Arrhythmia - Causes, Treatment, Types And Prevention

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Arrhythmia: causes, types and treatment

What is arrhythmia?

Arrhythmia is a malfunction of the successive contractions of the heart muscle. In humans, the heart beats at a certain rhythm. This rhythm is formed by a certain conducting system of the heart. By itself, it represents the nodes, bundles of nerve tissue, the accumulation of these nerve cells and fibers is located in the myocardium and there it generates all the impulses of the heart and conducts them. The rhythm and frequency of heart contractions depend on all this. When there is a failure in the activity of even one education, then arrhythmia occurs.

With different types of arrhythmias, a failure occurs in the frequency of heart contractions, this can lead to an increase in contractions (tachycardia) or, conversely, a decrease in contractions (bradycardia), at the same time, contractions may remain normal. In a healthy person, the heart rate is approximately 60–70 beats per minute.

Content:

• What is arrhythmia?
• Arrhythmia symptoms

• Causes of arrhythmia

  Risk factors

• Types of arrhythmias
• Arrhythmia diagnostics
• Complications

• Arrhythmia treatment

  • Antiarrhythmic drugs
  • Sodium channel blockers
  • Potassium channel blockers
  • Calcium channel blockers
  • Additional drugs
• Traditional methods of treating arrhythmia

• Diet

  What to exclude from the diet?

• Prevention of arrhythmias
• Which doctor to contact

Arrhythmia symptoms

Sometimes arrhythmia is latent. For a long time, a person can live an ordinary life and not notice that his heart is working intermittently. However, at a doctor's appointment, for example, when undergoing an annual medical examination, heart rhythm disturbances cannot go unnoticed. Timely detection of arrhythmia will allow starting treatment on time to prevent the development of complications.

However, in most cases, arrhythmia still makes itself felt, worsening the quality of life. Its main symptoms are:

• Feeling of a heartbeat (normally a person does not feel it).
• Rapid heartbeat against the background of absolute physical and emotional rest.
• Feeling of slow heartbeat.
• Chest pain.
• Dyspnea.
• Dizziness.
• Fainting or light-headedness.

Causes of arrhythmia

The cause of arrhythmia can be a disease of the cardiovascular system, as well as arterial hypertension, traumatic brain injury, climacteric changes in the body, diseases of the adrenal glands and thyroid gland.

Also, the causes of arrhythmias can be frequent stress, overload - both nervous and physical, smoking and alcohol abuse, as well as toxic and medicinal substances. A failure in the rhythm of the heart can not manifest itself for quite a long time, or it can dramatically worsen the state of health, it often happens that it is very life-threatening.

Risk factors

It is wrong to think that the diagnosis of "arrhythmia" is made exclusively to elderly patients. The disease can be detected in young people and even in children. To find out the cause that triggered the development of arrhythmia, doctors use various diagnostic techniques and screening tests.

Knowledge of the risk factors for arrhythmia will allow you to take preventive measures in time, thanks to which it will be possible to prevent its development. These include:

• Genetics. Some types of arrhythmias are inherited, for example, those that follow the type of Wolff-Parkinson-White syndrome. This also includes congenital malformations.
• Thyroid dysfunction. It is responsible for the synthesis of hormones that affect the metabolic rate, slow down or accelerate it. Tachycardia develops with thyrotoxicosis, and bradycardia with hypothyroidism.
• Hypertension. This disease provokes the development of ischemic heart disease with cardiac arrhythmias.
• Recurrent hypoglycemia. Arrhythmia often develops in people with low blood glucose levels. Decompensated diabetes provokes the development of arterial hypertension and coronary heart disease, which is accompanied by disturbances in the heart rhythm.
• Obesity. Overweight is one of the leading risk factors for the development of cardiopathologies accompanied by arrhythmias, for example, ischemic heart disease. Moreover, even without disease, the burden on the heart in obesity increases significantly, contributing to a rapid heart rate.

• High cholesterol. Its indicators can go beyond the normal range even in young people, but elderly patients over 55 years of age should be especially alert. At this age, many additional risk factors appear, which, in combination with high cholesterol, can provoke heart and vascular diseases.
• Low blood iron levels. Against the background of anemia, organs and tissues suffer from a lack of oxygen. The heart muscle is no exception. The longer a person has anemia, the higher their risk of developing arrhythmias.
• Hormonal disorders. Arrhythmia in women most often manifests itself during the onset of menopause.
• Osteochondrosis. Compression of the nerve roots provokes a disorder of autonomic regulation, which affects the functioning of the vagus nerve and the sympathetic nervous system. Such violations directly affect the work of the heart and blood vessels.

Types of arrhythmias

Sinus tachycardia. The main thing in the area of the myocardium - the formation of electro-impulses - is the sinus node. When a person is sick with sinus tachycardia, the frequency of contraction of the heart muscle sometimes exceeds 90 beats per minute. A person feels such a deviation as a strong heartbeat. The origin of sinus tachycardia is explained by severe stress, emotional overstrain, fever with colds, not often, but still it can arise from heart disease and all of the above reasons for the appearance of arrhythmias.

Sinus bradycardia. It manifests itself as a decrease in heart rate, often to 55 beats per minute or less. Bradycardia can also manifest itself in physically healthy, trained people, during rest or sleep. Bradycardia can be accompanied by hypotension, heart disease. As a rule, bradycardia occurs with a decrease in the functions of the thyroid gland. Bradycardia is felt as discomfort in the region of the heart, there may be general weakness and dizziness.

Sinus arrhythmia. It is characterized as an irregular alternation of heart beats. This type of arrhythmia is most commonly seen in children and adolescents. Sinus arrhythmia can functionally be associated with breathing. During inhalation, heartbeats become more frequent and decrease during exhalation. Such respiratory arrhythmia does not affect well-being and, as a rule, does not require treatment. When diagnosing this type of arrhythmia, breath holding is used, during which the arrhythmia disappears.

Extrasystole. This is an extraordinary contraction of the heart muscle. In healthy people, rare extrasystoles can be observed, they can be caused by various diseases, as well as bad habits. Arrhythmia can be felt in this form as strong shocks in the area of the heart muscle or in the form of fading.

Paroxysmal tachycardia. Paroxysmal tachycardia is the correct work of the heart, but with a rapid beat. Thus, the heart rate can reach 140-240 beats per minute. This type of tachycardia occurs and disappears suddenly. Symptoms: increased heart rate, increased sweating, and weakness.

Atrial fibrillation. This disease is characterized as an irregular contraction of individual muscle fibers, while the atrium does not contract completely, the ventricles begin to contract irregularly at a frequency of about 100 to 150 beats per minute. With atrial flutter, they begin to contract faster and faster, the frequency of contractions is from 250 to 300 beats per minute. This condition is often observed in people with heart disease and defect, as well as thyroid disease and alcoholism.

Symptoms may be absent, the patient may not feel a change in well-being. Most often they complain of fluttering in the chest area, sometimes pain in the heart, and complain of shortness of breath. The main symptom of flickering arrhythmia is a lack of pulse, that is, the detected heart rate while listening is higher than the pulse rate.

Flutter and fibrillation of the ventricles is considered the most severe rhythm disturbance, this can occur from any serious heart disease, due to an injury from electricity, with an overdose of certain medications.

Symptoms: sudden cardiac arrest, pulse cannot be felt, loss of consciousness, hoarse breathing, possible convulsions, dilated pupils. The first and urgent aid to a person in this condition consists in immediate external indirect heart massage and artificial respiration.

Heart block. With this type of arrhythmia, the conduction of impulses in all structures of the myocardium slows down and stops. A characteristic sign of blockages is periodic loss of pulse, blockages can be either complete or incomplete. Complete blockages are often accompanied by a decrease in heart rate. They often cause fainting and seizures. A complete transverse blockade can cause heart failure and even sudden death.

Arrhythmia diagnostics

Diagnosis of arrhythmia consists in the indicators of the patient's examination, these indicators include: appearance, skin color, probing the pulse, determining the boundaries of the heart, measuring the heart rate, breathing.

An electrocardiogram must be done, with the help of which you can quite accurately determine the type of arrhythmia and choose the right method of treatment.

Complications

The latent course of arrhythmia does not make it harmless. It can provoke serious complications, harm health and even be fatal.

A particular danger is arrhythmia, which occurs in combination with heart disease. Complications to which it can lead:

• Heart failure. The longer a person has tachycardia or bradycardia, the higher the risk of blood stagnation in the cardiac cavities. By controlling the heart rate, these problems can be avoided.
• Stroke. Atrial flutter can lead to it, which in this state is not able to fill the ventricles with the required amount of blood. Disorders of blood flow provoke the formation of blood clots, which can reach the brain through the vessels, clog one of the collaterals there and become an impetus for the development of a stroke.
• Cardiac arrest, against the background of which atrial fibrillation is often observed. If the person is not provided with emergency medical care, he will die.

Arrhythmia treatment

Treatment of arrhythmia involves the provision of medical care, which should be aimed at eliminating the underlying disease that provoked the violation of the heart rhythm. In addition, the patient will have to receive medications to relieve the symptoms of the arrhythmia itself. With bradycardia, which occurs against the background of organic damage to the heart, angioprotectors and acetylsalicylic acid in small doses are often prescribed. These drugs allow to normalize blood flow, improve myocardial nutrition, and reduce the risks of complications of atherosclerosis.

Low-dose aspirin will need to be taken over a long period of time. In small quantities, the drug does not have an ulcerogenic effect and does not increase the likelihood of bleeding.

Sometimes the arrhythmia is the result of medication. In this case, their use is completely abandoned, or the dose is reduced. If the body gives a similar reaction to drugs to lower blood pressure, then an alternative is required.

Antiarrhythmic drugs

Direct antiarrhythmics - affect the permeability of ion channels, which in turn reduces the heart rate:

• Amiodarone. This drug is used to stabilize the work of all parts of the heart. The effect of its use persists for a long time after drug withdrawal. It will work for several more months, but only on condition that the person has received it for a long time. It is forbidden to prescribe the drug for the treatment of pregnant women, nursing mothers, people with low blood pressure, patients with thyroid pathologies. Do not use Amiodarone in patients with potassium deficiency in the body.
• Allapenin is an antiarrhythmic drug of class I C. It has a moderate antispasmodic, coronary dilating, anticholinergic, local anesthetic and sedative effect.
• Ritmonorm is a sodium channel blocker, highly effective in ventricular arrhythmias; with supraventricular rhythm disturbances, the effectiveness is somewhat lower. Propafenone has a weak beta-adrenergic blocking effect.

Drugs that affect the cardiac conduction system, they slow down the heart rate, therefore they are more often used for tachycardia and atrial fibrillation:

• 

  Digoxin is a cardiac glycoside of plant origin. It is used to treat atrial fibrillation and heart failure. Patients are prescribed 0.25 mg several times a day. If the patient develops extrasystole, then treatment should be abandoned. The drug inhibits sodium and potassium channels, which must be taken into account when prescribing antiarrhythmic drugs. It is forbidden to use Digoxin for the treatment of patients with ventricular fibrillation, with myocardial infarction and against the background of tachycardia.

• Propranolol. This drug is not prescribed for patients with hypotension, bradycardia, and cardiogenic shock. Taking it can lower your heart rate, but it can trigger symptoms of atrial flutter. Patients complain of a feeling of stopping or even turning the heart. It should not be used to administer therapy to people with depression. Analogues of Propranolol are drugs such as: Obsidan and Anaprilin.
• Metoprolol. This drug has the same effects and contraindications as Propranolol. It can be used to treat pregnant women, people with low blood pressure, and patients who have had myocardial infarction, but have passed the acute stage of the disease. The doctor determines the dose on an individual basis, depending on the specific clinical case. The drug is taken once a day with water. There is no dependence on food. The analogue of Metoprolol is Atenolol.
• Bisoprolol. This drug is prescribed for patients with high blood pressure because it helps to lower it. Most people tolerate therapy well, they do not develop pronounced edema, they do not complain of dizziness. Bisoprolol does not cause heart complications. The price of the drug is not high.
• Others: Timolol, Nadolol, Esmolol, Carvedilol

Sodium channel blockers

Sodium channel blockers are drugs that help bring the heart rate back to normal. Thanks to them, impulse conduction is normalized. The blockade will be the more intense, the more the patient's pulse quickens. Medicines differ depending on their effect on the repolarization time.

Repolarization refers to the transition of the heart muscle cells to a relaxed state after the contraction.

If one drug from this group is not suitable for a particular patient, then you can replace it with an analogue, but with a different mechanism of influence on the repolarization process.

There are drugs that increase the repolarization time and moderately block sodium channels. They are used to treat tachycardia of the sinus node, used for atrial fibrillation. These drugs include:

• Quinidine. It is used to prevent ventricular fibrillation. The drug helps to lower blood pressure, relieves stress from the heart muscle. Quinidine is not prescribed for quinine intolerance. Its use is discarded when thrombocytopenia develops in the patient during therapy. The maximum daily dose is equal to 3-4 g. It is divided several times. It is forbidden to prescribe Quinidine to patients undergoing therapy with Verapamil and anticoagulants.
• Procainamide. This medication is in the form of a solution for injection. The starting dose is 250-500 mg, and the daily dose is 4 g. It is forbidden to use the drug for the treatment of patients with myasthenia gravis, bronchial asthma, atherosclerosis, severe kidney and liver damage. It is not used to treat people who have had myocardial infarction.
• Disopyramide. This drug has the same effect on the patient's body as Quinidine. It helps to increase the tone of arterioles. During therapy, side effects such as: allergies, dyspepsia, headache may develop.

Analogs of the listed drugs are drugs such as: Novocainamide and Aimalin.

The next type of drugs in this group are drugs that reduce the repolarization time and weakly block sodium channels. They are used to treat arrhythmias of the cardiac ventricles, are prescribed for extrasystole, for arrhythmia that develops after a myocardial infarction. Also, these drugs can be used to relieve attacks of atrial fibrillation. These include:

• Lidocaine. It is prescribed to patients with bradycardia, as well as patients who have a high risk of developing blockages. You can use the drug for the treatment of hypotensive patients. However, during treatment, patients may faint and sometimes even worsen their respiratory function. The drug is not used for oral administration. It does not last long.
• Phenytoin or Diphenin. These drugs are prescribed at a dosage of 4 mg / kg of body weight. They are able to slow down psychomotor reactions, and they are used with caution to treat people with epilepsy and seizures. It is forbidden to use Phenytoin and Diphenin for the therapy of women in the position, as they have a negative effect on the fetus.
• Mexiletin. This drug has a good effect in terms of treating ventricular extrasystole. It does not irritate the organs of the digestive system. All side effects are limited to the effect of the drug on the central nervous system. If the patient does not tolerate the injections of Lidocaine, then it can be replaced by oral administration of Mexiletine, which has a prolonged effect. An analogue of the listed drugs is the drug Diphenylhydantoin.

The third type of drugs in this group are medicines that do not affect the repolarization time, but at the same time they strongly block sodium channels. They are used to treat tachycardia. These include:

• Propafenone or Propanorm. These drugs not only block sodium channels, but also affect the work of calcium and beta-adrenergic receptors. They must be injected slowly, since at high speed the risk of cardiac arrest or the development of bronchospasm increases. For the same reason, the dose must be carefully calculated. The drugs affect the composition of the blood.
• Etatsizin. Its reception allows you to relieve tension from the heart muscle, increase the time of contractions, and eliminate the phenomena of ischemia. The effect develops after 2 doses, but no significant decrease in heart rate is observed. The drug is taken 3 times a day, gradually increasing the daily dose to 200-300 mg. The drug is used to treat tachycardia, but it can provoke the development of another type of arrhythmia.

Potassium channel blockers

Potassium channel blockers are prescribed for patients who are at high risk of developing ventricular fibrillation. If drugs from the group of sodium channel blockers can be replaced with one another, since their mechanism of action is the same, then it will not be possible to do this with drugs from the group of potassium channels.

• Ibutilid. The drug acts mildly, but at the same time has a pronounced effect on the liver. It is prescribed for the treatment of paroxysmal arrhythmias, as well as for atrial fibrillation. The drug can only be used in a hospital, under the control of an ECG.
• Sotalol. The drug is prescribed for various types of arrhythmia. It does not accumulate in the liver and kidneys, so it can be used to treat patients with pathologies of these organs. Sotalol blocks the susceptibility of beta-adrenergic receptors. The daily dose should not exceed 80 mg. It is mandatory to control the level of creatinine and the amount of fluid consumed.
• Nibentan. This is one of the most effective drugs for the treatment of arrhythmias. Its therapeutic effect is similar to the effect of taking Ibutilide. The drug is prescribed to patients with atrial flutter and ventricular fibrillation. Therapy can only be performed in a hospital.

Calcium channel blockers

• Verapamil. Verapamil is one of the most commonly prescribed drugs for the treatment of atrial fibrillation. It is forbidden to use it for the treatment of patients with hypotension, as well as in severe heart failure. The drug is well absorbed by the body. It is recommended to take it with meals. The starting dose of the drug is 48 mg. If necessary, the dose can be gradually increased. Verapamil is taken several times a day. Experts do not recommend using it in combination therapy with other antiarrhythmic drugs. The drug Diltiazem has a similar effect.
• Adenosine. The preferred form of this drug is a drug called adenosine triphosphate. It normalizes the heart rate, relieves excitement from the myocardium. The drug starts working 10 seconds after taking it. During treatment, it is required to control the heart rate so that its rate does not drop below 55 beats per minute. You also need to monitor the level of blood pressure. The drug is prescribed with Dipyridamole. This increases the level of adenosine in the blood. If a patient is diagnosed with ventricular tachycardia, then the drug is prohibited from being taken.

Additional drugs

This includes drugs that help improve metabolic function, as well as nutrition and protect the myocardium from the effects of ischemia.

Panangin - (or its analogue Asparkam) is used for the treatment of arrhythmias, as an electrolyte that replenishes the loss of trace elements in the myocardium. If a patient is diagnosed with a pronounced lack of potassium and magnesium in the body, then he is placed in a hospital and the drug is administered intravenously. In the future, the patient is transferred to oral administration of Panangin. He is prescribed 3 times a day. An analogue of the drug is Asparkam.

Mildronate - restores the balance between the delivery and demand of cells for oxygen, eliminates the accumulation of toxic metabolic products in cells, protecting them from damage. As a result of its use, the body acquires the ability to withstand stress and quickly restore energy reserves.

Riboxin - improves myocardial metabolism, has antihypoxic and antiarrhythmic effects. Increases the energy balance of the myocardium. Has a protective effect on the kidneys in conditions of ischemia during the operation.

And other drugs, such as: ATP (adenosine triphosphoric acid), Potassium normmin, Calipose, Cocarboxylase, Thiotriazolin, Mexicor, Preductal MR.

Traditional methods of treating arrhythmia

In addition to traditional medicines, there are many alternative treatments for arrhythmias. The most effective recipes:

• Infusion based on calendula flowers. To prepare it, you will need 0.5 liters of boiling water and 2 tsp. dry raw materials. Flowers are poured with boiling water, covered with a lid and infused for an hour. Take the infusion 4 times a day for 4 tbsp. l., regardless of food.
• Cornflower tincture. For 2 tsp of blue cornflower flowers, take 0.2 liters of boiling water. The plant is insisted for an hour, filtered and taken in a quarter of a glass, 15 minutes before meals.
• Infusion of valerian root. To prepare it, you need a glass of warm water and 1 tbsp. l. valerian root. The holding time of the infusion is 12 hours. It is most convenient to cook it at night. In the morning, filter the composition and take a dessert spoon 4 times a day.
• Infusion of fresh medicinal asparagus (not to be confused with asparagus sold in grocery stores). Shoots are crushed, poured in 250 ml of boiling water and left for 2 hours under a closed lid. Take the infusion 4 times a day for 2 tbsp. l. The course lasts 21-28 days. Infusion allows you to cope with tachycardia.
• Tincture of the herb lumbago uncovered. Raw materials in the amount of 2 tsp. pour 0.3 l of cool water and leave overnight under a closed lid. After straining, take 1/3 cup half an hour before meals: morning and evening.

Diet

It will not be possible to cope with arrhythmia with only one diet. However, adherence to certain dietary rules can reduce the risk of complications, and is also one of the ways to prevent its development.

The diet should be built in such a way that the heart muscle is not deficient in trace elements. Errors in nutrition are a direct path to malfunctions of the endocrine system, which will certainly lead to cardiac dysfunction.

Foods that should be present in the diet of a person suffering from arrhythmia:

• Buckwheat, nuts, legumes, yeast, spinach, avocado, and cucumber. All of them saturate the body with magnesium.
• Bananas, parsley, dried apricots and raisins, potatoes and cabbage. These foods are a source of potassium.
• Corn, seafood, fish, beets, seeds, cabbage. They are high in calcium.

People involved in arrhythmia therapy should include in their diet seaweed, beet and carrot tops, and lean meat.

What to exclude from the diet?

Products that should not be on the menu:

• Canned food, smoked meats, marinades.
• Pickles.
• Fatty meat.
• Sauces and spicy dishes.

Patients with atrial fibrillation should drink enough water. Some drinks must be excluded.

Basic recommendations for water and drinks:

• Banned coffee, black and green tea of strong brew, energy drinks with guarana extract.
• The daily volume of fluid consumed is 1.5 liters. When these norms are exceeded, the load on the heart muscle increases.
• Preferred drinks: teas with mint, linden, chamomile, lemon balm, weak green tea, still mineral water.

Adequate physical activity will help increase the effectiveness of the diet. Exercise should not be too intense so as not to overload the heart.

From time to time, you can spend fasting days, during which they drink rosehip broth or still water.

Prevention of arrhythmias

Measures aimed at preventing arrhythmia and its complications:

• Treat infectious diseases in a timely manner, do not try to transfer the disease on the legs.
• Quit smoking, reduce alcohol consumption.
• Do not ignore symptoms that signal heart disease, endocrine gland and arterial hypertension.
• Avoid stress.
• Control blood glucose and cholesterol levels, monitor weight.

Which doctor to contact

The detection, prevention and treatment of arrhythmias is within the competence of the arrhythmologist. However, in most polyclinics there is no such narrow specialist in the staff, therefore a cardiologist deals with the therapy of heart rhythm deviations.

Diagnostics is reduced to performing ultrasound, ECG or Holter monitoring. This is the responsibility of the functional diagnostics doctor.

The detection of concomitant diseases requires consultation with narrow specialists. The endocrinologist is engaged in the treatment of the endocrine glands; the pathological course of menopause requires regular visits to the gynecologist.

If complex conservative therapy did not allow achieving the desired effect, consultation with a cardiological surgeon is necessary. If indicated, the patient can undergo radiofrequency ablation or implantation of a pacemaker. The question of the need for an operation is decided on an individual basis.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".