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

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

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

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

What are the indicators of cardiac activity?

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

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

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

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

4. External manifestations of heart activity.

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

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

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

Heart sounds- This sound phenomena, arising in the beating heart. There are two tones: I-systolic and II-diastolic.

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

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

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

Heart rhythm and factors influencing it. The heart rhythm, i.e. the number of contractions per minute, depends mainly on the functional state of the vagus and sympathetic nerves. When the sympathetic nerves are stimulated, the heart rate increases. This phenomenon is called tachycardia. When the vagus nerves are excited, the heart rate decreases - bradycardia. The rhythm of the heart can change under the influence of humoral influences, in particular the temperature of the blood flowing to the heart. Local irritation of the region of the right atrium with heat (localization of the leading node) leads to an increase in heart rate; when cooling this region of the heart, the opposite effect is observed. Local irritation by heat or cold of other parts of the heart does not affect the heart rate. However, it can change the speed of excitations through the conduction system of the heart and affect the strength of heart contractions.

The heart rate in a healthy person depends on age.

What are the indicators of cardiac activity?

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

Systolic, or stroke, volume of the heart is the volume of blood that comes from the ventricle in one systole. The size of the systolic volume depends on the size of the heart, the condition of the myocardium and the body. In a healthy adult at relative rest, the systolic volume of each ventricle is approximately 70-80 ml. Thus, when the ventricles contract, 120-160 ml of blood enters the arterial system.

Cardiac minute volume is the amount of blood that the heart pumps into the pulmonary trunk and aorta in 1 minute. The minute volume of the heart is the product of the systolic volume and the heart rate per minute. On average, the minute volume is 3-5 liters. Systolic and cardiac output characterizes the activity of the entire circulatory system.

Assessment of the functional state of the body, taking into account their level motor activity

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

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

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

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

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

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

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

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

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

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

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

Heart rhythm disturbances

Heart rhythm disturbances are a very complex branch of cardiology. The human heart works throughout life. It contracts and relaxes 50 to 150 times per minute. During the systole phase, the heart contracts, ensuring blood flow and delivery of oxygen and nutrients throughout the body. During the diastole phase it rests. Therefore, it is very important that the heart contracts at regular intervals. If the systole period is shortened, the heart does not have time to fully provide the body with blood movement and oxygen. If the diastole period is shortened, the heart does not have time to rest. Heart rhythm disturbance is a disturbance in the frequency, rhythm and sequence of contractions of the heart muscle. Cardiac muscle - myocardium consists of muscle fibers. There are two types of these fibers: working myocardium or contractile, conducting myocardium that provides contraction, creating an impulse to contract the working myocardium and ensuring the conduction of this impulse. Contractions of the heart muscle are provided by electrical impulses arising in the sinoauricular or sinus node, which is located in the right atrium. Electrical impulses then travel along the conductive fibers of the atria to the atrioventricular node, located in the lower part of the right atrium. The bundle of His originates from the atrioventricular node. He goes to interventricular septum and is divided into two branches - the right and left bundle branches. The branches of the His bundle, in turn, are divided into small fibers - Purkinje fibers, through which the electrical impulse reaches the muscle fibers. Muscle fibers contract under the influence of an electrical impulse in systole and relax in its absence in diastole. The frequency of the normal (sinus) contraction rhythm is about 50 contractions during sleep, at rest, to 150-160 during physical and psycho-emotional stress, and when exposed to high temperatures.

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

Extrasystole (extraordinary contraction)

Atrial fibrillation (completely irregular rhythm)

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

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

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

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

Endocardial (from the inner cavity of the heart)

Transesophageal electrophysiological research methods



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

Features of the phenomenon

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

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

In this case, the heart, under the guidance of impulses from the atrioventricular system, contracts 40 ÷ 60 times per minute. Passive impulses work 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. Negative manifestation affects insufficient blood supply heart, kidneys, 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,
  • in case ,
  • 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 junctional rhythm or the absence of problems.

Treatment

If observed sinus bradycardia and the nodal 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 fresh 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

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

Folk remedies

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

Recipe No. 1

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

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

The infusion is drunk in small sips for a month.

Recipe No. 2

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

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

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

Disease prevention

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

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 - change acid-base balance towards an acidic reaction can cause disturbances in the functioning of the heart. Diseases that initiate an increase in acidic environment, choose the right diet using expert advice.
   • Hyperkalemia – occurs when there is an increased level of potassium cations in the blood. Potassium is a mineral essential for kidney, heart and general condition. 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 junctional rhythm is caused dangerous violations, 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 which caused heart rhythm disturbances.

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

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 should mind their own business.

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 simple as possible, without going deep into physiological mechanisms occurrence 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 up 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 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, application medicines(caffeine, aminophylline).

Tachycardia displays work 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 muscle), cardiomyopathies (changes in the shape of the heart muscle), and heart size).

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 the load, the heart does not start beating strongly because it is accustomed to the load).

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(flu, viral hepatitis, sepsis, etc.), hypothermia (lowering body temperature); hyper-calcemia ( increased content calcium in the blood), hyperkalemia (increased potassium in the blood).

Causes of bradycardia associated with heart disease: myocardial infarction, atherosclerosis (deposition atherosclerotic plaques on the wall of the vessel, 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 in women occurs 2 times more often than in men, often causing a decrease 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: ischemic disease heart, acute myocardial infarction; mitral stenosis (narrowing mitral valve heart disease), 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 is a complication after extensive heart attack myocardium, 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 enlargement of the parts of the heart, loss of elasticity of the heart muscle, it ceases to contract adequately, blood stagnates inside the heart, or 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 structures and structures of the heart that affect its functioning and contribute to the development of arrhythmia;
• myocarditis - inflammatory disease cardiac 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. Overdose of cardiac glycosides, antiarrhythmic drugs, diuretics, beta blockers (drugs to regulate blood pressure and heart rate) leads to heart rhythm disturbances (arrhythmias).

3. Electrolyte disturbances(violation of 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 for a long time not manifest itself in any way, and the patient may not suspect that he has an arrhythmia until the doctor identifies the disease during normal medical examination or taking 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 heart rate, “fluttering” of the heart, extremely fast or, conversely, slow heartbeat, dizziness, shortness of breath, pain in chest 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 violations rhythm disturbances can lose consciousness, and patients who have truly life-threatening rhythm disturbances do not present 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(defects) 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.

Reception medicines- 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 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, a stroke. In third place, after the vessels of the heart and brain, are the blood vessels lower limbs.

Arrhythmia can cause the development of diseases such as myocardial infarction, cerebral stroke, thromboembolism pulmonary artery, thrombosis of intestinal vessels, thrombosis of vessels of the extremities with subsequent amputation, and also lead to sudden cardiac arrest. Diagnostics ECG arrhythmias(electrocardiogram) - recorded electrical activity heart, assess 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 suffered a heart attack myocardium; 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) - the most accurate and informative method determination of 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 special examination and determining the type of arrhythmia: from which part of the heart and under the influence of what causes did it arise? this state.

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. At intravenous administration antiarrhythmic activity appears 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 blocks (atrioventricular), thyroid diseases 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. Main function ECS is the imposition of 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; drug intoxication; overdose of cardiac glycosides; acute poisoning alcohol 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 strain).

MA forms by nature clinical course: paroxysmal - a first-time attack that lasts up to five days, usually less than a day; persistent - a condition when attacks recur periodically, the attack lasts more than seven days, but with effective treatment it is relieved immediately after 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 increases 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. At very high frequency heart rate (200-300 or more beats per minute), dizziness and fainting are noted. 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 arrhythmogenic shock (sharp decline blood pressure, loss of consciousness and cardiac arrest).

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

Diagnostics atrial fibrillation similar to that described above (ECG, echocardiography or ultrasound of the heart, Holter daily 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), his examination (listen to erratic heartbeats and determine the pulse rate) and transesophageal electrophysiological study is a method of studying the heart, which 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!

Goals drug treatment MA: restoration of the correct (sinus) heart rhythm, prevention of relapses (repeats) of an attack of MA, 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. With frequently recurring attacks or chronic form MAs “cauterize” (using a special electrode) the area of ​​the heart responsible for conducting the impulse, and thereby cause 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; 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, thorough examination, prescribing 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:

• coronary heart disease;
• 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, it is noted the following types arrhythmias:

• 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;
• upon admission strong tea, coffee, alcohol.

Tachycardia is often diagnosed in children preschool age. 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, resulting in a decrease in blood pressure 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 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 serious illnesses heart problems, 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 a mild form of bradycardia is practically not felt, but pathological form has certain symptoms. These include:

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

At severe forms bradycardia, to stabilize the heart rhythm, the doctor prescribes drug therapy. IN 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;
• irregular pulse;
• nausea;
• difficulty breathing.

Mer significant 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 required surgery, during which a pacemaker is installed.

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 lead to fatal outcome. 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, stressful situation, 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 physiological form tachycardia is not required, it is enough to exclude provoking factors. Pathological arrhythmia requires accurate diagnosis and therapy 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. Main causes: hypothyroidism, jaundice, alkalosis, overdose medications, infectious diseases.
• Intracardial. Develops due to damage to the sinus node. The causes are the following diseases: heart defects, heart attack, ischemia, cardiosclerosis.

On early stage There are no pronounced symptoms, only when the pathology develops, 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 it is required emergency treatment. With the development of extrasystole, patients note the following symptoms:

• Strong tremors;
• Sweating and hot flashes;
• "Somersault of the Heart";
• Feeling 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 stopping acute condition using 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 you to completely eliminate symptoms.

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, decreased physical endurance, discomfort in the heart area, angina attack, 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, blockers calcium channels, antiarrhythmic drugs.

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 departments heart muscle. There are these types of arrhythmia:

• Atrial blocks are characterized by slow conduction of impulses. Pathological condition sometimes confused with the development of bradycardia. There are left and right blockades, depending on the type of atrium. This violation rhythm 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, 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 it occurs extraordinary reduction heart 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. A violation occurs heart rate 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 referred to as permanent form arrhythmias. 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

More dangerous look deviations from the norm – supraventricular and ventricular tachycardia, which occur in both adults and children, both men and women. The disease is especially dangerous during pregnancy. No emergency here qualified assistance can't get by.

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 birth defects heart and 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 ultrasound examination 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 the use of 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 is 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 obvious signs functional arrhythmia. And even if expectant mother Having never suffered from heart disease before, being 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.

Irregularity of heart rhythm, normal percentage