Atrial fibrillation is the second in frequency after the beats of the heart rhythm disturbance. It includes two types of atrial arrhythmias:
auricular fibrillation
atrial flutter.
Flicker (atrial) fibrillation - a twitching of individual muscle bundles atrial muscle. As a result, the total effective reduction of the atrium is absent. In the atrioventricular connection, large amounts of electrical impulses. Some of them retained the remaining muscles reach the ventricles, causing them to cut.
The rhythm of these contractions unstable. The number of ventricular contractions can be large, up to 200 per minute. This form of atrial fibrillation is tahisistolicheskoy. In case of violation of the electrical impulse in the atrioventricular junction to the ventricles can reach a much smaller number of pulses. Then the frequency of ventricular is less than 60 beats per minute. This form is bradisitolicheskoy.
When atrial fibrillation is not a so-called atrial addition, when cutting the atria, the blood is injected into the ventricles. Effective reduction of the atria is not, so the ventricle in diastole phase is completed only by the action of the free flow of blood from the atria to the ventricles. With frequent ventricular contractions of the muscles time to time the ventricles do not have time to fill and then under reducing emissions of blood into the aorta does not occur. For atrial fibrillation leads atherosclerotic heart disease, myocardial infarction, heart diseases, especially rheumatic fever, thyroid disease, poisoning, cardiomyopathy, potassium deficiency. Promote the development of atrial fibrillation, smoking, mental and physical stress, alcohol consumption.
Atrial fibrillation may be constant or occur intermittently. At the same time patients feel palpitations, "fluttering heart" cuts to the heart. Sometimes atrial fibrillation can occur unnoticed by the patient. Auscultation listened irregular heartbeat, a different volume. Pulse spasmodic, a different filling. There is a so-called pulse deficit - the number of heartbeats per minute is greater than the number of pulse waves. This is because not every heartbeat ends in the ejection of blood into the aorta. An electrocardiogram showed no signs of reduction in atrial, ventricular complexes are chaotic.
Atrial flutter - a frequent reduction of the whole muscle fibrillation, following each other almost without interruption. Virtually absent diastolic pause - a time when the atrial muscle relaxes. As the atrium is almost always in a state of systole, the filling of the blood is difficult, and it does not help fill the ventricles with blood. The frequency of atrial reduction can be up to 220 per minute. Go to the ventricles through the atrio-ventricular connection can be up every second, third or fourth pulse, while the rhythm of ventricular permanent - and this is the correct form of atrial flutter.
If the conductivity of the atrioventricular node changes, the rhythm of ventricular chaotic and thus a form of atrial flutter is incorrect. With the correct form of atrial flutter at a frequency of about 60 complaints per minute the patient may not be. Auscultation auscultated normal rhythm. Instead of the wave on the electrocardiogram, the corresponding reduction in fibrillation, atrial waves are found.
Treatment of paroxysmal atrial fibrillation depends on the form of atrial fibrillation.
If this is tahisistolicheskaya form (with a large number of heartbeats), then used a single dose of quinidine, Ethacyzin. In 10% of patients have survived finoptin.
In some patients paroxysms disappeared after intravenous or novokainamida ritmonorma.
If you have heart failure may use cardioversion.
If you attempt to restore the rhythm was unsuccessful, and the patient's condition as satisfactory, it is sometimes limited to the appointment of agents potassium, sedatives or tranquilizers, and anaprilina. After recovery rate prescribed course of prophylactic antiarrhythmic agents for 2-4 weeks.
If the frequency of seizures in more than two months, the patient must take anti-arrhythmic drugs for many months or even years. Selection of the preparation is carried out by a doctor, because each patient requires individual treatment.
In identifying the patient's atrial fibrillation required is carried out and treatment of the underlying disease that led to the emergence of arrhythmias.
