аритмия сердца

Content

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

When to Contact a Medical Professional

Prevention

Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and most often irregular.

Causes

When working well, the 4 chambers of the heart contract (squeeze) in an organized way.

Electrical signals direct your heart to pump the right amount of blood for your body's needs. The signals begin in an area called the sinoatrial node (also called the sinus node or SA node).

In atrial fibrillation, the electrical impulse of the heart is not regular. This is because the sinoatrial node no longer controls the heart rhythm.

·       Parts of the heart cannot contract in an organized pattern.

·       As a result, the heart cannot pump enough blood to meet the body's needs.

In atrial flutter, the ventricles (lower heart chambers) may beat very rapidly, but in a regular pattern.

These problems can affect both men and women. They become more common with increasing age.

Common causes of atrial fibrillation include:

·       Alcohol use (especially binge drinking)

·       Coronary artery disease

·       Heart attack or heart bypass surgery

·       Heart failure or an enlarged heart

·       Heart valve disease (most often the mitral valve)

·       Hypertension

·       Medicines

·       Overactive thyroid gland (hyperthyroidism)

·       Pericarditis

·       Sick sinus syndrome

Symptoms

You may not be aware that your heart is not beating in a normal pattern.

Symptoms may start or stop suddenly. This is because atrial fibrillation may stop or start on its own.

Symptoms may include:

·       Pulse that feels rapid, racing, pounding, fluttering, irregular, or too slow

·       Sensation of feeling the heart beat (palpitations)

·       Confusion

·       Dizziness, lightheadedness

·       Fainting

·       Fatigue

·       Loss of ability to exercise

·       Shortness of breath

Exams and Tests

The health care provider may hear a fast heartbeat while listening to your heart with a stethoscope. Your pulse may feel fast, uneven, or both.

The normal heart rate is 60 to 100 beats per minute. In atrial fibrillation or flutter, the heart rate may be 100 to 175 beats per minute. Blood pressure may be normal or low.

An ECG (a test that records the electrical activity of the heart) may show atrial fibrillation or atrial flutter.

If your abnormal heart rhythm comes and goes, you may need to wear a special monitor to diagnose the problem. The monitor records the heart's rhythms over a period of time.

·       Event monitor (3 to 4 weeks)

·       Holter monitor (24-hour test)

·       Implanted loop recorder (extended monitoring)

Tests to find heart disease may include:

·       Echocardiogram (ultrasound imaging of the heart)

·       Tests to examine the blood supply of the heart muscle

·       Tests to study the heart's electrical system

Treatment

Cardioversion treatment is used to get the heart back into a normal rhythm right away. There are two options for treatment:

·       Electric shocks to your heart

·       Drugs given through a vein

These treatments may be done as emergency methods, or planned ahead of time.

Daily medicines taken by mouth are used to:

·       Slow the irregular heartbeat. These drugs may include beta-blockers, calcium channel blockers, and digoxin.

·       Prevent atrial fibrillation from coming back. These drugs work well in many people, but they can have serious side effects. Atrial fibrillation returns in many people, even while they are taking these medicines.

Blood thinners are medicines that are used to reduce the risk of developing a blood clot that travels in the body (and that can cause a stroke, for example). They include heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa).

These drugs increase the chance of bleeding, so not everyone can use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your provider will consider your age and other medical problems when deciding which drugs are best.

A procedure called radiofrequency ablation can be used to scar areas in your heart where the heart rhythm problems are triggered. This can prevent the abnormal electrical signals that cause atrial fibrillation or flutter from moving through the heart. You may need a heart pacemaker after this procedure. All people with atrial fibrillation will need to learn how to manage this condition at home.

Outlook (Prognosis)

Treatment can often control this disorder. Many people with atrial fibrillation do very well.

Atrial fibrillation tends to return and get worse. It may come back, even with treatment.

Clots that break off and travel to the brain can cause a stroke.

When to Contact a Medical Professional

Call your provider if you have symptoms of atrial fibrillation or flutter.

Prevention

Talk to your provider about steps to treat conditions that cause atrial fibrillation and flutter. Avoid binge drinking.

Source https://medlineplus.gov/ency/article/000317.htm

Contents

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

When to Contact a Medical Professional

Prevention

An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregularly.

Causes

Normally, your heart works as a pump that brings blood to the lungs and the rest of the body.

To help this happen, your heart has an electrical system that makes sure it contracts (squeezes) in an orderly way.

• The electrical impulse that signals your heart to contract begins in the sinoatrial node (also called the sinus node or SA node). This is your heart's natural pacemaker.
• The signal leaves the SA node and travels through the heart along a set electrical pathway.
• Different nerve messages signal your heart to beat slower or faster.

Arrhythmias are caused by problems with the heart's electrical conduction system.

• Abnormal (extra) signals may occur.
• Electrical signals may be blocked or slowed.
• Electrical signals travel in new or different pathways through the heart.

Some common causes of abnormal heartbeats are:

• Abnormal levels of potassium or other substances in the body
• HEART ATTACKor a damaged heart muscle from a past heart attack
• Heart disease that is present at birth (congenital)
• Heart failure or an enlarged heart
• Overactive thyroid gland

Arrhythmias may also be caused by some substances or drugs, including:

• Alcohol, caffeine, or stimulant drugs
• Heart or blood pressure medicines
• Cigarette smoking (nicotine)
• Drugs that mimic the activity of your nervous system
• Medicines used for depression or psychosis

Sometimes medicines used to treat one type of arrhythmia will cause another type of abnormal heart rhythm.

Some of the more common abnormal heart rhythms are:

• Atrial fibrillation or flutter
• Atrioventricular nodal reentry tachycardia (AVNRT)
• Heart block or atrioventricular block
• Multifocal atrial tachycardia
• Paroxysmal supraventricular tachycardia
• Sick sinus syndrome
• Ventricular fibrillation or ventricular tachycardia
• Wolff-Parkinson-White syndrome

Symptoms

When you have an arrhythmia, your heartbeat may be:

• Too slow (bradycardia)
• Too quick (tachycardia)
• Irregular, uneven, or skipping beats

An arrhythmia may be present all of the time or it may come and go. You may or may not feel symptoms when the arrhythmia is present. Or, you may only notice symptoms when you are more active.

Symptoms can be very mild, or they may be severe or even life-threatening.

Common symptoms that may occur when the arrhythmia is present include:

• Chest pain
• Fainting
• Light-headedness, dizziness
• Paleness
• Shortness of breath
• Sweating

Exams and Tests

The doctor will listen to your heart with a stethoscope and feel your pulse. Your blood pressure may be low or normal.

Heart monitoring devices are often used to identify the rhythm problem, such as a:

• Holter monitor (used for 24 hours)
• Event monitor or loop recorder (worn for 2 weeks or longer)

Other tests may be done to look at heart function:

• Coronary angiography
• ECG (electrocardiogram)
• Echocardiogram

A special test, called an electrophysiology study (EPS), is done to take a closer look at the heart's electrical system.

Treatment

When an arrhythmia is serious, you may need urgent treatment to restore a normal rhythm. This may include:

• Electrical "shock" therapy (defibrillation or cardioversion)
• Implanting a short-term heart pacemaker
• Medicines given through a vein (intravenous) or by mouth

Sometimes, better treatment for your angina or heart failure will lower your chance of having an arrhythmia.

Medicines called anti-arrhythmic drugs may be used:

• To prevent an arrhythmia from happening again
• To keep your heart rate from becoming too fast or too slow

Some of these medicines can have side effects. Take them as prescribed by your health care provider. Do not stop taking the medicine or change the dose without first talking to your health care provider.

Other treatments to prevent or treat abnormal heart rhythms include:

• Cardiac ablation, used to destroy areas in your heart that may be causing your heart rhythm problems
• An implantable cardiac defibrillator, placed in people who are at high risk of sudden cardiac death
• Pacemaker, a device that senses when your heart is beating irregularly, too slowly, or too fast. It sends a signal to your heart that makes your heart beat at the correct pace.

Outlook (Prognosis)

The outcome depends on several factors:

• The kind of arrhythmia you have. (Some abnormal heart rhythms may be life threatening if not treated right away, or do not respond well to treatment.)
• Whether you have coronary artery disease, heart failure, or valvular heart disease

When to Contact a Medical Professional

Call your health care provider if:

• You develop any of the symptoms of a possible arrhythmia.
• You have been diagnosed with an arrhythmia and your symptoms worsen or do not improve with treatment.

Prevention

Taking steps to prevent coronary artery disease may reduce your chance of developing an arrhythmia.

Source: https://www.nlm.nih.gov/medlineplus/ency/article/001101.htm