of loss of consciousness.

Loss of consciousness in this case lasts no more than 2 minutes, after which the person comes to his senses. Blood pressure is unstable.

Some diseases can cause the development of bradycardia:

• increased intracranial pressure;
• swelling or swelling of the brain;
• stomach ulcer;
• stroke;
• myocardial infarction;
• cardiosclerosis.

In addition, bradycardia can occur when the dose of medications is exceeded or poisoning with toxic substances.

Bradycardia can be age-related and occur in people over 60 years of age.

L The mild form of bradycardia is practically not felt, but the pathological form has certain symptoms. These include:

• pain in the heart of the chest;
• dyspnea;
• swelling of the legs;
• noise in ears;
• pallor.

In severe forms of bradycardia, the doctor prescribes drug therapy to stabilize the heart rhythm. In rare cases, it is necessary to resort to surgery and the introduction of a pacemaker.

Ek Strasystole is manifested by an extraordinary cardiac contraction, which is felt as a sudden cardiac impulse. You may feel your heart sinking and a rush of blood to your head. The following symptoms are also characteristic:

• hot flash;
• weakness;
• discomfort;
• anxious feeling;
• lack of air;
• dizziness;
• fainting.

Episodic extrasystoles occur from time to time in relatively healthy people. For example, in women, during menstruation, or after drinking strong coffee. Stress and neuroses can cause extrasystolic attacks. This pathology often accompanies serious heart disease.

Single attacks do not require treatment. But if such conditions occur regularly, drug treatment and additional diagnostics to determine the concomitant disease will be required.

Flicker arrhythmia is a special condition characterized by chaotic heartbeat. Namely, alternating correct and incorrect rhythm. The heart rate can reach up to 600 beats per minute. Atrial fibrillation is expressed in two forms:

1. Atrial fibrillation (irregular activity of the atria).
2. Atrial flutter (regular rhythm arrhythmia).

These two types of atrial fibrillation are closely related and can replace each other, but atrial flutter is much less common.

When an attack of atrial fibrillation occurs, the patient experiences the following sensations:

• heaviness in the heart area;
• chaotic heart twitching;
• weakness;
• cold extremities;
• panic state;
• pulse disturbance;
• nausea;
• labored breathing.

Mer causative arrhythmia has quite serious consequences. It can promote the formation of blood clots in the heart. Atrial fibrillation requires urgent diagnosis of the whole body and a course of treatment. The basis of therapy is drug treatment.

In special cases, surgery is required to install a pacemaker.

The causes of the disease are in most cases heart disease. Elderly people are also at risk.

Heart block is a serious pathology that can be fatal. Blockades are divided into two types:

1. Atrial block.
2. Ventricular block.

Ventricular bl Okadas can be a complete blockade, in which cardiac activity stops completely. Complete blockade requires immediate hospitalization and immediate treatment.

The disease is caused by diseases of the heart and circulatory system. Symptoms of heart block include bluish lips, weakness, shortness of breath, wheezing in the lungs, and the patient may lose consciousness.

The occurrence of arrhythmia attacks indicates that something is going wrong in the human body.

Before starting treatment, it is necessary to find out what forms of arrhythmia there are. This will require a consultation with a cardiologist.

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Arrhythmias caused by impaired automaticity

There is an abnormal change in heart rate or sequence. The classification of arrhythmias involves the identification of two forms of disorders depending on the pathological mechanism: nomotopic and heterotopic.

Nomotopic form

This type of arrhythmia is characterized by changes in the parameters of pulse movement. However, the sinus node retains its function as the main pacemaker. It generates impulses leading to myocardial contraction.

The pathology is characterized by a significant increase in the number of contractions of the heart muscle while maintaining normal rhythm. There is an increase in the rate of impulse generation by the sinus node, so the heart rate can reach 180 beats per minute.

Cardiologists distinguish the following forms of sinus tachycardia:

• Physiological. Occurs in an absolutely healthy person during physical activity, a stressful situation, or experiences;
• Pathological. Develops with ischemic heart damage.

With this form of arrhythmia, patients report the following symptoms:

• Heartbeat. The heart seems to “flutter” in the chest;
• Shortness of breath with slight exertion;
• Weakness;
• Decreased performance;
• Chest pain, dizziness, and loss of consciousness are also possible.

Special treatment for the physiological form of tachycardia is not required; it is enough to exclude provoking factors. Pathological arrhythmia requires accurate diagnosis and treatment of the underlying disease.

Sinus bradycardia

This form of arrhythmia is characterized by a decrease in the heart rate of the heart muscle to less than 60 beats in 60 seconds. This condition is caused by reduced automaticity of the sinus node when exposed to the parasympathetic nerve.

The main forms of sinus bradycardia:

• Extracardiac. Associated with a toxic effect on the sinus node, activation of the parasympathetic nerve, which leads to disruption of the vagal component. The main causes: hypothyroidism, jaundice, alkalosis, drug overdose, infectious diseases.
• Intracardial. Develops due to damage to the sinus node. The causes are the following diseases: heart defects, heart attack, ischemia, cardiosclerosis.

At an early stage, severe symptoms do not occur, only with the development of pathology does dizziness, pain in the heart area, and weak pulse occur. Treatment involves eliminating the causes of arrhythmia; Belloid, Eufillin, Alupent, and Atropine are often used.

Sinus arrhythmia

The condition is characterized by an uneven and inconsistent distribution of impulses in the node. Both increased and decreased heart rate is possible. The cause of the condition is instability of the vagus nerve or uneven filling of the myocardium with blood during the act of breathing. The condition often develops at a young age after severe infectious diseases.

Patients feel a change in heart rate during physical activity, weakness occurs, and fainting is possible.

Heterotopic arrhythmias

This pathology occurs when the excitability of the sinus node is suppressed, so the ventricular component becomes the new pacemaker.

Atrioventricular rhythm

Some factors (heart attack, infections, rheumatism, quinidine, digitalis) lead to the appearance of a new pacemaker in the atrioventricular node. This results in a reduction in the time it takes for an impulse to reach the atrium or ventricles.

A sign of pathology is an increase in the pulsation of the veins in the neck. Heart rate is in the range of 40-80 beats.

Sick sinus syndrome

Pathology occurs due to disturbances in the automatism of the sinus node. The causes of the pathology are ischemic lesions, cardiosclerosis, myocarditis or organic defects. As a result, migration of the pacemaker is noted with the involvement of the atrioventricular node. There are 3 types of syndrome: transient, latent and permanent.

Arrhythmias caused by impaired excitability

The following forms of pathology are distinguished: extrasystole and paroxysmal tachycardia.

With this disorder, the appearance of one or more contractions of the heart muscle, which are extraordinary, is noted. It develops as a result of the appearance of impulses not only from the sinus node, which is the main pacemaker, but also from secondary elements that should only normally conduct the main impulses.

Of particular danger is arrhythmia, which people do not feel. In such cases, immediate treatment is required. With the development of extrasystole, patients note the following symptoms:

• Strong tremors;
• Sweating and hot flashes;
• "Somersault of the Heart";
• Sense of anxiety;
• Lack of air;
• Fading of the heart muscle;
• Possible: headache, shortness of breath, fainting, urination problems, angina attack.

Measuring the pulse is often not indicative, because only normal pulse beats reach the extremities.

Paroxysmal tachycardia

The pathology is a heart rhythm disorder, which is characterized by a sharp increase in heart rate up to 240 beats. Additional signals from secondary pacemakers may appear. Treatment of this form involves relief of the acute condition with Verapamil, Novacainamide, and for the ventricular type - Lidocaine, Etatsizin, Etomozin.

Mixed arrhythmia

This is the most dangerous pathology, the development of which is caused by a violation of several myocardial functions: excitability and conductivity.

This pathological condition is characterized by a change in rhythm, which is associated with the occurrence of chaotic impulses in the myocardium, fibrillation of individual muscle fibers. Heart rate can reach 500-600 beats. Atrial fibrillation is characterized by the occurrence of a pulse deficit: the number of minute contractions is greater than the pulse waves. With long-term pathology, the risk of stroke and blood clots is significantly increased. This is the most common type of arrhythmia, which occurs mainly in elderly patients.

There are the following types of pathology:

• Constant. Electrical cardioversion is noted to be ineffective. The duration of the attack is more than a week;
• Persistent. May be recurrent;
• Transient. The attack can last up to 7 days, usually up to 24 hours.

Patients note the following symptoms of arrhythmia:

• Chaotic heartbeat;
• Sweating;
• Trembling and fear;
• Weakness;
• Polyuria;
• Possible: fainting, dizziness.

Restoring normal sinus rhythm allows symptoms to be completely eliminated.

Atrial flutter

This form of mixed arrhythmia is supraventricular tachycardia. Characterized by uncoordinated electrical activation of the atria up to 700 beats. As a result, myocardial contractility decreases and the ventricular filling phase is lost.

The following options are available:

• Typical. Circulation of the excitation wave is noted in the right atrium in a normal circle. Heart rate is 250-350 beats;
• Atypical. The excitation wave circulates in both atria in an abnormal circle. Heart rate can reach 700 beats.

Symptoms of the pathology: palpitations, shortness of breath, reduced physical endurance, discomfort in the heart, an attack of angina, pulsation of the veins in the neck, dizziness, decreased blood pressure. The frequency of arrhythmia attacks can vary from 1 in 12 months to several paroxysms per day.

Treatment of the pathology is aimed at stopping the attack, restoring normal sinus rhythm, and preventing the development of episodes in the future. For this purpose, beta blockers, cardiac glycosides, calcium channel blockers, and antiarrhythmic drugs are widely used.

Arrhythmias caused by conduction disturbances

Pathology is associated with the occurrence of obstacles to the propagation of impulses. As a result, they may not penetrate into the underlying sections or may be delayed. This condition is called blockade. It can be congenital or acquired, and can be localized in various parts of the heart muscle. There are these types of arrhythmia:

• Atrial blocks are characterized by slow conduction of impulses. The pathological condition is sometimes confused with the development of bradycardia. There are left and right blockades, depending on the type of atrium. This rhythm disturbance sometimes occurs in healthy people;
• Atrioventricular blocks (atrioventricular) occur when there are obstacles to impulses on the way from the atrium to the ventricle;
• Ventricular blockades. The pathology is characterized by conduction disturbances in the His bundle. The cause of the pathology can be ischemic lesions, cardiomyopathy, endocarditis, and heart attacks. Hospitalization and emergency treatment are required for blockade of both branches of the His bundle.

Treatment of this type of arrhythmia is based on the use of Isoprenarine hydrochloride, Orciprenaline sulfate, Atropine. In severe conditions, electrical stimulation is prescribed. Pacemaker implantation is indicated for patients over 60 years of age.

Arrhythmia can lead to the development of serious pathologies. Therefore, this condition requires careful and accurate diagnosis and effective therapy. At the first signs of pathology, you should contact a cardiologist.

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Types of arrhythmia

• Flickering.
• Ventricular tachycardia.
• Heart rate disturbances.

The most common is extrasystole, when an extraordinary contraction of the heart occurs with sensations of an additional cardiac impulse or its fading. When this happens, the heart rhythm is disrupted, and the person himself does not notice it.

Extrasystole is a disease characteristic of older people, which is also called atrial fibrillation. There is a violation of cardiac contraction due to atherosclerotic damage to the blood vessels of the heart muscles, which forms cardio-sclerotic areas, leading to chaotic and irregular contractions.

When starting recovery, it is necessary to consider the duration of the changes, exclude the presence of blood clots and, depending on the person’s condition, make the right decision.

Sometimes extrasystole is classified as a permanent form of arrhythmia. But in this case, it is still necessary to undergo a course of treatment to bring the extrasystole to normosystole. That is, ensure that the heart rate does not exceed 90 beats per minute.

Ciliated

This type of deviation is more often called “atrial flutter”, which is often not noticed due to its regular nature. Most often, atrial fibrillation occurs due to diseases associated with lung diseases.

Ventricular tachycardia

A more dangerous type of deviation from the norm is supraventricular and ventricular tachycardia, which occurs in both adults and children, both men and women. The disease is especially dangerous during pregnancy. Here you cannot do without urgent qualified help.

Ventricular - when the heart contracts from the sinus node. If variability occurs elsewhere, arrhythmia appears, even if the heart rate is normal, and the number of beats per minute is far beyond acceptable limits.

Ventricular and supraventricular arrhythmias can be caused by many diseases and may not necessarily be associated with heart disease.

Rate abnormalities in adults can occur as a result of tachyarrhythmias and bradyarrhythmias, abnormalities that are associated with congenital heart defects and in rheumatism and myocarditis.

Treatment

For extrasystoles, treatment is prescribed only when an adult or child is bothered by an extraordinary contraction, and is carried out only with medications, the prescription of which depends on the presence of a certain number of extrasystoles and the causes of the disease.

After a course of drug treatment, the patient stops complaining of extraordinary contractions, that is, the heart rhythm normalizes.

Rhythm failure with atrial fibrillation, as well as with extrasystole, is treated with medication. Only in this case, before prescribing drugs, the doctor determines the likelihood of blood clots using an ultrasound examination of the heart and its vessels. To maintain the normal rate of strokes, the doctor prescribes a special course of drug treatment.

Ventricular and supraventricular arrhythmias are more difficult to treat. Here, in addition to medications, in emergency cases, electrical discharges are used, which must be carried out as quickly as possible, since the patient can lose consciousness at any moment, which will worsen the condition, which can cause death.

But there are cases when it is possible to normalize the functioning of a person’s heart only after cardiac surgery.

Treatment of arrhythmia in adults and children is carried out only in a hospital after a preliminary complete examination.

The cause of heart rhythm disturbances can be diseases of the endocrine system, most often thyrotoxicosis, when the heart rate increases. Here it is necessary to treat the underlying disease, aimed at reducing hormones in the blood, then heart rate variability (HRV) will return to normal.

Abnormal heart rhythm in adults, when the heart rate is above 91 beats, can be caused by anemia - oxygen deficiency is compensated.

If the beats per minute is below 59, this is a clear sign of sinus bradycardia, weakening of the sinus node occurs, which occurs more often in older people than in young people. Their sinus bradycardia is of a slightly different nature and manifests itself as a result of a decrease in the level of thyroid hormones.

Irregular heart rhythm – blockade – is a disease that can only be cured with cardiac surgery. It all depends on the degree of the disease.

Arrhythmia during pregnancy

Pregnancy is a change in the body of women, which is accompanied by disturbances in heart rhythm. It’s rare that a woman does not notice a rapid heartbeat, especially at the end of her pregnancy. Arrhythmia develops during pregnancy in 58% of women. Moreover, 44% of pregnant women have clear signs of functional arrhythmia. And even if the expectant mother has never suffered from heart disease before, while pregnant, she may experience an increase in heart rate. In this regard, it is urgent to normalize the patient’s heart rate. After all, pregnancy is already a kind of complication that occurs with a change in heart rhythm.

Features of arrhythmia in women and men

The symptoms of the disease are similar. There are some differences though. For example:

• In women, heart rhythm is disrupted after the age of 50.
• Men experience their first attacks of arrhythmia by the age of 45.

With arrhythmia, weakness, interruptions in heart function, anxiety, pain in the chest, and shortness of breath are felt.

The main causes of arrhythmia in women:

• Excessive emotionality.
• Stress.
• Excess weight.
• Physical overexertion.

The main causes of arrhythmia in men:

• Unhealthy lifestyle, that is, unhealthy diet, alcohol abuse.
• Incorrect transition to physical activity during sports training.
• Passive lifestyle.

Recently, smoking has been the cause of arrhythmia in both.

Failures in the normal rhythm of the heart do not always require treatment, although there are cases when the failure is difficult to bear, then the help of a specialist will not hurt. The main thing is to consult a doctor in a timely manner to prevent the development of stroke, heart attack, and so on.

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Single supraventricular extrasystole - what is it? Arrhythmia tablets
Sinus arrhythmia in children

Heart rhythm disturbances are a very complex branch of cardiology. People who have no idea about the structure of the heart and its conduction system will find it difficult to understand the mechanisms of arrhythmia. No need! For this purpose, there is a whole section of cardiology that deals only with heart rhythm disturbances (arrhythmology), and the doctor who treats them is an arrhythmologist. Everyone must do their job.

Arrhythmias are very common in our lives, and every person should know what arrhythmia is, how and under what circumstances it occurs, how it manifests itself and why it is dangerous.

As simply as possible, without delving into the physiological mechanisms of arrhythmias, we will consider their most common types. What is arrhythmia

There is a special node in the heart - the sinus node. It sets the rhythm for the whole heart. The correct (normal) heart rhythm is called sinus rhythm. The heart rate in normal (sinus) rhythm is 60-90 beats per minute. All rhythm disturbances (arrhythmias) are irregular (non-sinus) rhythms, with an increased (more than 90 beats per minute) or decreased (less than 60 beats per minute) heart rate. In other words, this is any deviation from the norm.

If the heart beats faster than 100 beats per minute, this is a disorder called tachycardia (increased heart rate). If the heart beats less frequently, for example, 55 beats per minute, this is bradycardia (rare heartbeats).

In young children, the heart rate is not 60-90 beats per minute, as in adults, but 140 or more, so for children 140 beats per minute is the norm.

Classification of arrhythmias. What are the types of arrhythmias?

1. Sinus tachycardia - increased heart rate to 120-200 beats per minute while maintaining a normal rhythm (the heart beats faster, but the rhythm is correct).

Sinus tachycardia is a normal response of the heart to physical activity, stress, and drinking coffee. It is temporary and is not accompanied by unpleasant sensations. The restoration of normal heart rate occurs immediately after the cessation of the factors that caused it.

Doctors are only concerned about tachycardia that persists at rest, accompanied by a feeling of lack of air, shortness of breath, and a feeling of palpitations. The causes of such tachycardia may be diseases that manifest themselves in heart rhythm disturbances or are accompanied by them: hyperthyroidism (thyroid disease), fever (increased body temperature), acute vascular insufficiency, anemia (anemia), some forms of vegetative-vascular dystonia, use of medications (caffeine, aminophylline).

Tachycardia reflects the functioning of the cardiovascular system in response to a decrease in the contractility of the heart, which is caused by heart diseases such as chronic heart failure, myocardial infarction (death of a section of the heart muscle), a severe attack of angina in patients with coronary heart disease, acute myocarditis (inflammation of the heart). muscles), cardiomyopathy (changes in the shape and size of the heart).

2. Sinus bradycardia - slowing the heart rate to less than 60 beats per minute.

In healthy people, it indicates good fitness of the cardiovascular system and is often found in athletes (in response to stress, the heart does not start beating strongly because it is accustomed to the stress).

Causes of bradycardia not related to heart disease: hypothyroidism, increased intracranial pressure, overdose of cardiac glycosides (drugs for the treatment of heart failure), infectious diseases (influenza, viral hepatitis, sepsis, etc.), hypothermia (lowered body temperature); hypercalcemia (increased calcium in the blood), hyperkalemia (increased potassium in the blood).

The causes of bradycardia associated with heart disease: myocardial infarction, atherosclerosis (deposition of atherosclerotic plaques on the vessel wall, which, when growing, narrow the lumen of the vessel and lead to circulatory disorders), post-infarction cardiosclerosis (a scar on the heart that interferes with its full functioning).

3. Paroxysmal ventricular tachycardia - a sudden onset and suddenly ending attack of increased heart rate from 150 to 180 beats per minute.

This type of arrhythmia occurs in people with the following heart diseases: myocardial infarction, post-infarction aneurysm (formation of a vascular “bag” of blood at the site of a heart attack after scarring), cardiomyopathies, heart defects (changes in the structure of the heart that interfere with its normal functioning).

Paroxysmal ventricular tachycardia occurs 2 times more often in women than in men and often causes a decrease in blood pressure and loss of consciousness.

4. Extrasystole - extraordinary contractions of the heart. It may be asymptomatic, but more often patients feel a jolt or a sinking heart.

Causes of extrasystole not related to heart disease: stress and, as a consequence, vascular reaction; emotional stress, overwork; abuse of coffee, smoking, alcohol, often during alcohol withdrawal due to chronic alcoholism (withdrawal syndrome); drug use.

Causes of extrasystole associated with heart disease: coronary heart disease, acute myocardial infarction; mitral stenosis (narrowing of the mitral valve of the heart), rheumatic carditis (heart disease due to rheumatism), thyrotoxicosis (thyroid disease), intoxication with cardiac glycosides.

5. Ventricular fibrillation is a serious condition in which the heart contracts chaotically, incoherently, and has no rhythm. As a rule, ventricular fibrillation of the heart, a complication after extensive myocardial infarction, is the cause of death

Causes of rhythm disturbances (arrhythmias)

1. Cardiovascular diseases:

• coronary heart disease (myocardial infarction, angina pectoris, post-infarction cardiosclerosis) - ventricular arrhythmias and sudden cardiac arrest occur more often due to damage to the heart muscle and a decrease in the ability of the heart to contract:
• heart failure - there is an increase in the parts of the heart, loss of elasticity of the heart muscle, it ceases to contract adequately, blood stagnates inside the heart, or a turbulence in its flow occurs, resulting in arrhythmia;
• cardiomyopathy - when the walls of the heart are stretched, thinned or thickened, the contractile function of the heart decreases (it cannot cope with its work), which leads to the development of arrhythmia;
• acquired heart defects - disorders of the structure and structure of the heart (usually after rheumatism), which affect its functioning and contribute to the development of arrhythmia;
• congenital heart defects - congenital disorders of the structure and structure of the heart that affect its functioning and contribute to the development of arrhythmia;
• myocarditis is an inflammatory disease of the heart muscle, which sharply reduces the function of the heart (prevents it from contracting) and can cause various arrhythmias; mitral valve prolapse - an obstruction in the mitral valve that prevents blood from flowing from the left atrium to the left ventricle (normally), blood from the ventricle is thrown back into the atrium (where it came from, but this should not happen), all these disorders can trigger the occurrence of arrhythmia .

2. Medicines. An overdose of cardiac glycosides, antiarrhythmic drugs, diuretics, beta blockers (drugs for regulating blood pressure and heart rate) leads to heart rhythm disturbances (arrhythmias).

3. Electrolyte disturbances (impaired water-salt balance in the body): hypokalemia, hyperkalemia, hypomagnesemia (decreased magnesium in the blood), hypercalcemia (increased calcium in the blood).

4. Toxic effects on the heart: smoking, alcohol, bioactive supplements, herbal treatment, working with toxic substances (poisons).

Clinical manifestations (symptoms and signs) of arrhythmia

Arrhythmias may not manifest themselves for a long time, and the patient may not suspect that he has an arrhythmia until the doctor identifies the disease during a routine medical examination or an electrocardiogram.

But often arrhythmias are not so “quiet” and make themselves known, significantly preventing a person from living his usual life. They can manifest themselves in the form of “turning over”, “transfusion” and “freezing” of the heart, but more often it is a feeling of interruptions in the heart, increased heartbeat, “fluttering” of the heart, extremely fast or, conversely, slow heartbeat, dizziness, shortness of breath, chest pain a cell of a pressing nature, a feeling of “failure” of the ground under your feet, nausea and (or) vomiting (especially when the normal rhythm changes to arrhythmia, and vice versa, when it is restored from arrhythmia to a normal heart rhythm), loss of consciousness.

Such diverse manifestations of arrhythmia do not always indicate the complexity of the rhythm disorder. People with minor rhythm disturbances may lose consciousness, but patients who have truly life-threatening rhythm disturbances do not show any complaints. Everything is very individual.

Risk factors for arrhythmia development

Age - with age, the heart muscle, our pump, weakens and can fail at any moment, and the diseases that we have “accumulated” over our lives will aggravate the situation.

Genetics - in people with congenital anomalies (malformations) of the development of the heart and its conduction system, arrhythmias are much more common.

Heart diseases - myocardial infarction and the scar on the heart that forms after it, coronary heart disease with vascular damage and rheumatism with damage to the heart valves are fertile ground for the development of arrhythmia.

Arterial hypertension (systematic increase in blood pressure) - increases the risk of developing coronary heart disease and contributes to the development of left ventricular hypertrophy (increase in size), which also increases the risk of developing arrhythmia.

Obesity is a direct risk factor for the development of coronary heart disease with all the ensuing consequences.

Diabetes mellitus - an uncontrolled increase in blood glucose can easily trigger the development of arrhythmia; coronary heart disease and arterial hypertension, which contribute to the development of arrhythmia, are faithful companions of diabetes mellitus.

Taking medications - uncontrolled use of diuretics and laxatives leads to disruption of the water-salt balance in the body and can cause arrhythmia.

Electrolyte disturbances - potassium, magnesium and sodium form the basis of the contractile mechanism of the heart, therefore, an imbalance in them (imbalance) can lead to arrhythmia.

Coffee, smoking and drugs are the cause of the development of extrasystole; amphetamine and cocaine provoke ventricular fibrillation and sudden cardiac arrest.

Alcohol abuse - risk of developing ventricular fibrillation; Chronic alcoholism leads to the development of cardiomyopathy (enlargement of the heart), followed by a decrease in the contractile function of the heart and the addition of arrhythmia. Complications of arrhythmia

A person with arrhythmia automatically falls into the risk group for the development of myocardial infarction and stroke, since the heart contracts incorrectly, the blood stagnates, blood clots (clots) form, which are carried throughout the body with the blood flow, and in the vessel where the blood clot gets stuck, it happens catastrophe. If a blood clot gets into the coronary (heart) vessels, there will be a heart attack, if it gets into the vessels of the brain, there will be a stroke. In third place, after the vessels of the heart and brain, are the vessels of the lower extremities.

Arrhythmia can cause the development of diseases such as myocardial infarction, cerebral stroke, pulmonary embolism, intestinal vascular thrombosis, vascular thrombosis of the extremities with subsequent amputation, and also lead to sudden cardiac arrest. Diagnosis of arrhythmia ECG (electrocardiogram) - records the electrical activity of the heart, evaluates the rhythm, heart rate and condition of the heart parts.

Ultrasound or echocardiography (echocardiography) - obtains an image of the heart. This method allows you to see all sizes, shapes and abnormalities of the heart; determine how the valves and parts of the heart work; recognize scars after myocardial infarction; assess the contractile function of the heart.

Daily Holter monitoring is the recording of an ECG during the day, which is possible thanks to a sensor attached to the patient. He wears it 24 hours, and an ECG is recorded during daily activities and during night sleep. After 24 hours, the rhythm, episodes of arrhythmia, at what time they occurred and what they are associated with are assessed.

EPI and mapping (electrophysiological study) is the most accurate and informative method for determining arrhythmia. Its essence is that the thinnest catheters are inserted into the cavity of the heart, recognizing the area of ​​the heart from which incorrect impulses emanate. In this case, thermal radiofrequency exposure is used, which allows not only to identify, but also to eliminate the source of arrhythmia.

Treatment of heart rhythm disturbances (arrhythmias)

Under no circumstances should you treat arrhythmia yourself! The recommendations that can be found on the Internet regarding self-medication of arrhythmia are illiteracy, obvious negligence and disregard for the patient and his life. Arrhythmia is a disruption of the heart, the most important motor in the human body, and its inept treatment, namely self-medication, can lead to death.

Arrhythmia should be treated by a doctor after conducting a special examination and determining the type of arrhythmia: from which part of the heart and under the influence of what causes this condition arose.

The goal of treating arrhythmia is to restore the correct (sinus) rhythm of the heart, reduce the manifestations of arrhythmia, eliminate its consequences and prevent complications.

There are two types of treatment for arrhythmia: medication and surgery.

Drug treatment of arrhythmia

Provides for the prescription and use of antiarrhythmic drugs. Their range is quite large. In cardiological practice, there are four classes of antiarrhythmic drugs.

1. Antiarrhythmic drugs: verapamil, adenosine, digoxin - used to eliminate atrial arrhythmias; lidocaine, disopyramide, mixletine - for ventricular arrhythmias; amiodarone, propafenone, flecainide - for both atrial and ventricular arrhythmias.

Amiodarone (cordarone) is the most commonly used and well-proven drug for the treatment of almost all types of arrhythmias. It is prescribed for arrhythmias in patients with myocardial infarction and heart failure. When administered intravenously, antiarrhythmic activity occurs within the first 10 minutes after administration. Usually, for the first two weeks after the onset of arrhythmia, cordarone is used orally to saturate the heart, and then the dose is reduced to a maintenance dose and continued thereafter. Contraindications for use: bradycardia (slow pulse, 50 beats per minute or less), bronchial asthma, heart block (atrioventricular), thyroid disease and pregnancy.

2. Beta-blockers are a group of drugs that have an antiarrhythmic and pronounced hypotensive (lowering blood pressure) effect. Beta blockers reduce heart rate and prevent the development of heart failure. Contraindications to the use of beta blockers are chronic respiratory diseases and bronchial asthma, since their use can cause an attack of suffocation.

3. Cardiac glycosides - increase myocardial contractility, improve blood circulation and reduce the load on the heart (digoxin, digitoxin, strophanthin, korglykon).

4. Metabolic drugs - help improve metabolism, nourish the heart muscle and protect the myocardium from ischemic effects.

Surgical treatment of arrhythmia Radiofrequency ablation is a procedure that allows, using small punctures, to completely cure arrhythmia. A special catheter is used in the heart to cauterize the area (source) of the arrhythmia and restore the correct heart rhythm.

Installation of an electrical pacemaker (ECS), a device that eliminates cardiac arrhythmia. The main function of the pacemaker is to impose a certain (desired) heart rate on the patient’s heart to maintain the correct heart rhythm. For example, if a patient has bradycardia (slow pulse) with a heart rate of 40 beats per minute, then when setting the pacemaker, the correct rhythm is set with a frequency of 80 beats per minute.

ditch per minute. There are one-, two- and three-chamber pacemakers. Single-chamber pacemakers are activated on demand. When bradycardia appears against the background of normal rhythm and heart rate (heart rate is 40-50 beats per minute), the pacemaker is turned on with the desired heart rate. Dual-chamber pacemakers automatically control heart rate. Three-chamber pacemakers are used to treat arrhythmias that threaten the patient’s life (ventricular arrhythmias) and are a reliable prevention of sudden death.

There is a so-called cardioverter - defibrillator. It instantly turns on and stimulates the heart, in other words, it resuscitates the heart when life-threatening arrhythmias develop.

Atrial fibrillation or atrial fibrillation

Atrial fibrillation (AF) is a heart rhythm disorder accompanied by an increase in heart rate to 350-700 beats per minute. At the same time, the heart rhythm is absolutely erratic and there is no way to accurately calculate the pulse. AF most often develops after 60 years and accounts for 40% of all hospitalizations for arrhythmias.

Causes of MA: heart disease (myocardial infarction, arterial hypertension, heart failure, cardiosclerosis, myocarditis, rheumatic heart disease); diseases of other organs (thyrotoxicosis; intoxication with narcotic substances; overdose of cardiac glycosides; acute alcohol poisoning and chronic alcoholism; uncontrolled use of diuretics; hypokalemia - decrease in potassium content in the blood; complication of severe poisoning and overdose of diuretics; stress and neuropsychic stress) .

Forms of MA according to the nature of the clinical course: paroxysmal - a first-time attack that lasts up to five days, usually less than a day; persistent - a condition when attacks are periodically repeated, the attack lasts more than seven days, but with effective treatment it is relieved immediately after the occurrence, after 3-5 hours; chronic (permanent) - erratic contractions of the heart over a long period of time.

• Based on the speed of heart contractions, the following variants of MA are distinguished: normosystolic - abnormal heart rhythm at a normal pace (60-90 beats per minute);
• tachysystolic - abnormal heart rhythm at a fast pace (90 or more beats per minute), patients tolerate this form of arrhythmia the worst;
• Bradysystolic - abnormal heart rhythm at a slow pace (60 or less beats per minute).

1. Fibrillation (atrial fibrillation). Normally, impulses from the atria enter the ventricles of the heart, and they contract, during which blood is pushed out of the heart. Fibrillation (atrial fibrillation) is a contraction not of the entire atrium, but only of its sections, and the remaining impulses do not reach the ventricles, but only jerk them and force them to contract in the wrong way. As a result, there is no complete transmission of the impulse from the atrium to the ventricles and proper contraction of the heart is impossible.

2. Atrial flutter - rapid contractions of the atria in the correct rhythm, but very fast (200-400 beats per minute). In this case, contraction of both the atria and ventricles suffers. The atria do not have time to relax because they work at a very fast pace. They become overfilled with blood and do not have time to give it to the ventricles. Because of this “greedy” relationship of the atria to the blood, the ventricles of the heart suffer, which cannot receive enough blood to push it out of the heart and give it to all the organs and tissues of the body.

Symptoms and complaints of patients with atrial fibrillation

Some patients may not feel the arrhythmia and still feel fine. Others feel a rapid heartbeat, “interruptions” in the heart, shortness of breath, which worsens with minimal physical activity. Chest pain may not always be present. Some patients feel pulsation in the neck veins. All this is accompanied by weakness, sweating, a feeling of fear and frequent urination. With a very high heart rate (200-300 or more beats per minute), dizziness and fainting are observed. All these symptoms disappear almost immediately after normal rhythm is restored. When the rhythm changes (from the correct rhythm to an arrhythmia and from an arrhythmia to the correct rhythm), nausea and vomiting may occur. Patients suffering from a permanent (chronic) form of MA stop noticing it. Complaints appear only with increased blood pressure, stress and physical activity, because the heart rate changes and arrhythmia reminds itself.

Complications of atrial fibrillation

Thromboembolism and stroke. In the presence of intracardiac thrombi, LA acts as a powerful provocateur of the development of thromboembolism in various organs. In AF, blood clots travel from the heart into the blood vessels of the brain and cause a stroke. Every seventh stroke develops in patients with MA.

Heart failure. MA in people suffering from mitral stenosis (narrowing of the mitral valve of the heart) and hypertrophic cardiomyopathy (thickening of the walls of the heart), against the background of heart failure, can lead to the development of cardiac asthma (an attack of suffocation) and pulmonary edema.

Dilated cardiomyopathy. MA against the background of heart failure provokes it and quickly leads to the development of dilated cardiomyopathy (enlargement of the cavities of the heart).

Arrhythmogenic shock. MA in the setting of heart failure can cause the development of arrhythmogenic shock (a sharp decrease in blood pressure, loss of consciousness and cardiac arrest).

Heart failure. AF (atrial fibrillation) can progress to ventricular fibrillation and cause cardiac arrest.

Diagnosis of atrial fibrillation is similar to that described above (ECG, echocardiography or ultrasound of the heart, Holter 24-hour monitoring, EPI and mapping, and also includes a conversation with the patient (they find out the probable causes of the arrhythmia, how long the person has been suffering from atrial fibrillation, how often and under what conditions the arrhythmia manifests itself) ), its examination (listen to erratic heartbeats and determine the pulse rate) and transesophageal electrophysiological study - a method of examining the heart that makes it possible to determine the source and mechanism of development of AF).

Treatment of atrial fibrillation

Only a doctor should prescribe medicine, select doses and restore rhythm!

The goals of drug treatment for AF are: restoration of the correct (sinus) rhythm of the heart, prevention of relapses (repeats) of an attack of AF, control of the heart rate and maintenance of the correct heart rhythm, prevention of thromboembolism. In case of AF, it is first necessary to treat the diseases that led to the development of arrhythmia.

Drug treatment of AF (atrial fibrillation) is similar to that described above and includes: antiarrhythmic drugs, beta blockers, anticoagulant therapy, metabolic drugs,

Surgical treatment of AF (atrial fibrillation):

• Radiofrequency ablation. In case of frequently recurring attacks or a chronic form of MA, they “cauterize” (using a special electrode) the area of ​​the heart responsible for conducting the impulse, thereby causing a complete blockade in the heart. After this, a pacemaker is installed, which sets the heart to the correct rhythm.
• Radiofrequency isolation of pulmonary veins. This is a method of radical elimination of MA (effectiveness is about 60%). The focus of “incorrect” excitation, located at the mouth of the pulmonary veins, is isolated from the atria.

Every year, new methods of surgical treatment of arrhythmias are developed, antiarrhythmic drugs are improved, and the number of side effects is reduced; Research continues to develop a universal antiarrhythmic drug. But all this does not give us the right not to be treated on time and correctly.

The longer an arrhythmia lasts, the more likely it is that it will remain for life. Do you need such travel companions? Get rid of them before it's too late...

Attention! All information in the article is provided for informational purposes only and cannot be taken as a guide to self-medication.

Treatment of diseases of the cardiovascular system requires consultation with a cardiologist, a thorough examination, prescription of appropriate treatment and subsequent monitoring of the therapy.

Cause various diseases and functional failures. This can be a subtle phenomenon or cause serious illness. Heart health should be treated with attention; if ailments occur, the right action would be to seek advice from 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 last for 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 with a retrograde movement upward to the atria and a natural movement downward, 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.

Read below about the reasons for the appearance of ectopic and other types of AV nodal rhythm.

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 intravenously, combining the drug with a glucose solution or
• atropine – used intravenously.

Medicines may cause unwanted effects:

• angina pectoris
• decrease in pressure,
• ventricular arrhythmias.

If these medications are not suitable for the patient, then the doctor may use aminophylline intravenously or in tablet form instead.

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

In case of rhythm disturbances caused by serious heart disease, measures are 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:

1. Use medications with caution:
   • reserpine,
   • digoxin,
   • morphine,
   • strophanthin,
   • antiarrhythmics.
2. Promptly treat heart diseases that can cause these disorders,
3. 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: