- Classification of atrial fibrillation
- Causes of atrial fibrillation
- Symptoms of atrial fibrillation
- Complications of atrial fibrillation
- diagnostic methods
- treatment of cardiac arrhythmias
Atrial fibrillation is a disturbance of the normal heart rhythm, manifested chaoticand part of a wave of excitation and contraction of atrial myocardium.The frequency of atrial contraction may reach 300-600 per minute, while the ventricular myocardium at the excitation wavelength does not apply.The main problem of this pathological condition becomes a significant increase in the risk of blood clots in the cavities of the heart, which can lead to ischemic stroke.Permanent atrial fibrillation can lead to serious disorders of hemodynamics and progression of circulatory failure.
data of medical statistics say that this version of arrhythmia is the most common heart rhythm disturbance - every third patient, hospitalized for arrhythmias, namely atrial fibrillation suffer.The likelihood of developing the disease increases with age.
Classification of atrial fibrillation
Depending on the clinical course, the causes of development and the type of rhythm disorders distinguish:
the embodiment of flow:
- paroxysmal (transient MA) - an attack lasts 1-7 days
- persistent (transientMA) - an attack there are more than 7 days, but it lends itself
- electrophysiological treatment of a chronic (permanent form of MA) - an attack can not be rectified even after cardioversion;
in the number of attacks:
- first emerged attack of atrial fibrillation;
- recurrence of cardiac arrhythmias;
the type of rhythm disorders:
- atrial fibrillation;
- Atrial flutter;
frequency of ventricular contraction:
- tachysystolic - frequency rate (pulse) is over 90 beats per minute;
- normosistolicheskaya - heart rate remains within the 60-90 per minute;
- bradisistolicheskaya - from the patient's heart rate less than 60 per minute.
attack The occurrence of atrial fibrillation disrupts the normal hemodynamics and blood flow in the chambers of the heart - the inefficient atrial contraction leads to incomplete filling of the ventricles, therefore, cardiac output decreases sharply.
Causes of atrial fibrillation
Causes of atrial fibrillation may become as heart disease and circulatory system, and pathological processes that occur in other organs and body systems.
From cardiac causes of AI should be allocated coronary heart disease and its complications (myocardial infarction, cardio), acquired valvular heart disease, cardiomyopathy, myocarditis, hypertension.
Because extracardiac reasons to be mentioned hyperthyroidism, thyroid disease with excessive production of its hormones, poisoning the body of alcohol and nicotine agonists overdose, cardiac glycosides, violations of water-electrolyte metabolism, psychological overload.
Symptoms of atrial fibrillation
clinical picture of the disease depends on the type of arrhythmia, myocardial condition, especially the psychological status of the patient, presence or absence of pathological changes in the heart valves.
When tahisistolicheskoy form of atrial fibrillation patients complain of general weakness pronounced, pronounced acceleration of the heart rate, shortness of breath, pain and feeling of disruptions in the heart, decreased exercise tolerance.
In the initial stages of the disease atrial fibrillation attacks occur periodically suddenly appear and disappear on their own, but as the deterioration of the heart muscle occurs negative dynamics.It is not always the patient suspects about the presence of his version of the rhythm disorders - diagnosis is based on the evaluation of the electrocardiogram (ECG).During an attack may occur pronounced dizziness, fainting - these symptoms disappear after a cupping of an attack.When a permanent form of atrial fibrillation patients "get used" to the existing rhythm disturbances, and stop paying attention to it.
a clinical examination of the patient the doctor may suspect the existence of atrial fibrillation is when the heart rate (heart rate) and heart rate, calculated by the pulsation of the radial artery, differ by more than 5 heartbeats.The ECG changes the shape of the heart curve - instead of the P wave on the tape are only visible chaotic and unsystematic excitation wave in the atria.to the content ↑
Complications of atrial fibrillation
most often against this disease develop progressive circulatory failure and thrombotic complications.Reduced pumping function of the heart can cause arrhythmogenic shock, which requires immediate treatment.In some cases, atrial flicker can pass into ventricular fibrillation leading to the death of the patient.to the content ↑
diagnostic methods for diagnosis is necessary to conduct a comprehensive examination of the patient - it should include all the necessary laboratory tests.From the instrumental methods of diagnosis may be necessary:
- ECG monitoring;
- tests with physical or drug load on the background of ECG - necessary for the identification and selection of effective antiarrhythmic drugs;
- holding transesophageal ECG;
- magnetic resonance imaging.
treatment of cardiac arrhythmias
In the treatment of atrial fibrillation is necessary to direct the efforts on:
- restoration and maintenance of normal sinus rhythm;
- prevent arrhythmia recurrence;
- control of heart rate;
- prevention of thromboembolism;
- treatment of the underlying disease, against which there was atrial fibrillation (if possible).
antiarrhythmic therapy should appoint a qualified cardiologist - and must be treated in a hospital, under the control of hemodynamic and ECG.
For the treatment can be used antiarrhythmic drugs of different clinical and pharmacological groups, cardiac glycosides.
In the absence of the effect of antiarrhythmic therapy shown holding electrical cardioversion, the use of surgical methods.