The heart is the most important organ human body, performing the work of pumping blood. In a healthy person, the heart rhythm is always smooth and constant. Violation heart rate(ICD code 10 – I49) is also called arrhythmia. This disease is considered secondary and has its own distinctive features. Below are the symptoms accompanying heart rhythm disturbances, causes, and treatment of the pathology.

You can understand the mechanism of development of disorders if you carefully understand how the organ functions. In the sinus node (also called the pacemaker), a signal is generated, which in a split second reaches the atrioventricular node. During this period of time, the atria contract, and after further signal transmission, the ventricles. The coordinated work of all these parts is the basis for proper blood circulation.

The cerebral cortex is responsible for the number of contractions of the heart muscle over a certain period of time and their intensity. Slowing or speeding up the heartbeat is associated with different situations: excessive physical activity, stress, sleep. This happens under the influence of pituitary hormones and the vagus nerve.

In a normal state, the heart rate is in the range of 60-80 beats/min. At the same time, the heart beats evenly and calmly. The failure that arises in the described process can be expressed by a violation of the conductivity of the heart, the contractility of its muscles, and automatism. Sometimes these problems combine, leading to even worsening of the condition.

Increased or slow heart rate caused by natural causes and returning to normal after some time is not a disease. Failures that arise as a result of deviations in the functioning of other organs and systems are considered pathological and require urgent medical intervention.

Classification of arrhythmias

All heart rhythm disturbances are classified according to the course of the disease, etiology of development and characteristic features. The following forms of pathology are distinguished:

In addition to slowing and increasing heart rate, there are three more types of rhythm disturbances:

1. Paroxysmal tachycardia. The disease is characterized frequent attacks sharp increase in heart rate. Sometimes the pulse can reach 140-200 beats/min. and higher. Contractions of the heart muscle occur rhythmically without interruption.
2. Rhythm disturbances such as ventricular extrasystole. Extraordinary excitation of the heart muscle, provoked by an additionally formed node, which takes on the functions of a pacemaker. This formation is located on the walls of the ventricles or atria and causes the heart to perform unnecessary contractions. This type arrhythmias can occur as bigeminy - when every second contraction of the muscle is provoked by something other than the sinus node, and as trigeminy - every third contraction.
3. Atrial fibrillation (atrial fibrillation). This condition is the most severe rhythm disorder. This type of arrhythmia occurs in the presence of chronic diseases cardiovascular system. The pathology is characterized by irregular and too frequent (rare) excitations of the heart muscle, its atria, and ventricles. At the same time, contractions are heterogeneous in strength and frequency, and the duration of the cycle fluctuates over large intervals. Depending on the heart rate, there are three types of atrial fibrillation: bradysystolic, normosystolic and tachysystolic.

Causes of pathology

The main factor provoking deterioration of cardiac activity is deviations in the electrolyte composition of the blood. An imbalance of the microelements magnesium, potassium and sodium as a result of the development of inflammation, hyperthermia, after overheating, hypothermia and many other conditions leads to one-time episodes of rhythm disturbances. After the underlying disease is eliminated, heart rate and rhythm return to normal.

The risk group for the development of arrhythmias are patients:

Severe forms of arrhythmia may occur against the background of certain concomitant diseases. This includes pathologies:

• cardiovascular system (heart attack, hypertension, heart failure, ischemia, cardiosclerosis, cardiomyopathy, endocarditis, myocarditis, heart defects);
• neurological nature (brain injuries, neuroses, VSD, circulatory disorders);
• endocrine glands (problems with the adrenal glands, diabetes, hyper-, hypothyroidism);
• gastrointestinal system ( peptic ulcer, cholecystitis, pancreatitis).

If it is not possible to establish the cause of the arrhythmia, an idiopathic cardiac arrhythmia is diagnosed and symptomatic treatment aimed at eliminating failures.

Symptoms of heart rhythm disturbances

Quite often, arrhythmias are practically asymptomatic, and patients learn about abnormalities in the heart only after undergoing an electrocardiogram. Heart rhythm disturbances are accompanied by symptoms, which doctors divide into two large groups, depending on the effect of the pathology on cardiac activity: it speeds up or slows down the work of the heart muscle. Patients suffering from tachycardial arrhythmias talk about feelings of interruptions in the functioning of the heart, and when the contraction slows down, deviations in the circulatory system appear.

To make a diagnosis, pay attention to general signs all arrhythmias:

Depending on the type of disorder, all symptoms vary in severity and can occur in combination. The most dangerous condition is atrial fibrillation, since there is a high probability of cardiac arrest during an attack.

Diagnostics

The most common diagnostic method detecting arrhythmias is an electrocardiogram. The graph clearly identifies deviations. In addition to the ECG, the patient may be prescribed other instrumental methods research:

In addition, cardiac ultrasound and magnetic resonance imaging may be required. These methods make it possible to identify abnormalities in the structure of the heart and diagnose tumor formations that caused arrhythmia.

Treatment

Only a doctor should treat all types of arrhythmias. Based on the results of the examination, a detailed examination, a treatment regimen is drawn up, including taking medications in conjunction with therapeutic exercises, diet. Sports activities – best way increase endurance, improve general condition patient, strengthen the heart muscle.

If there are disturbances in the heart rhythm, nutritional correction is necessary. Fried, smoked, too fatty, and salty foods should be excluded from the diet. Food is best prepared by regular boiling or using a steamer. It is worth giving up confectionery products, and instead diversify your diet with vegetables and fruits.

You should not strain your body with excessive stress. Regular exercise, walking fresh air – best option for patients with arrhythmia. Over time, the load can be gradually increased.

Drug treatment

Elimination of rhythm disturbances is carried out with special blockers. The principle of action of such drugs is to prevent the influence of certain factors on the blood vessels and muscle of the heart. Among the most effective, it is worth highlighting means that block:

Choose suitable medicine In case of cardiac arrhythmia, only a doctor should treat the pathology. Independent selection of antiarrhythmic drugs can lead to a deterioration in the patient’s condition and provoke the development of complications.

In addition, for arrhythmias, vitamin and mineral complexes are prescribed to restore electrolyte balance blood, as well as cardiac glycosides. The action of the latter is aimed at reducing heart rate and restoring the rhythm of the sinus node.

Surgical intervention

If it is not possible to restore normal heart function with the help of medications, then surgery will be required. Surgical intervention is necessary to relieve arrhythmia and reduce the risk of death. Several different techniques can be used for this.

Average service life electronic device is 8-10 years, after which it requires checking and replacing the batteries. When a device becomes obsolete, it is replaced with a new one.

Traditional methods of treatment

Medicinal herbs can be an excellent addition to the main course of treatment for cardiac arrhythmias. However, they should not completely replace prescribed medications. The following plants are considered the most effective:

The drug course of therapy can last six months or more. Folk remedies used at the end of treatment for prophylaxis.

Features in children and adolescents

Heart rhythm disturbances in children may occur due to congenital anomalies heart development and acquired. Perinatal pathologies diagnosed in newborns account for no more than 25% of the total number of diseases; in other cases, disorders develop due to restructuring child's body during the period of growth.

Arrhythmias are almost always asymptomatic in children. Their identification usually occurs with standard medical examinations. Typically, such arrhythmias are not accompanied by persistent disturbances in cardiac activity, and therefore are easily amenable to drug correction.

Arrhythmia can develop in the fetus during pregnancy. There can be many reasons for this: unbalanced diet, chronic diseases in a woman, disruptions in metabolic processes, bad habits. Treatment in this case should only be prescribed by a doctor.

Complications

In the absence of necessary therapy against the background of arrhythmias, serious and dangerous consequences may develop:

• myocardial infarction due to lack of oxygen in the blood and tissues;
• ischemic stroke due to thrombosis in the cardiac cavity;
• thromboembolism of the main pulmonary artery;
• collapse (presyncope, sharp decrease in blood pressure);
• ventricular fibrillation (necessary urgent Care).

Forecast

If pathological changes are absent in the structure of the heart, the prognosis for the life of patients with arrhythmia is quite favorable. Most rhythm disturbances respond well to drug treatment. In other situations, the prognosis depends on the type, severity of the disease and the presence of concomitant pathologies. With an uncomplicated course, patients of military age are subject to recruitment into the army.

Heart rhythm disturbances (arrhythmias) are conditions in which the frequency, rhythm and sequence of contractions of the heart muscle changes.

Normally, these processes are regulated by the conduction system of the heart. The electrical impulse is generated in the sinus node, which is located in the right atrium. From there, the impulses go to the next node, located between the atrium and the ventricle, and then along the bundle of His and its legs - to the right and left ventricles. As a result, cardiac contraction occurs.

Heart rhythm disturbances can be caused by changes that occur in any part of the conduction system. Accordingly, atrial, atrioventricular and ventricular arrhythmias are distinguished.
More often rhythm disturbances occur in various functional and organic diseases of the cardiovascular system, endocrine disorders (and primarily in diseases thyroid gland), autonomic disorders, intoxications.

Symptoms of heart rhythm disturbances

• Palpitations (a person feels that the heart is beating loudly in the chest)
• Increased heart rate more than 90 beats per minute (tachycardia) or slower than 60 beats per minute (bradycardia)
• A feeling of periodic “fading” of the heart, interruptions in its work - with extrasystole
• A sudden disruption of the heart rhythm (the heart is “pounding furiously in the chest”) - an attack of paroxysmal tachycardia
• The appearance of dizziness, general weakness, fainting due to heart rhythm disturbances
• Arrhythmia may be accompanied by pain in the heart area, shortness of breath
• Often concomitant neurotic disorders develop: anxiety, a feeling of fear of death, panic

Main types of arrhythmia

• Tachycardia is an increase in heart rate at rest above 90 beats per minute. This condition often occurs normally in a healthy person during physical and psycho-emotional stress and quickly passes after a short rest and relaxation. Persistent tachycardia appears in acute period infectious diseases(including influenza and acute respiratory infections), heart diseases (myocarditis, heart failure), intoxication, anemia
• Paroxysmal tachycardia is a sudden attack of rapid heartbeat with a frequency of 140-240 beats per minute (“rhythm failure”), which occurs under severe stress and heart disease. An attack of cardiac arrhythmia may spontaneously end in a few seconds or minutes, or it may continue for hours, worsening general well-being, accompanied by weakness, fainting and without timely assistance, death may occur
• Bradycardia is a decrease in heart rate to 60 beats per minute or lower. In healthy people, bradycardia can occur during rest, during sleep, and also during on an ongoing basis in well-trained individuals involved in sports (especially runners, rowers, swimmers, skiers). A heart rate of 40-60 beats per minute may be a sign of vegetative-vascular dystonia, organic heart disease (myocarditis, cardiosclerosis, myocardial infarction), hypothyroidism, some viral diseases, intoxications. With heart blocks, the heart rate can often be below 40 beats per minute. This state represents real threat life without timely installation of a pacemaker ends sadly.
• Atrial fibrillation is an abnormal heart rhythm caused by atrial fibrillation. In this case, the pulse varies in filling and frequency and varies from 100 to 150 beats per minute. The cause of atrial fibrillation is mitral heart defects, angina pectoris, thyrotoxicosis, alcoholic cardiomyopathy. Without treatment, atrial fibrillation often leads to the formation of blood clots and the development of pulmonary embolism, coronary and cerebral circulation disorders.
• Extrasystoles are periodic extraordinary contractions of the heart. These heart rhythm disturbances most often occur, both in healthy people and in intoxications, neurotic disorders. Extrasystoles can be atrial, atrioventricular, or ventricular. With rare functional extrasystoles, no treatment is usually required. Frequent (more than 5 extrasystoles per minute), polymorphic, early and other potentially dangerous extrasystoles require emergency care.

Diagnosis of heart rhythm disturbances

• Study of anamnesis, complaints, objective medical examination with examination of the pulse (its frequency, rhythm, filling) on ​​radiation and carotid arteries, its comparison with heart contractions during auscultation
• Electrocardiographic examination (ECG), including under load (bicycle ergometry, treadmill test)
• Long-term ECG recording (Holter monitoring)
• Electrophysiological study of the heart (intracardiac or transesophageal ECG)
• Laboratory research (study electrolyte metabolism, hormonal status etc.)

About the need for treatment of arrhythmia, recommended medications, possibility of use surgical intervention Your doctor will tell you in detail. Along with the recommendations of a cardiologist, it can be used, with his consent, in case of heart rhythm disturbances and medicinal herbs, acupressure, exercises physical therapy. These methods will be discussed in the following articles.

Heart rhythm disturbances: types, causes, signs, treatment

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

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

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

Different types of rhythm disturbances occur in different percentages:

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

Nevertheless, Disturbances in the functioning of the sinus node are even more common, in particular, and those that arose without heart pathology. Probably every inhabitant of the planet has experienced stress caused by stress or emotions. Therefore these types physiological abnormalities have no statistical significance.

Classification

All rhythm and conduction disorders are classified as follows:

1. Heart rhythm disturbances.
2. Conduction disorders in the heart.

In the first case, as a rule, there is an acceleration of the heart rate and/or irregular contraction of the heart muscle. In the second, the presence of blockades is noted varying degrees with or without slowing down the rhythm.
Generally The first group includes disorders of the formation and conduction of impulses:

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

Causes of heart rhythm disturbances

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

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

Diseases that cause rhythm disturbances

Pathology of the cardiovascular system occurring against the background of:

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

Non-cardiac diseases:

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

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

1. Obesity,
2. Bad habits
3. Age over 45 years,
4. Concomitant endocrine pathology.

Do cardiac arrhythmias manifest themselves in the same way?

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

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

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

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

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

How to diagnose pathology?

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

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

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

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

Additional diagnostic methods usually include the following:

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

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

Treatment of rhythm disturbances

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

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

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

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

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

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

Are there possible complications of heart rhythm disturbances?

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

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

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

In a small number of cases, the patient suddenly develops rhythm disturbances, one of the complications and death. This condition is included in the concept of sudden cardiac death.

Forecast

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

Heart rhythm disturbances (arrhythmias)

Contractions of the heart muscle produce electrical impulses that are conducted into the heart tissue called the cardiac conduction system. Any deviation from of a certain order contractions of cardiac muscle cells in medicine are called arrhythmia, or rhythm disturbance. Arrhythmias are different, and therefore let’s talk about what a heart rhythm disorder can be, treatment, and the causes of its occurrence.

Arrhythmias are distinguished by their occurrence in different parts of the heart and are divided into atrial, sinus and ventricular.

Abnormal heart rate

Deviations in the rhythm of the heart are characterized by heart rate and, depending on this, the following are identified:

tachycardia, at which the pulse rate is above 80 beats per minute. Tachycardia is noted as a normal reaction to physical or emotional stress, to an increase in temperature (one degree above normal increases the frequency of beats by 10 more). The concern is caused by tachycardia that occurs under normal conditions, which indicates serious deviation in the work of the main body and urgent appeal see a cardiologist for qualified help;

bradycardia, this condition is characterized by a decrease in heart rate to 55-60 beats per minute. It occurs in absolutely healthy people in a state of complete rest and relaxation (as a rule, it is more common in athletes). It is worse when bradycardia turns into bradysphygmia, when a rather rare pulse is noted against the background of a normal frequency.

IN separate group highlight:

paroxysmal heart rhythm disturbances(from the word paroxysm - a sudden condition, attack). Such an attack is expressed in extremely rapid heartbeat, and it is impossible to count the number of beats in one minute. Moreover, such a beat can be both rhythmic and non-rhythmic. Studies have found that the pulse can exceed 200 beats per minute. During an attack, the person’s general condition deteriorates significantly: weakness, nausea, malaise, and even quick loss consciousness. The attack begins and ends suddenly. Any arrhythmia is a danger signal, and paroxysmal arrhythmia is the most serious and in some cases requires urgent medical attention;

extrasystole, at which in normal rhythm the work of the heart interferes with premature contraction. This disorder is often a consequence of vegetative-vascular dystonia, previous myocarditis, tonsillitis, the result of smoking or a sudden stressful situation;

refers to the most common type of arrhythmias, when one phase of the work cycle disappears - atrial contraction. As a result, muscle fibers lose the ability to work synchronously, and the atria twitch chaotically, as if flickering.

Causes of arrhythmias

Medical professionals distinguish between heart rhythm disturbances that are caused by organic (or irreversible) damage to the myocardium and the so-called functional disorders(with quite healthy heart). Adverse events of an organic nature occur when:

Hemodynamic heart defects,
coronary ischemia,
hypertension,
heart failure,
toxic effects,
after viral infections,
hormonal changes,
surgeries on the lungs and heart,
adolescence.

Treatment of heart rhythm disorders

Self-medication for the considered health deviations is contraindicated; it is strongly recommended to seek qualified help from cardiologists, who, based on research using the latest modern equipment, will provide correct diagnosis and prescribe adequate treatment.

Treatment is carried out both on an outpatient basis (for minor short-term disorders), and in a hospital setting or intensive care unit in particularly complex cases.
Treatment of disorders is carried out using electrophysiological techniques:

Defibrillation,
catheter ablation,
electrocardiostimulation, etc.

In some cases, the patient is advised to use a pacemaker.
Also, the basis for the treatment of arrhythmias is the use of medicines, a wide range of which is now produced by the modern pharmacological industry.

The heart is the basis of the body’s functioning, therefore any failure should not go unattended: when the first symptoms appear, you must immediately contact medical institution to the doctors.

Extrasystole is a fairly common disorder, especially when it comes to elderly patients. This condition is accompanied by a disturbance in normal heart rhythm. And today that's all more people are interested in questions about what causes such a problem and how dangerous it can be to health.

Extrasystole - what is it?

Today, many clinic patients face a similar problem. So what is extrasystole? This is a disorder that is associated with certain disorders. In such a disease, extraordinary contractions (systoles) are observed either of the whole myocardium or of its individual parts (for example, atria, ventricles).

Is extrasystole normal or a threat to health?

Of course, today many people face a similar problem. So how dangerous can these disorders be? In fact, extraordinary contractions can and, in fact, occur at any age. For example, young people often complain of a feeling of strong heart beat, this is extrasystole. Moreover, according to statistics, about 80% of people over fifty years of age suffer from periodic “unscheduled” shocks from time to time.

What causes systole? With some disorders of blood vessels, the conduction system changes: so-called ectopic foci, areas increased activity. Most often, such a disorder appears in the conduction tracts of the ventricles, atria, and atrioventricular node. It is these ectopic foci that generate impulses that trigger the contraction mechanism of the heart during its relaxation phase (diastole). This is what extrasystole looks like. This, by the way, can be extremely dangerous.

Of course, occasional impulses do not pose a serious threat to human health. Nevertheless, they signal the presence of a particular problem; experts recommend that such patients pay more attention to their lifestyle, monitor their diet and undergo regular examinations.

On the other hand, too frequent extrasystoles affect the functioning of the entire body. Indeed, as a result of multiple extraordinary contractions, the release of blood decreases, which leads to a decrease in blood flow in the brain and coronary vessels. In such cases, cardiac extrasystole is extremely dangerous, as it can lead to myocardial damage, fainting, or even sudden death person.

Heart rhythm disturbances: causes

In fact, there are many factors under the influence of which an attack of extrasystole can occur. For example, abnormal heart rhythms may be associated with exposure to certain chemicals, including certain foods, alcoholic beverages, narcotic substances, even strong tea or coffee. Smoking is also a risk factor. Functional cardiac extrasystole can also occur in women during menstruation.

In addition, the causes include some diseases, including spinal osteochondrosis (especially cervical spine), as well as vegetative-vascular dystonia, neuroses of various origins and others.

There are other factors under the influence of which cardiac arrhythmias are observed. The reasons may be associated with organic lesions of the myocardium and conduction system. For example, attacks often occur in patients with various defects, as well as against the background of cardiosclerosis, cardiomyopathy, coronary artery disease, inflammatory diseases(myocarditis, pericarditis). Risk factors also include diseases such as hemochromatosis, sarcoidosis, amyloidosis, since in such conditions there is a high risk of heart damage.

An attack of extrasystole often occurs against the background of severe fever. In addition, certain medications may have the same effect, including those medicines, which contain caffeine, ephedrine, aminophylline, novodrine, as well as tricyclic antidepressants, diuretics and glucocorticoids.

Severe stress, physical overexertion, disruption of mineral content in myocardial cells - all this can provoke an attack of increased contraction of the heart muscle.

Classification of violations

Of course, today there are many classification systems that make it possible to understand what extrasystole is - for example, depending on the location of the ectopic focus. Most often, rhythm disturbances are observed in the ventricles; more than 60% of patients see a doctor with this diagnosis.

In 25%, atrial extrasystole is observed. Much less frequently, foci of rhythm disturbances occur in the atrioventricular junction; in such cases they are called atrioventricular. In addition, there are various combinations the forms described above.

In some cases, the main sinus rhythm is maintained simultaneously with the formation of an ectopic focus; this disorder is called parasystole. Violations are classified according to the number of foci of excitation; they can be either mono- or polytopic.

If there are two extrasystoles in a row, then they are called paired. If extraordinary contractions follow the pattern of “more than two in a row,” then this is a burst extrasystole. In addition, such violations are divided into groups depending on the moment of their occurrence during heart rate(these are early, middle and late). If we take into account the frequency of occurrence of extrasystoles, they can be rare (extraordinary contractions less than 5 per minute), average (from 6 to 15) or frequent (for example, frequent ventricular extrasystole is accompanied by more than 15 extraordinary contractions of the ventricle per minute).

Naturally, there is a system by which extrasystole is classified depending on its origin. For example, heart rhythm disturbances may be associated with organic or toxic tissue damage or physiological disorders.

How does extrasystole manifest?

In fact, not all patients have signs of heart disease; sometimes rhythm disturbances are detected by chance during a routine electrocardiogram. Moreover, there are many factors that can influence the number and intensity of signs present. For example, patients with organic myocardial lesions can quite easily tolerate attacks of extrasystole, while clinical picture in people with vegetative-vascular dystonia it looks much more severe.

Most often, the extrasystole is subjectively felt as a strong push, even a heartbeat against the chest from the inside. In some cases, patients report that they feel as if the heart is “turning over” or even “tumbling.” Such sensations are associated with a strong, energetic and sharp contraction of the myocardium.

In some patients, an attack of extrasystole is somewhat reminiscent of the symptoms of coronary artery disease or angina pectoris. Extrasystole, which is associated with functional changes, often accompanied by other signs. For example, patients complain about increased sweating, feeling of lack of air, hot flashes, severe, sudden weakness, discomfort. Sometimes even inexplicable fear arises.

There are other signs of heart disease. For example, dizziness. Frequent atrial or ventricular extrasystole is accompanied by a decrease in blood ejection, which causes this symptom. In patients with cerebral atherosclerosis, such rhythm disturbances can lead to circulatory disorders, which is accompanied by paresis, fainting, aphasia and other disorders. In any case, if such conditions occur, you should immediately consult a doctor, as the consequences can be extremely dangerous and severe.

Extrasystole in childhood

In fact, extrasystole in children is diagnosed quite often. A child of any age can suffer from it; sometimes a similar disorder is registered during intrauterine development. According to statistics, more than 75% of children suffer from heart rhythm disturbances to one degree or another. And for last decade The number of children with similar disorders has increased significantly.

What are the main causes of heart rhythm disturbances in children? First of all, it is worth noting congenital defects and cardiomyopathies. In addition, the most common include infectious myocarditis, rheumatic carditis, and genetically determined diseases.

In some cases, the disease is associated with certain endocrine and nervous system. For example, hypothyroidism or diabetes mellitus. On the other hand, chronic inflammatory and infectious processes, as well as vitamin deficiency and deficiency of certain elements, too much physical or emotional stress. In any case, such a disorder requires proper treatment. As for forecasts, an average or rare extrasystole, which is not accompanied by organic heart damage, is considered relatively safe form diseases.

Modern diagnostic methods

Naturally, there are many diagnostic methods, including ECG. Extrasystole in such a study is usually clearly visible. However, this is not where the diagnostic process begins. To begin with, the doctor must conduct a full examination, which begins with collecting information. The patient must tell the specialist what symptoms he has, how intense his attacks are, and how often they occur.

It is extremely important to determine the cause of heart rhythm disturbances. For this purpose, anamnesis is collected; the doctor must know about the presence of other diseases and medications. The fact is that the choice largely depends on the cause and nature of lesions of the conduction system of the heart. effective methods treatment.

After this, the doctor usually palpates the pulse on the radial artery. In case of extrasystole, a specialist can replace pulse wave which occurs prematurely. Sometimes, on the contrary, extrasystole is accompanied by episodes of “loss” of the pulse, which is observed when the ventricles are insufficiently filled during diastole.

Next is carried out. When listening, you can notice the presence of premature І and ІІ tones. By the way, with such a disease, the first sound is intensified, which is associated with a slight filling of the ventricles. But the second tone, on the contrary, is weakened, since the release of blood into the aorta and pulmonary artery much less.

After this, the doctor will probably send the patient to do a heart cardiogram. This is one of the most precise methods research. In some cases, a so-called Holter ECG is performed. What is this procedure? A special portable device is attached to the patient’s body, which records the heart rhythm for 1-2 days. Along with this, the patient keeps an activity diary in which he describes his feelings and actions taken. Similar research used if it is necessary to find out what provokes an attack of extrasystole.

If heart rhythm disturbances are not observed at rest, carry out additional tests- this is a bicycle ergometry and treadmill test. Such studies make it possible to measure indicators ( blood pressure) and do an ECG during physical activity (for example, walking on a treadmill, riding an exercise bike). If organic myocardial lesions are suspected, patients are recommended to undergo ultrasound and MRI of the heart.

How is extrasystole treated?

As already mentioned, the treatment of cardiac extrasystole directly depends on the causes of its occurrence. For example, if a rhythm disturbance is associated with taking some medications, then, of course, they must be discontinued. If the reasons lie in a disorder of the digestive or cardiovascular systems, then they need to be treated first, and the attacks of extrasystoles will disappear along with the primary disease.

In some cases, diagnostics helps to understand that rhythm disturbances arose against the background of nervous overstrain. Such patients are referred for consultation to a neurologist and, as a rule, are prescribed mild sedatives or sedative herbal mixtures.

Single and rare attacks of extrasystole do not require specific drug treatment, patients are only advised to follow the principles healthy image life and undergo repeated examinations from time to time.

If attacks occur frequently and are accompanied by shortness of breath, with strong blows and weakness, then, most likely, the doctor will select suitable medications. As a rule, to eliminate violations, so-called drugs are prescribed, including lidocaine, sotalol, procainamide, diltiazem, quinidine, cordarone, mexilen. Under no circumstances should you use these drugs yourself, since the dosage and regimen are purely individual. Moreover, sometimes medications are started to be administered during Holter ECG monitoring, this makes it possible to understand whether the drug really works as it should and whether it will cause even more harm to the body.

For benign extrasystoles, medications are taken until the attacks completely disappear, or at least their number is reduced to a minimum. After this, the amount of drugs begins to be gradually reduced, and then they are completely canceled. As a rule, such treatment lasts several months. But with malignant forms of the disorder, patients take antiarrhythmic drugs throughout their lives.

In cases where such drugs do not work, or the patient is intolerant to them, other treatment methods are used, in particular. By the way, the indication for this form of therapy is the ventricular form of extrasystole, which is accompanied by 20-30 thousand attacks per day. This is a surgical procedure that is classified as minimally invasive methods. It is carried out using a special endovascular catheter, which transmits high-frequency currents. Thus, the electrode acts precisely on areas of the heart where conductivity is impaired. Using a similar procedure, it is possible to block the transmission of pathological, “wrong” impulses and restore normal sinus rhythms.

Consequences of heart rhythm disturbances and prognosis for patients

Prognosis for patients directly depends on the course of the disease and the presence related violations. For example, extrasystoles that develop against the background of a heart attack, cardiomyopathy and organic lesions myocardium.

In any case, the lack of qualified and timely assistance can lead to a lot of complications. Despite the fact that in most cases extrasystole is benign, sometimes others develop against its background dangerous diseases, including paroxysmal tachycardia, atrial fibrillation and atrial flutter. Similar conditions may lead to sudden death of the patient.

There are some other complications that accompany extrasystole. These are, first of all, problems with blood circulation and tissue nutrition. Indeed, with repeated extrasystoles, the volume of blood ejected by the heart decreases significantly. This leads to oxygen starvation and disruption of normal blood circulation. Often extrasystole leads to the development chronic failure renal, coronary and cerebral vessels, which entails even greater complications.

Prevention methods

Of course, the patient similar problems must be registered with a cardiologist and undergo regular examinations. The main method of prevention dangerous complications extrasystole is correct treatment primary disease. Sick people must take medications prescribed by a specialist, as well as follow the schedule and treatment regimen. In addition, regular heart rate studies are mandatory, as this gives the doctor the opportunity to monitor the rate of development of the disease and the effect of prescribed medications.

Surely patients will need to radically reconsider their lifestyle. Any heart disease requires special diet. Quitting smoking, drinking alcohol and caffeine is mandatory. And, of course, moderate but regular physical activity and walks in the fresh air will be useful for the functioning of the cardiovascular system.

We should also talk about first aid. An attack of extrasystole usually occurs suddenly. The patient should lie down and calm down. It is also recommended to unbutton the top buttons of the shirt, loosen the tie and belt, in short, remove all possible obstacles that interfere with breathing. If the attack was caused by stress, then it is allowed to take a small amount sedative. It is best to call an ambulance, as the consequences of extrasystole can be dangerous.