The presence of atrial fibrillation flash for more than 48 hours leads to a higher risk of ischemic stroke, myocardial infarction, thromboembolism, different organs and peripheral vascular disease, severe cardiovascular failure.
What it is?
Atrial fibrillation is translated from Latin means "crazy heart". It is synonymous with the term "fibrillation", and the definition of the disease include atrial fibrillation - a type supraventricular tachycardia, atrial characterized chaotic activity with their reduction with a frequency of 350-700 minute.
This heart rhythm disturbance is fairly common and can occur at any age - children, the elderly, men and women, young and middle aged. Up to 30% of cases, the need for emergency care and hospitalization for violations of rhythm is associated with the consequences of atrial fibrillation. With age, the incidence of the disease increases if 60 years it occurs in 1% of patients, the disease later recorded already in 6-10% of people.
In atrial fibrillation, atrial contraction occurs in the form of apnea, atrial flutter, as it were, on them is the shimmering ripples, with separate groups of fibers running uncoordinated with respect to each other. The disease leads to a natural disruption of the right and left ventricle, which can not get enough blood into the aorta. Therefore, when atrial fibrillation in a patient is often detected pulse deficit in large vessels, and irregular heart rate. The final diagnosis can be made on the ECG, which reflects the abnormal electrical activity of the atria, and identifies random, inadequate cardiac cycles.
Causes of
Provoke a breach of heart rhythm as atrial fibrillation are various acute and chronic conditions.
are sharp reasons:
- exposure temperature factors - hyper- or hypothermia;
- operations;
- myocardial infarction;
- excessive use of caffeine, alcohol and nicotine;
- inflammatory heart disease - pericarditis, myocarditis;
- administration of drugs with arrhythmogenic effect;
- mechanical effects on the body - injuries, vibration;
- some other types of arrhythmias (WPW-syndrome).
The impact of the factors mentioned above, in a healthy heart, most likely atrial fibrillation do not provoke - it contribute to the emergence of structural and metabolic changes in the myocardium, as well as some types of non-cardiac pathology:
- cardiomyopathy;
- Heart tumor;
- constrictive pericarditis;
- endocrine pathology, in particular;
- coronary heart disease;
- purchased and some congenital heart defects;
- arterial hypertension;
- hyperthyroidism;
- diseases of the gastrointestinal tract (calculary cholecystitis, diaphragmatic hernia);
- pathology of the central nervous system;
- intoxication.
Symptoms of atrial fibrillation
It should be remembered that in 20-30% of cases of atrial fibrillation occurs without symptoms, without causing any sensation. Detection of this form is usually accidentally.
The main complaints of patients with atrial fibrillation include:
- The main complaint - the sudden onset of palpitations or irregular heartbeat feeling of constant irregular heartbeat, pulsation of the veins in the neck;
- constricting pain in the heart of the type of angina pectoris;
- general weakness, fatigue;
- shortness of breath (dyspnea), especially during exercise;
- dizziness, unsteady gait;
- semiunconscious state, fainting;
- excessive sweating;
- rarely increase of urine (polyuria) when allocating natriuretic hormone.
With the constant development of forms of the disease, patients no longer feel discomfort or disruption of the heart and adapt to live with this disease.
complications
The most dangerous complications of MA:
- Development of thromboembolism due to thrombus formation in the chambers of the heart.
- Heart failure.
- The onset of sudden death due to cardiac arrest caused by blockage of its internal openings.
- Development of cardioembolic stroke, which occurs due to the stagnation of blood in the atria.
- Cardiogenic shock, provoking a significant reduction in blood pressure, which resulted in the authorities and human tissue no longer receive the necessary nutrition, and irreversible processes begin in them.
- Thrombus formation, which the bloodstream can get into any organ, including the brain, triggering death of brain tissue (stroke).
Atrial fibrillation is only at first glance it seems a simple disease. Patients with this diagnosis should be remembered that the flickering arrhythmia - is a pathology which is associated with a risk complications arising from lack of timely adequate treatment or transition into a chronic disease shape.
Diagnostics
Expose the diagnosis of atrial fibrillation on the basis of:
- collection and analysis history;
- detecting characteristic complaints of the patient;
- detection of certain specific changes to record a standard electrocardiogram.
Electrocardiographic signs of this pathology are as follows:
- found multiple wave f, confirming fibrillation (flicker) atria. This type of waves may be different amplitude, shape and other characteristics;
- on recordings completely absent prongs P which are necessarily found in normal sinus rhythm of the heart beat;
- while maintaining the QRS complexes, there is a chaotic violation of RR intervals.
In addition, during the standard electrocardiography doctors are able to determine the patient's cardiac pathology associated provoking rhythm disorder. Also, to establish an accurate diagnosis and detection of all the doctors can comorbidities diagnostic methods using such as Holter monitoring, echo cardiography, US heart and so on.
EXAMPLE paroxysmal atrial arrhythmias in the EKG
Treatment of atrial fibrillation
To date, in atrial fibrillation using several treatments aimed at restoring an adequate heart rate and prevent new attacks. Used drugs, electrical cardioversion. With a weak effectiveness of these techniques use surgical methods of treatment - ablation catheter or pacemaker implantation. An integrated approach to therapy can prevent new attacks.
The following drugs for atrial fibrillation:
- Prevent the occurrence of blood clots blood thinning agents - desagregants.
- Beta-blockers (betaxolol, carvedilol nebivalol, metoprolol, pindolol, propraolol, celiprolol, esmolol) and calcium blockers (verapamil, diltiazem) - they slow down the heart rate. These drugs for atrial fibrillation of the heart prevent excessively rapid contraction of the ventricles, but not regulate the heart rhythm.
- For antiplatelet therapy, anticoagulation are appointed, not excluding the formation of blood clots, but reduce the risk of this, and, consequently, the occurrence of stroke (heparin, fondaparinux, enoxaparin).
- Also, drugs that prevent the formation of thrombi and occurrence of stroke (warfarin pradaksa) are used in the diagnosis of atrial fibrillation.
- Antiaritmichnye agents (amiodarone, dronedarone, ibutilide, procainamide, propafenone, sotalol, flecainide).
In order to control the influence of medication requires regular blood tests. Only a doctor will be able to choose the right pill for atrial fibrillation, because many of them have serious contraindications, and the proarrhythmic activity when receiving the drug itself may trigger a sudden atrial fibrillation.
Before you treat atrial fibrillation of the heart, should be taken into account comorbidities, available to the patient. Sometimes taking the medicine begins in the hospital, where doctors easier to control the body's response and heart rate. With this therapy in 30-60% of the patient's condition improves, but with time can be reduced efficacy. Therefore, doctors often prescribe several anti-arrhythmic agents.
Treatment of persistent atrial fibrillation
In this form of the patients were administered tablet formulations, slows the heart rate. Main group herein are beta-blockers and digitalis glycosides, e.g. konkor mg x 5 times in 1 day Coronal 1 x 5 mg once a day, egilok 25 mg x 2 times a day, betalok KRC 1 x 25-50 mg once a day and et al. Of the cardiac glycosides used digoxin 0.025 mg on 1/2 tablets x 2 times a day - 5 days, a break - 2 days (Sat, Sun).
Required assignment anticoagulants and antiplatelet agents, e.g. cardiomagnyl 100 mg per meal, or 75 mg of clopidogrel for lunch, or warfarin 2.5-5 mg x 1 per day (mandatory under the control of multi - parameter blood coagulation, is usually recommended 2.0-2.5). These drugs prevent blood clots and reduce the increased risk of heart attacks and strokes.
Chronic heart failure to be treated diuretics (1.5 mg indapamide morning veroshpiron 25 mg in the morning) and an ACE inhibitor (Prestarium 5 mg in the morning, enalapril 5 mg x 2 times a day, lisinopril 5 mg in the morning), providing organo effect on the vessels and heart.
Surgical treatment of diseases
In view of the active development of science and medicine, a surgical method for the treatment of arrhythmias is very promising. There are several different approaches:
- The implantation of a cardioverter-defibrillator mini. This treatment option is more suitable for people who have infrequent paroxysms of atrial fibrillation. Such a device will automatically recognize the rhythm disturbance and produces an electrical impulse that can restore normal heart function.
- Physical destruction element atrioventricular node or pathological beam of nerve impulse from the atria to the ventricles. By resorting to such embodiment, when no effect of drug treatment. As a result, heart rate reduction operation is achieved by normalizing the amount of signals conducted to the ventricles. At the same time quite often atrioventricular connection is completely blocked, and for normal ventricular pacemaker is implanted in them (IOM - an artificial pacemaker).
Lifestyle in atrial fibrillation
All heart disease suggest maintaining lifestyle, which is traditionally described as healthy. Atrial fibrillation is not an exception.
Standard recommendations include light exercise with atrial fibrillation heart: morning exercises, daily walks in the fresh air. One should preserve natural mobility should not lie permanently (except arrhythmic episode periods).
A separate issue is the combination of a diagnosis of atrial fibrillation and alcohol. People with heart disease should not abuse alcohol.
At the same time, we know that alcohol in small quantities can have a positive effect, in particular: on nervous system (sedative effect), digestive system (stimulates digestion), receptacle (widens vessels). In exceptional cases, a person suffering from atrial fibrillation, can drink per day of not more than 50 g of beverage with an alcohol fraction of 40% and not more than 150 g of a beverage with 12% alcohol fraction.
Diet
In such patients based on the power plant must be low-fat foods, and cereals from whole cereals, soups water. Showing vegetable stews and casseroles, fresh salads, dressed with a small amount of any refined oil, boiled or steamed prigotolennaya sea fish.
There is a need in small portions: overeating causes irritation of the vagus nerve, which affects the function of depressing sinus corner where then there are pathological impulses.
Separately want to say about any alcohol: it must be completely removed from the food system. Even in relatively healthy people drinking alcohol can trigger an arrhythmia, to stop that is very difficult due to the rapidly advancing degenerative changes in the heart.
What is the prognosis?
Life Prediction for atrial fibrillation is determined primarily causes disease. For example, survivors of acute myocardial infarction and with significant cardiosclerosis short-term prognosis for life can be beneficial, and health and in the medium term unfavorable, since a slight amount of time the patient develops chronic heart failure, worsening the quality of life and shorten its duration.
However, with regular intake of prescribed drugs prognosis for life and health certainly improves. And patients with documented at a young age a permanent form of MA, with proper compensation live with it still up to 20-40 years.
