Atrial fibrillation of the heart: what is it?
Heart rate is an important characteristic of the functional state of the myocardium. Is a parameter that characterizes the frequency of contractions of the heart. Normally, this figure is an average of 70 beats per minute. Under certain conditions, heart rate can change. In this case we talk about arrhythmia. This article discusses atrial fibrillation, describes what it is, and how clinically.
Atrial fibrillation usually occur in people after age 50, men get sick more often. It is manifested by frequent (sometimes up to 700 strokes/min) and chaotic contraction of the fibres of the heart (the so-called «flickering» of the myocardium). With so much heartbeat blood circulation and increases the risk of thrombosis and stroke. On the etiology of atrial fibrillation is cardiac and noncardiac origin. Cardiac causes:
- arterial hypertension;
- pathology of the heart, in which the affected coronary vessels;
- insufficiency of the valvular apparatus of the heart;
- congenital heart disease;
- cardiomyopathy that lead to heart failure;
- surgery on the heart;
- the defeat of the sinus node.
- chronic lung diseases that occur with obstructive processes;
- pathology of the thyroid gland;
- viral disease;
- electrolyte imbalance;
- chronic alcoholism;
- diabetes mellitus;
- taking certain medicines;
- metabolic disorders in the body.
In addition, atrial fibrillation of the heart may occur after taking excessive amount of alcoholic beverages, coffee, after insect bites, and also as a result of eating too much and wearing too tight clothing. This pathology also provokes shock electrocution, sleep apnea, increased vagal tone.
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Depending on seizure duration are the following forms:
- chronic arrhythmia;
- persistent arrhythmia;
- paroxysmal arrhythmia.
The chronic form is logged continuously persisting more than 7 days, and paroxysmal, as a rule, lasts for hours. Also there are primary arrhythmias and recurrent disorders in which there are periodic fibrillation. Depending on the heart rate are:
- tahisistolicescie form, when the heart is declining at a rate of 90 beats/min or more;
- normostenichesky (heart rate is 60 – 90 beats /min);
- it’s bradycardic the form, when the myocardium contraction is less than 60 beats/min.
Also, depending on the activity of the Atria may be the actual so-called fibrillation and the a-FIB. The last form occurs only partial reduction of the Atria. Also disrupted the transmission of impulses to the ventricles that do not contract and are unable to fully push out the blood.
The severity of symptoms of atrial fibrillation depends on the shape and General well-being of the patient and the condition of the heart valves. Sometimes people do not feel any wrongdoing. The most common symptoms include:
- heart palpitations;
- pain in the chest;
- an increased secretion of sweat;
- shortness of breath and muscle weakness;
- the feeling of fear;
The examination of the patient detects the shortage of the pulse. This is a condition in which there is a mismatch between the number of heart beats, and heart rate (it becomes irregular, alternating rhythm and frequency). May develop unstable angina. In some cases the first manifestation is stroke. Auscultation can be heard flapping first heart tone, but this symptom is not specific, so not possible to differentiate atrial fibrillation from other forms.
If you experience a bout of atrial fibrillation the patient is directed to the following surveys:
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- Electrocardiography. It is the main method to identify a specified heart failure. ECG revealed certain changes. For example, the prong R is F waves (frequency up to 600 per minute). Also identify irregular rhythm of ventricles. If untreated, the heart rate accelerated to 160 beats per minute, although it may be less than 100. In addition, you may notice an electrical alternation, when there are minor changes in waves amplitudes in the QRS complex. The QRS complexes are narrow or extended, if there are persistent blockade of bundle branch block.
- Ultrasonic examination of the heart (Echocardiography), which allows not only to determine the morphofunctional state of the heart, but also to find out the etiology of cardiac arrhythmias. With the help of this examination determine the diameter of the Atria, detect blood clots, and possible heart defects and structural changes.
- If necessary, can be carried out load tests.
- Also determine the functional state of the thyroid gland.
- Coronary angiography.
- X-rays, or other methods of research of breathing organs.
Complications of atrial fibrillation
The main complications are the development of heart failure and systemic thromboembolism. With the development of tahisistoliceskih types of arrhythmia of the heart chamber are emptied incorrectly, leading to increased pressure in the pulmonary veins. As a consequence, developing alveolar pulmonary edema and cardiac asthma. With the progression of pathological changes heart failure is getting worse.
The risk of systemic embolism is increased among patients after the age of 65 years with history of transient ischemic attack, and those patients who detect associated diabetes mellitus and hypertension or symptoms of congestive heart failure.
Principles of treatment
Methods of therapy determined by the physician, given symptoms of arrhythmia, its shape and the General condition of the patient. Conservative methods include the appointment of the following groups of drugs:
- Medications that regulate the heart rate. Prescribe calcium channel blockers and beta-blockers. The whole rhythm of the heart they have no influence, but help to slow the contraction of the ventricles.
- Drugs that prevent blood clots, reducing the risk of strokes. Prescribe anticoagulants and antiplatelet agents. To monitor the effectiveness of pharmacological treatment of these drugs you should periodically do a blood test.
- Medicines that help keep the heart rate at 60 beats per minute. In 60% of cases, this therapy improves the condition of patients, but over time the medications lose their pharmacological effectiveness, therefore, as a rule, in atrial fibrillation make some antiarrhythmics.
In the absence of effect of conservative treatment resort to surgery, the effectiveness of which is 70 – 85%.