If the heart rhythm does not recover. Reasons for the development of the failure. How is normal heart rhythm restored?

Treatment of atrial fibrillation is a rather complex problem in modern cardiology. In every family you can find a person who knows it firsthand. That's why brief overview ways to restore rhythm is information that every person should know.

Treatment of paroxysmal form

Let's start with treatment paroxysmal form atrial fibrillation, which consists of two mandatory stages:

At the first stage measures are taken aimed at stopping the normalization (restoration) of the correct sinus rhythm.

At the second stage must be done therapeutic measures aimed at maintaining the correct rhythm.

The second stage is very important, since with frequent “disruptions” of the rhythm, more likely is that atrial fibrillation can become permanent.

Atrial fibrillation that has become permanent cannot be restored to normal sinus rhythm on its own!

This type of recovery requires lengthy preparation and is carried out only in hospitals under the supervision of a doctor.

Methods used to restore sinus rhythm

Before the ambulance arrives You can take bisoprolol (Concor) at a dose of 5 mg, anaprilin at a dose of 4 mg, Egilok 25 mg, or any other beta-blocker prescribed by your doctor.

Relief of paroxysm of atrial fibrillation is carried out in a block intensive care(BIT) cardiological profile.

Sinus rhythm must be restored within 48 hours from the moment the rhythm “breaks”. If the paroxysm lasts more than two days, then before restoring the rhythm, transesophageal echocardiography is performed to examine the atria for the presence of blood clots. When they are detected, the rhythm is not restored, and atrial fibrillation becomes permanent.

In the BIT, electrical or medicinal cardioversion is performed , that is, the rhythm is restored either using electrical defibrillation or medicines.

In the first method use electropulse therapy (discharge of electric current 100 J, with an increase to 200 J). This type of rhythm restoration is rarely used. Indications for it are: serious condition a patient with pulmonary edema, fainting, cardiac asthma, etc.

In the second case medications are used to help normalize sinus rhythm.

Cordarone (amiodarone) is a good antiarrhythmic drug and, when administered intravenously, restores rhythm well. It is administered in a dose of 150 - 450 mg.

The patient is taken to the intensive care unit
Electropulse therapy is carried out
Cordarone is administered intravenously
Heparin is administered subcutaneously

According to many studies, cordarone ranks first in stopping paroxysms of atrial fibrillation.

Procainamide, propafenone and quinidine are also used.

If the rhythm is not restored when the above drugs are administered, then cardiac glycosides (digoxin), as well as antagonists, are administered intravenously. calcium channels(verapamil) to slow down the heart rate.

If the effect of drug cardioversion is positive, they switch to continuous use of antiarrhythmic drugs (cordarone, rhythmylene, ethmosin or procainamide).

In each specific case, only the doctor prescribes this or that drug and determines the dose.

Restoration of sinus rhythm with a permanent form of atrial fibrillation

IN in this case the rhythm is also restored with antiarrhythmic drugs, and sometimes electric pulse therapy is used.

Before restoration, long-term anticoagulant therapy is carried out (at least three weeks before and two weeks after rhythm restoration) to “dissolve” the blood clot.

For this, heparin or Clexane is usually prescribed subcutaneously several times a day, the dose is selected individually. Clexane is more expensive and is not used in all hospitals.

1. Normalization of blood electrolytes.
2. Treatment of heart defects using surgical techniques.
3. Treatment of thyrotoxicosis.
4. Normalization of psycho-emotional state, cessation of smoking and alcohol.

Often, having eliminated all provoking factors, the rhythm is restored and no longer “breaks down”.

Why is the rhythm not always restored?

Normal sinus rhythm is not always restored in atrial fibrillation. The reason for this is the long period of atrial fibrillation. Due to the fact that blood stagnates in both atria, they expand significantly.

If echocardiography reveals an increase in the volume of the left atrium of more than 4.5 cm, then, as a rule, in this case the rhythm cannot be restored.

If cardioversions (electrical and medicinal) are ineffective, they switch to tablet forms of beta-blockers to increase the heart rate during the tachysystolic form of fibrillation. At normal frequency heart rate, of course, beta blockers do not need to be taken.

Cardiac glycosides, such as digoxin, are prescribed when heart failure occurs.

Since with atrial fibrillation high probability thrombus formation, it is necessary to take anticoagulants (warfarin, Plavix).

Taking warfarin daily reduces the risk of ischemic stroke, which is a complication of atrial fibrillation.

The dose of warfarin is selected under the control of the INR (INR is the international normalized ratio), which should be within 2 - 3! For one patient this is 1 tablet per day, while for another it may be 3 tablets.

Taking warfarin requires constant monitoring of the INR, at least once a month.

When the INR increases above 3, the risk of bleeding increases. If you are planning any surgery, then be sure to warn your doctor about this!

Some patients do not want to constantly monitor their INR, then they can take Plavix. It does not require laboratory monitoring, but is much more expensive than warfarin and not everyone can buy it monthly.

During drug treatment of atrial fibrillation, you must carefully monitor your well-being! Any changes in your health (episodes of palpitations, dizziness, tendency to bleeding and bruising) should be written down in a diary and then shown to your doctor.

Increased bruising is a sign of excessive anticoagulant therapy!

Surgical treatment

Just as with extrasystole, electrophysiological testing is performed followed by RFA ( radiofrequency ablation). Surgical treatment is considered today very in an efficient way treatment of atrial fibrillation.

Traditional (non-drug) methods of treatment

Viburnum berries widely used as an antiarrhythmic agent. A decoction of these berries is used, take half a glass 2-3 times a day.

Hawthorn fruit infusion can also be taken for any arrhythmias.

Rosehip infusion Take as tea several times a day.

The most common remedy for the prevention of all arrhythmias The following recipe is recommended: take equal amounts of seedless raisins, walnuts peeled, dried apricots, lemon. Grind everything using a meat grinder, pour in honey, mix. Take one tablespoon every morning.

In general, atrial fibrillation is a serious disease, and getting carried away folk ways not worth it.

In conclusion, I would like to say that if any interruptions in the functioning of the heart occur, do not hesitate to call ambulance! Treatment of this rhythm disorder on the first day is much more effective than on subsequent days.

Video about atrial fibrillation and ways to combat it

Atrial fibrillation (atrial fibrillation) is a heart rhythm disorder manifested by frequent chaotic contractions of individual sections of the heart muscle that forms the walls of the atria and an irregular heart rhythm.

In we talked about the causes and symptoms of the disease, and now we’ll talk about methods of treating atrial fibrillation.

Treatment of atrial fibrillation (AF) includes two areas:

• therapy directly for rhythm disturbances;
• prevention of complications caused by.

Arrhythmia can be treated in two ways:

• restoration and maintenance of sinus rhythm;
• control of ventricular rhythm while maintaining an irregular rhythm.

Restoration of sinus rhythm

Restoration of regular sinus rhythm, or cardioversion, is usually performed routinely for persistent (that is, almost constant) AF. In some cases, cardioversion must be performed urgently. The need for this arises in case of acute or arterial hypotension in patients with. When restoring sinus rhythm, it is necessary to reverse special attention for the prevention of thromboembolic complications. There are two ways to restore sinus rhythm: with medications (pharmacological cardioversion) and with an electrical shock.

Pharmacological cardioversion

Restoring rhythm with medications is technically simpler, but less effective. In some cases, it is even carried out at home.
The main disadvantage of this method is the potential toxicity of antiarrhythmic drugs.

Restoring sinus rhythm is most effective when carried out in the first week after the onset of an arrhythmia attack, especially the first in life. With persistent arrhythmia, the effectiveness of drug restoration of rhythm is significantly reduced.

With a purpose medicinal recovery For sinus rhythm in AF, amiodarone, propafenone, and novocainamide are most often prescribed in Russia. Dofetilide, flecainide, ibutilide, and quinidine can also be used. Procainamide, digoxin, and sotalol are considered less effective.

Electrical cardioversion

Electrical cardioversion is the application of an electrical impulse (discharge) that coincides in time (synchronized) with the electrical activity of the heart. It is performed under short-term general anesthesia.

Usually through electrodes placed on the surface chest, apply several discharges with increasing power and an interval between them of at least 1 minute.

There is a method in which the shock is delivered through a catheter inserted through a vein into the right atrium. In this case, the patient does not need anesthesia. This method is especially indicated in the presence of an artificial heart pacemaker.

Dangerous complications of electrical cardioversion are thromboembolic complications and cardiac arrhythmias.

Maintaining sinus rhythm

Maintaining restored sinus rhythm is significant for the prognosis of the disease. For this purpose, the following are used: amiodarone, disopyramide, dofetilide, flecainide, procainamide, propafenone, quinidine, sotalol.
In Russia, allapinin and etacizin are sometimes used. During drug treatment, it is necessary to take into account the likelihood of developing severe complications, including ventricular tachycardia, dyspepsia, skin lesions and others.

Maintenance therapy helps reduce the severity of symptoms and also prevents the development of arrhythmia.
In most patients, even with constant medication use, sooner or later MA recurs. This is especially true for women with organic heart disease.

At the same time, it is necessary to treat the heart disease that caused MA. When treating with antiarrhythmic drugs, it is necessary to periodically monitor the level of potassium and magnesium in the blood, as well as renal function.

The choice of drug for long-term therapy aimed at preventing AF attacks is based on the duration of the arrhythmia, the nature of the underlying heart disease, and the expected arrhythmogenic effect. A cardiologist should prescribe treatment.

Non-pharmacological treatments

A common non-drug treatment for this arrhythmia is catheter ablation, which is the destruction of electrically active tissue in the atria. It is carried out using a special catheter, which is inserted through a vein into the cavity of the heart. After such an operation, the risk of recurrence of arrhythmia within a year is up to 50%.

Another operation that is widely performed is the destruction of the atrioventricular junction, through which impulses from the atria chaotically excite the ventricles. At the same time, a two-chamber device is installed, which makes it possible to simulate the physiological work of the heart and control the frequency of ventricular contractions in patients with AF.

Ventricular rate control

In case of AF, it is necessary to control the ventricular contraction frequency (VFR) so that at rest it does not exceed 60–80 beats per minute, and during exercise – no more than 115 beats per minute.
For this purpose, digoxin, diltiazem, metoprolol, verapamil or amiodarone are prescribed. If they are ineffective, indications for installing an artificial pacemaker are considered.

Prevention of thromboembolic complications

Stroke is a fairly common complication of MA. To prevent it, it is necessary first of all to conduct an echocardiographic study to determine the function of the left ventricle, the condition of the valves, the presence of blood clots in the left atrium and its appendage.
Depending on the risk of thrombosis, patients are prescribed aspirin or oral medications (warfarin). Aspirin is used at a lower risk in patients under 60 years of age, without organic damage heart and without risk factors, which include heart failure, low left ventricular ejection fraction and arterial hypertension. In all other cases, anticoagulants are prescribed.
Continuous treatment with anticoagulants should be carried out under the control of a special indicator that determines the risk of thrombosis and bleeding, the so-called international normalized ratio (INR). Its target level should not be lower than 2.0. At the beginning of therapy, INR is determined weekly, when the patient’s condition is stabilized - monthly.

Treatment with folk remedies

cure atrial fibrillation only by means traditional medicine impossible. However, their judicious use will improve the condition of the heart muscle and normalize the content of electrolytes in the blood.

An aqueous infusion of dill seeds and alcohol tincture yarrow herbs.
The following recipe is very popular for heart disease, including atrial fibrillation: take equal amounts of honey, dried apricots, raisins, peeled walnuts and lemons with peel, chop, mix, take one tablespoon on an empty stomach.

A doctor from an Israeli clinic talks about new methods of treating atrial fibrillation:

Cardiologist

Higher education:

Cardiologist

Saratov State Medical University named after. V.I. Razumovsky (SSMU, media)

Level of education - Specialist

Additional education:

"Emergency Cardiology"

1990 - Ryazan Medical Institute named after Academician I.P. Pavlova

Cardiac arrhythmias are varied and are almost always the result of serious diseases. Every person faces one of its types - tachycardia. Rapid heartbeat is not always a pathology; it can be a variant of the norm during physical and nervous stress. The same can be said about a slow heartbeat - bradycardia. The situation is more serious with other types of arrhythmias, which clearly indicate problems in the body.

Is it possible to restore the heart rhythm on your own?

Heart rhythm disturbances occur due to a malfunction of its conduction system. There are several main types of arrhythmias:

• tachycardia (fast heartbeat);
• bradycardia (slow heartbeat);
• extrasystole (extraordinary contraction);
• atrial fibrillation (random contraction of the atria).

It is not recommended to cope with attacks of any type of arrhythmia on your own, but the first first aid It can be used to normalize heart rhythm, especially with rapid heartbeat. As for extrasystole and atrial fibrillation, the situation here is more complicated and it is impossible to do without the help of a doctor. Medicines will be needed to restore the heart rhythm.

With physiological tachycardia normal heartbeat is restored after the load is removed. Bradycardia does not require assistance unless the heart rate drops below 55 beats per minute and is not accompanied by other painful symptoms.

Signs of arrhythmias

To have an idea of ​​how you can restore heart rate it is important to be able to determine the nature of the arrhythmia and know its signs. To do this, you need to be able to feel the pulse and count it correctly, especially during an attack of atrial fibrillation. Comparison of the pulse and other symptoms will give an idea of ​​​​how the heart works.

Rapid heartbeat

The first sign is a pulse above 90 beats per minute. This may cause the person to sweat a lot. Trembling of fingers on outstretched arms and a nervous state are also signs of an attack of pathological tachycardia. The patient may feel short of breath, and during a severe attack it becomes impossible to count the pulse. The skin turns pale and appears cold sweat, fear of death appears.

Physiological bradycardia is typical for people involved in sports and heavy physical labor. Pathology is indicated when the pulse rate drops below 55 beats per minute, and at 40 beats, urgent medical attention is required. An invariable companion of pathological bradycardia is severe weakness, pallor of the skin and mucous membranes. With a strong decrease in heart rate, convulsions and loss of consciousness may occur.

Extrasystole

Extrasystole does not always require emergency measures. Normally, each person can experience an “extra stroke” up to several times a day. With pathological prolonged extrasystole, medical attention is needed, since in patients with coronary artery disease it can signal the onset of myocardial infarction and other serious conditions. When listening to the pulse after an extraordinary beat, a long pause is observed, which is called compensatory. The patient perceives it as a sinking heart. Extrasystole may also be accompanied by increased rhythm. Possible associated symptoms- nausea and shortness of breath.

The attack is accompanied strong heartbeat, this type is called tachysystolic. The patient clearly feels interruptions in the heart, at times an acute lack of air, pain syndrome in the heart area and dizziness. Seizures may also be accompanied by a decrease in heart rate or occur when normal speed blows.

First aid for arrhythmias

How to restore heart rhythm on your own? There are rules for first aid. But first of all, you need to call a doctor, since not all types of arrhythmia can be dealt with without the use of medications that restore the heart rhythm.

First aid for tachycardia

The first thing to do is to lay the patient down or sit down, remove all constricting clothing that interferes with breathing, and provide him with a flow of fresh air. Fast recovery heart rate will help:

• sedative - tea with mint, lemon balm or motherwort tincture;
• 30 - 50 drops of Corvalol or Valocardin will not only relieve nervous tension, but also dilate blood vessels and slow down the pulse;
• holding your breath - you need to take a deep breath, do not breathe for 5 - 10 seconds, and then exhale and cough;
• washing cold water, and if possible, you just need to dip your face in a bowl of cold water and hold your breath;
• with a little effort you need to press on eyeballs for 5 seconds, then release, repeat several times.

During a severe attack, you can induce vomiting by pressing on the root of the tongue.

How to help with bradycardia?

If a rare heartbeat is accompanied by fatigue, fainting, or weakness, you can provide first aid at home with improvised means that restore normal heartbeat:

• give the patient strong tea or coffee, caffeine will “invigorate” the blood vessels and increase the heart rate;
• You can also use tincture of ginseng or eleutherococcus to improve tone;
• movement and any physical activity will help normalize the rhythm (walking up the stairs, exercises);
• warm bath.

All these activities must be carried out after measuring the heart rate. If the heart rate is below 40 beats, medical attention is required.

Extrasystole and atrial fibrillation

It is impossible to restore rhythm during extrasystole and atrial fibrillation with home remedies. These arrhythmias are signs serious illnesses, and they are treated only with medications. Your doctor should tell you how to properly restore your heart rhythm with the help of medications. Only he can prescribe antiarrhythmic drugs, taking into account existing contraindications and concomitant diseases.

To alleviate his condition during an attack, the patient needs to sit comfortably, or even better, lie down, remove constricting clothing and open access fresh air. In case of a prolonged attack, you must call an ambulance.

During an attack of atrial fibrillation, which can be quite painful, you can try to restore the rhythm by stimulating the vagus - the vagus nerve, which is responsible, in particular, for the innervation of the heart. Need to do deep breath, pinch your nose and mouth and try to exhale forcefully. This method helps with all types of arrhythmias, but, unfortunately, not for all patients.

Most often, medications are used to restore rhythm in atrial fibrillation. If they are also powerless, electrical cardioversion is used. Immersed in short nap the patient is restored normal rhythm using synchronized current discharge. Subsequently, the restored rhythm is maintained using carefully selected drug therapy.

If episodes of atrial fibrillation become significantly less frequent, medications may be discontinued. All medications in this case are aimed at preventing attacks. Sometimes doctors are forced not to treat atrial fibrillation, but only to maintain the heartbeat normal and prevent complications. This tactic is used in severe cases.

Heart treatment is not only drug therapy. Weighted physical activity and nutritional correction are necessary measures to maintain normal heart function.

Human health depends on the proper functioning of the heart. Everyone knows this. As well as the fact that smoking, alcohol, passive lifestyle and poor nutrition negatively affect the functioning of this organ, causing arrhythmia and dangerous pathologies. But not everyone knows that if not neglected, the problem is solved. And not expensive medicines, hospitals and consultations the best doctors, but with affordable and pleasant measures. We will tell you how to restore your heart at home in this article.

Is it possible to restore a heart?

Not every person with cardiovascular problems has a chance to rehabilitate on their own. So, if the doctor has already discovered pathological changes heart, it is forbidden to take the initiative and start cardio training. In this case, there is only one way out - follow the doctor’s recommendations and monitor your well-being.

1. Measure your resting heart rate. Up to 65 beats per minute is normal, above 75 is bad.
2. If the results are good, quickly squat 20 times, in case of poor results, but feel normal, 10 times.
3. Re-measure your pulse. Below 120 beats is normal, above 140 is bad.

In the second case, you will have to look for a doctor who will identify heart problems (disease or lack of proper exercise) and help get rid of them. If the test results are satisfactory, you can begin independent rehabilitation.

How to restore heart function?

Cardio training helps train the heart, restore its rhythm and strengthen the cardiovascular system. There are many tables that show permissible loads depending on age, weight and gender. But such indicators are approximate, and you don’t need to rely only on them. It is much more important to listen to personal sensations and observe your heartbeat during physical activity.

Sports that help restore heart function.

It happens that “the heart beats in the chest like a bird” or “like an autumn leaf trembles.” And sometimes “it will clog up, then it will freeze.”

In medical language, all this is called cardiac arrhythmia. Heart contractions become irregular and irregular.

Keeping the rhythm

Use of Medportal materials on other sites is possible only with the written permission of the editors. User agreement.

Heart disease

iserdce

Drug treatment of atrial fibrillation

Atrial fibrillation is a heart rhythm disorder in which the timing of atrial contraction changes.

In this case, the ventricles can contract at a normal pace (normosystole), slow (badisystole) or accelerated (tachysystole). Treatment of atrial fibrillation can be carried out surgically or medically. Next we will talk about the second treatment option.

General principles

For atrial fibrillation, approaches to treatment tactics can be fundamentally divided into two groups:

• The first group includes drugs that are aimed at restoring sinus rhythm. It makes sense to do this for rare attacks of arrhythmia, normal sizes chambers of the heart, as well as in the absence structural changes myocardium.
• The second group includes drugs that will control the frequency of contractions not of the atria, but of the ventricles. In this case, the ultimate goal is the transition of atrial fibrillation to a normosystolic form. This option is suitable for patients with frequent attacks of arrhythmia, secondary changes in the heart muscle, and large atria.

Regardless of the choice of treatment strategy, most patients with atrial fibrillation are prescribed blood thinners. They are especially relevant when there is a high risk of blood clots and thromboembolism in the vessels of the brain, heart, and limbs.

To effectively treat atrial fibrillation, it is necessary to clearly define the goals of therapy, and then prescribe specific drugs.

Medicines to control pulse

With atrial fibrillation, the doctor usually first strives to gain control over the rate of contraction of the ventricles of the heart. This is due to the fact that the normosystolic form significantly less often leads to the appearance of symptoms of heart failure and is subjectively well tolerated by patients. The goal of this drug treatment is to reduce the ventricular rate to less than 80 (60 with concomitant coronary heart disease) per minute.

If a patient does not control his pulse rate, his risk of developing the following conditions increases significantly:

• sudden cardiac death;
• exacerbation or increase in symptoms of chronic heart failure;
• ischemic stroke;
• systemic bleeding;
• other life-threatening cardiac arrhythmias.

First of all, to reduce the heart rate, it is necessary to eliminate some possible concomitant conditions:

• high body temperature;
• infectious process;
• anemia;
• hypoxia;
• dehydration or hypovolemia.

Beta blockers

Quite often, to reduce the frequency of ventricular contraction, various drugs from the group of beta blockers:

• esmolol;
• propraolol;
• metoprolol

For atrial fibrillation, treatment using these drugs is especially effective in the case of increased activity sympathetic nervous system, which is characteristic of thyrotoxicosis and other endocrine pathologies. This group is also indispensable for patients with concomitant coronary heart disease.

Calcium blockers

For atrial fibrillation, non-dihydroperidine blockers, which include tablets such as verapamil and diltiazem, are used to reduce the heart rate. These drugs are suitable for patients without significant symptoms of heart failure, as well as in cases where there are contraindications to taking beta blockers, for example, with cardiac asthma.

Cordaron

Atrial fibrillation can also be treated using a fairly effective and common drug called cordarone. However for long-term use This drug is not suitable for everyone. It is advisable for patients with the following conditions to avoid taking this drug to treat atrial fibrillation:

• increased sensitivity to iodine;
• weakness of the sinus node;
• electrolyte disturbances (lack of magnesium or potassium);
• atrioventricular block;
• diseases thyroid gland;
• prolongation of the QT interval on the cardiac cardiogram.

In case of hyperthyroidism or hypothyroidism for long-term treatment patients with atrial fibrillation can use sotalol. This drug does not contain iodine and is therefore safe, but its effectiveness is also reduced.

Digoxin

It makes sense to prescribe digoxin for long-term use to patients with severe heart failure. This is due to the fact that in addition to its antiarrhythmic effect, digoxin stimulates and enhances heart contraction, and also increases the ejection fraction.

Due to the fact that this drug tends to accumulate in the body and lead to intoxication, long-term use in patients with atrial fibrillation should be monitored periodically.

At the first signs of digitalis intoxication, it is necessary to discontinue the medicine and prescribe appropriate treatment.

Techniques for restoring sinus rhythm

Most effective technique restoration of sinus rhythm in patients with atrial fibrillation is cardioversion. In this case, the doctor places electrodes on the patient’s chest (in the area of ​​the apex of the heart and in the right subclavian region) and produces a discharge. The success of the procedure largely depends on the presence of structural and anatomical changes in the heart.

It should be remembered that it is safe to restore sinus rhythm only in the first 48 hours after the onset of an arrhythmia attack. In the future, the risk of embolism increases significantly with the development of stroke, gangrene of the limb or heart attack.

Therefore, in this case, patients are prescribed anticoagulants (warfarin, Pradaxa, etc.), which will prevent thrombus formation in the atrium cavities.

Medical cardioversion is alternative technique restoration of sinus rhythm. Treatment of atrial fibrillation using this technique is most effective when:

• recent paroxysm;
• availability clinical symptoms an attack of arrhythmia;
• failed electrical cardioversion;
• as preparatory stage with prolonged paroxysm.

For this purpose, various antiarrhythmic drugs are used:

• procainamide;
• propafenone;
• flecainide;
• sotalol;
• amiodarone;
• dronedarone;
• ibutilide

Their effectiveness largely depends on the duration of the arrhythmia, so in certain situations it is preferable to use certain tablets or solutions:

• For short-term attacks (less than a week), it is advisable to use ibutilide, propafenone, flecainide and dofetilide, while quinidine and amiodarone are less active.
• If the paroxysm lasts more than 7 days, it is advisable to prescribe ibutilide, amiodarone, flecainide, propafenone, quinidine.
• In the case of a three-month rhythm disorder, it is advisable to use amiodarone, propafenone or dofetilide tablets.

From the above data it becomes clear that cordarone is universal and the most effective drug. When prescribed for continuous use, it has a large number of contraindications, while in an emergency it can be used almost everywhere.

Another effective and fairly new drug for treating patients with atrial fibrillation is dronedarone. Its effect is similar to cordarone, but there are significantly fewer side effects, since it does not contain iodine ions in its structure. Because it increases mortality in patients with decompensated heart failure and in those with low left ventricular ejection fraction (less than 35%), it should not be prescribed to patients in these categories.

It should be remembered that all antiarrhythmic drugs have a potential proarrhythmic effect, that is, they themselves can lead to various heart contraction disorders.

Anticoagulants

Treatment of atrial fibrillation, in addition to normalizing the rhythm and frequency of ventricular contractions, also includes the prevention of blood clots and thromboembolism.

Warfarin is most often used to treat a permanent form of atrial fibrillation or for frequent attacks. Its mechanism of action is based on its influence on the cascade of blood clot formation. As a result, not only does the risk of thrombosis decrease, but there is also the possibility of resorption or organization of existing thrombotic masses.

The main disadvantage of this drug is that it is quite high risk development of bleeding (nasal, gastrointestinal, etc.). Therefore, during treatment with warfarin, the blood coagulation system should be carefully monitored. To do this, patients undergo an analysis at least once a month, in which the most important indicator is the INR. The optimal value to maintain is 2.5-3.5.

Pradaxa is a fairly new anticoagulant that is used in the treatment of atrial fibrillation. Due to its special properties, its use does not require monitoring of coagulation parameters, and the risk of bleeding is significantly lower than when taking warfarin.

Atrial fibrillation can be treated in different ways. The main goal of drug therapy is to normalize the heart rate, eliminate the symptoms of the disease and prevent blood clots. If therapy is ineffective, surgical treatment is resorted to.

Cardiac arrhythmia.

Atrial fibrillation

It happens that “the heart beats in the chest like a bird” or “like an autumn leaf trembles.” And sometimes “it will clog up, then it will freeze.” In medical language, all this is called cardiac arrhythmia. Heart contractions become irregular and irregular. There are different types of arrhythmias, but one of the most common is atrial fibrillation.

It is known that with each heartbeat there is a sequential contraction of its parts - first the atria, and then the ventricles. Only such alternation ensures effective work hearts. For arrhythmia that has received beautiful name“flickering”, one of the phases disappears cardiac cycle, namely, contraction of the atria. Their muscle fibers lose the ability to work synchronously. As a result, the atria only twitch chaotically - flicker. As a result, the ventricles begin to contract irregularly.

Why does atrial fibrillation occur?

There are many reasons that can lead to this disease. For example, various diseases hearts: some heart defects, infectious lesion heart and heart failure, ischemic disease heart (CHD) and its formidable complication– myocardial infarction.

Very often, an attack of atrial fibrillation is provoked by drinking more alcohol than usual. There is even such a concept - “cardiac arrhythmia” holidays" On any given day, you can expect arrhythmias to appear in people with thyroid disease (especially those with excessive thyroid function) and some other hormonal disorders.

Arrhythmia often develops after surgical interventions, stroke, various stresses. Certain medications can also provoke its development. For example, taking diuretics for the purpose of losing weight often lands “your own doctor” in a hospital bed. There is a high risk of developing atrial fibrillation in people with diabetes, especially if diabetes is combined with obesity and high blood pressure. Hereditary predisposition also matters. However, doctors are not always able to determine the cause of the arrhythmia.

How to find out about the onset of the disease? It is signaled, for example, by palpitations, when the heart is pounding so much that it seems like it is about to jump out of the chest, while the person himself often feels that the heart is not beating rhythmically. But often the arrhythmia goes unnoticed. Only by feeling the pulse can you establish the irregularity of heart contractions. Often the disease is detected only during a clinical examination using an ECG. But it can be worse: the first manifestations of the disease are complications.

Why is atrial fibrillation dangerous?

It is often accompanied by tachycardia, that is, an increase in heart rate. At the same time, a colossal load falls on the heart. As a result, chest pain may appear - symptoms of angina pectoris or even myocardial infarction. Arrhythmia may reduce the efficiency of the heart. This will lead to another complication - heart failure.

Can arrhythmia go away on its own?

In principle, it can. But if the arrhythmia persists for several hours or complications arise, you should immediately seek help. medical care. However, even if the arrhythmia disappears on its own, you should not postpone your visit to the doctor. Repeated rhythm disturbance can occur at any time and end tragically. Therefore, self-medication will not help much.

As a good song says: “No matter how much you treat the heart with validol, there are still continuous interruptions.” The fact is that restoration of normal rhythm is best done in the first day from the onset of arrhythmia. You can eliminate the arrhythmia later than this period, but then you will need additional training. With atrial fibrillation, when the atria do not contract normally, the blood flow in them sharply slows down, and therefore formations occur. blood clots– blood clots. This occurs on the second day after the onset of arrhythmia. When the normal rhythm is restored and the atria begin to contract, fragments of blood clots can break off and clog the vessels of any organ. Typically, blood clots “float” into the vessels of the brain. And this leads to a stroke.

That is why anyone who consults a doctor more than an hour after the onset of arrhythmia is prescribed drugs that slow down blood clotting. Only when the effect is obtained, after about 1-2 weeks, is it possible to restore the rhythm.

How is normal heart rhythm restored?

The most common is to restore the heart rhythm with the help of medications. These medications are called antiarrhythmics. As a rule, to restore rhythm, they are administered intravenously. However, in some cases, the patient himself can take a tablet of a previously selected medication, which stops the attack of atrial fibrillation. Unfortunately, there are no special signs to determine which medicine will be more effective. In practice, you have to try several medications before you can choose the drug that is most suitable for a particular patient.

In some cases, when an attack of atrial fibrillation cannot be treated with medications or there is an immediate threat to the patient’s life, so-called electrical cardioversion is used to restore the rhythm. Sick on short time(1-2 min) falls into sleep, then a special synchronized (i.e. applied at a certain phase of the cardiac cycle) electric current discharge restores the heart rhythm. The method has several disadvantages - the need to put the patient to sleep, the need for special equipment to carry out the procedure. In addition, this procedure must be performed in a hospital that has highly trained personnel. But there are also significant advantages. Thus, the rhythm is restored in almost all cases (unlike drugs, which restore the rhythm only in 60-80%). This method is the safest, since any medicine has side effects. If they appear, then it takes time for the medicine to leave the blood. Taking into account the advantages of cardioversion, special devices sewn under the skin - cardioverters - were created that detect atrial fibrillation and stop it. However, these devices are not yet widely used.

Keeping the rhythm

After the rhythm is restored, it is necessary to maintain it. It is necessary to treat the disease that led to atrial fibrillation and eliminate the factors that provoke the attack. If attacks are rare, then sometimes special antiarrhythmic therapy is abstained. However, most often you have to take medicine to prevent the development of arrhythmia.

Sometimes, for frequent attacks that are difficult for patients to tolerate, surgical treatment must be used.

Can atrial fibrillation persist for a long time and is it dangerous?

There are two main forms of arrhythmia: paroxysmal, which manifests itself in individual attacks, and constant, when atrial fibrillation persists for years or even decades. With a permanent form, it is preferable to refuse to restore the normal rhythm. Of course, constant arrhythmia threatens major complications, especially if accompanied by tachycardia. But here regular use of medications that slow down the heart rate helps. Is it harmful to take pills all the time? It’s a shame that even in our enlightened age people prefer to get sick so as not to “contaminate the body with chemicals.” It is safe to say that refusing treatment will bring much more more harm body.

Diagnosis and treatment of arrhythmias

Arrhythmia can be an independent disease, or it can be a symptom of another disease. Some arrhythmias may go away on their own. But if the arrhythmia persists for several hours or complications arise, you should immediately seek medical help. However, even if the arrhythmia disappears on its own, you should not postpone your visit to the heart pain or shortness of breath.

To determine the cause of arrhythmia, an electrocardiogram (ECG) of a person is recorded as prescribed by an arrhythmologist. ECG-atropine tests (this is a method based on taking a cardiogram after the injection of atropine into a vein - a substance that causes a change in the regulation of heart rhythm), ECG in a state of physical activity, ECG monitoring during the day and ultrasound examination of the heart - echocardiography.

Treatment

If arrhythmia develops as a complication of another disease, it may go away after the underlying disease that caused it is eliminated, although additional antiarrhythmic drugs are sometimes required. When arrhythmia is an independent disease, drugs that normalize the rhythm become the main method of treatment. In some cases, upon the direction of an arrhythmologist or cardiologist, transesophageal electrical stimulation of the heart is performed to restore the heart rhythm - this method is also used to diagnose arrhythmia. If the arrhythmia is constant symptom and cannot be cured medicinally, then the person is implanted with a pacemaker - an artificial pacemaker. For arrhythmias associated with anatomical abnormalities of the conduction system, there are surgical treatment options.

If you suffer from arrhythmia attacks, you should take care to prevent them if possible. For example, people suffering from arrhythmias during solar activity - i.e. magnetic storms, - you must carefully follow doctors’ orders and always have your medications with you. Remember, attempting to self-treat arrhythmia is an unreasonable and dangerous practice! The method of treating arrhythmia for each patient should be chosen by a specialist, taking into account the cause, type and degree of arrhythmia after all the necessary studies.

How to treat cardiac arrhythmia

What is cardiac arrhythmia? Normally, the heart contracts at regular intervals at a rate of 60–90 beats per minute. In accordance with the needs of the body, it can either slow down its work or speed up the number of contractions within a minute. According to WHO definition, arrhythmia is any rhythm of cardiac activity that differs from normal sinus rhythm.

Why does my heart skip a beat?

In general, the conduction system is responsible for the contractions of the heart muscle, which consists of special fibers that move the bulk of the contractile cells of the myocardium, and special pacemakers that obey normal conditions sinus node.

Sometimes in the case of myocardial disease, the presence of scar tissue, damage electric shock the initiative is temporarily intercepted by other cardiac pacemakers: the atrioventricular node or the ventricular conduction system.

What types of arrhythmias are there?

Depending on which part of the conduction system of the heart is responsible for the occurrence of changes in heart rate, the following types of arrhythmias are distinguished:

1. Pacemaker – sinus node: sinus tachycardia and bradycardia, sinus arrhythmia, as well as sick sinus syndrome.
2. The pacemaker is not the sinus node: atrioventricular and lower atrial, idioventricular rhythm.

In addition, there are:

1. Arrhythmias arising due to impaired excitability of various parts of the heart: extrasystoles, paroxysmal tachycardia.
2. Arrhythmias based on conduction disturbances: WPW syndrome, various blockades.
3. Mixed arrhythmias: flutter, ventricular or atrial fibrillation.

How is arrhythmia diagnosed?

Some types of arrhythmias, for example single extrasystoles, are practically not felt by a person, therefore the most reliable way to register them is an ECG, including 24-hour monitoring (for example, Holter). On an ECG, arrhythmia is recorded in the form of a curve that has deviations from the standard one.

Particularly dangerous types of arrhythmias: flickering and fluttering

Atrial flutter is characterized by a pulse rate of up to 150–160 times per minute, and special F waves appear on the ECG (their frequency is up to 350 times per minute).

Fibrillation, atrial fibrillation

Registration of f waves on the ECG (frequency - over 350 per minute). The heart beats at an irregular rate.

Ventricular fibrillation

The contraction frequency of myocardial fibers reaches 480 in 1 minute, while the heart actually stops working and stops.

Atrial fibrillation: how to treat with folk remedies?

Irregular heart rhythm is a symptom of internal failures or external factors, affecting the conduction system. Atrial fibrillation (atrial fibrillation, ventricular fibrillation) is characterized by increased heart rate up to beats per minute. Contraction of the ventricles and atria occurs chaotically. Most often it is detected in elderly men who have had heart disease for a long time. The basis of the treatment regimen is medications. It is possible to reduce the severity and frequency of attacks of atrial fibrillation by supplementing the course of treatment folk remedies. They saturate the body with useful substances and have a minimum number of contraindications.

Definition

Atrial and ventricular fibrillation (flutter) are chaotic contractions of individual muscle tissues, which disrupt hemodynamics (blood flow). The cause of arrhythmia lies in a violation of the conduction system of the heart. Its trigger (the triggering mechanism of the attack) is often extrasystole. This type of failure is characterized by extraordinary reductions.

According to the form of manifestation, atrial fibrillation can be of the following types:

By contraction frequency this type Arrhythmias are of the following types:

Reasons for the failure

The main culprit of disturbances in the conduction system of the heart, causing atrial fibrillation, is a weakened sinus node (natural pacemaker). Its functions compensate for the emerging foci of ectopic (replacement) signals. Various external and internal factors, which are divided into cardiac and non-cardiac. The first category includes the following reasons:

• Hypertension is manifested by high blood pressure. The heart works faster, pushing a large volume of blood, which is why it gradually hypertrophies (grows). Muscle tissue weakens, which leads to dysfunction of the sinus node and the conduction system as a whole.
• Disruption of blood flow coronary arteries is the main cause of failures in the conduction of the sinus node impulse. The heart muscle does not receive the required amount nutrients, as a result of which arrhythmia develops.
• Inflammatory diseases disrupt the conduction of electrical impulses. The essence of the problem is damage to the walls of the heart muscle, due to which the signal cannot fully pass through.
• Heart surgery is extremely dangerous and leaves behind traces in the form of scar tissue at the site of intervention. They don't conduct the electrical impulse, so it has to take other paths, causing an arrhythmia.
• Tumors gradually grow and cause disruptions in the conduction system. The impulse cannot reach its target, which leads to the development of pockets of false signals.
• Heart defects can cause atrial fibrillation even in young people. Particularly common is prolapse (incomplete closure) of the valves, due to which a small amount of blood enters the atria during the contraction of the ventricles. Over the years, individual chambers of the heart muscle hypertrophy, which leads to arrhythmia and other pathological processes. No less noticeable among congenital defects are insufficiently developed vessels feeding the myocardium. Because of them, the patient may experience cardiac ischemia.
• Heart failure can be both a consequence of atrial fibrillation and its trigger. The occurrence of pathology is associated with birth defects And hypertension. Because of it, the automaticity of the heart is disrupted, which manifests itself in various failures.

A group of non-cardiac factors influencing the development of arrhythmia:

• Abuse bad habits has a detrimental effect on the heart muscle and blood vessels. The main triggers for heart failure are alcohol, cigarettes and drugs. Because of them, organic damage gradually develops.
• Stressful situations provoke disruptions in nervous system, which is the main regulator of heart rhythm. No less dangerous is the excessive release of adrenaline, which is intensely synthesized under their influence and increases the pulse rate.
• Physical overload must be compensated. The heart has to work much harder to increase blood flow to muscle tissue. The wiring system malfunctions due to increased load.
• Abuse of caffeine and strong tea leads to the development of tachycardia. It is characterized by rapid heartbeat, which can subsequently cause atrial fibrillation.
• Medicines that have antiarrhythmic effects (diuretics, adrenoreceptor stimulants, calcium blockers and other drugs) provoke disruptions in the electrolyte balance. The impulse begins to be carried out worse or problems arise with its creation.
• Diseases caused by infections are manifested by an increase in body temperature. One degree above normal increases the heart rate by 10 beats per minute. Their inherent intoxication is no less dangerous. It provokes disruptions in the autonomic (vegetative) part of the nervous system. The combined effect of these factors leads to the development of arrhythmia.
• Dysfunction of the thyroid gland contributes to increased synthesis of its hormones. Because of them, the heart rate increases and blood vessels constrict.
• Disturbances in electrolyte balance often develop due to strict diets, improperly formulated diets and prolonged fasting. A person develops a deficiency of microelements necessary for the normal functioning of the heart (potassium, calcium, magnesium). Their lack leads to disruption of impulse conduction.
• Respiratory diseases chronic course are one of the main reasons oxygen starvation, due to which malfunctions of the heart occur. The natural pacemaker ceases to adequately perform its functions and arrhythmia develops.
• Diabetes mellitus, which results from impaired insulin perception or production, is often accompanied by obesity. Because of it, metabolic disruptions occur and blood vessels are destroyed under the influence high level Sahara.
• Night apnea manifests itself in the form of stopping breathing for a short period of time (5-10 seconds). This phenomenon leads to the development of oxygen starvation, which causes disturbances in the heart rhythm.
• Electric shock can cause severe disruption to the transmission of impulses through the wiring system. Usually the patient experiences erratic contraction of the atria or the heart stops altogether.

Clinical picture

Attacks of atrial fibrillation are manifested by a whole complex of symptoms. The main one is considered to be increased heart rate. The ventricles can contract up to 180 times per minute, and the atria up to. The heart may not be able to withstand such a rhythm and takes short breaks, as a result of which the patient feels that it stops beating at some moments. The pulse is difficult to palpate during an attack. Related similar phenomenon due to insufficient blood flow into the ventricles, since the atria, contracting with such frequency, cannot fill them fully.

Among other manifestations of a malfunction in the heartbeat, the most basic ones can be identified:

• Pain in the chest area occurs due to overwork of the heart muscle or its insufficient nutrition. Nerve endings located in the organ, send corresponding impulses, which leads to unpleasant sensations.
• General weakness, loss of consciousness and dizziness are manifested as a result of brain hypoxia against the background of hemodynamic disturbances during an attack.
• Increased synthesis of urine (urine) occurs under the influence high pressure and disruption of the nervous system. Afferent nerves transmit a signal that causes the kidneys to work harder.

• Shortness of breath occurs when receiving physical activity. Experts believe that this symptom is a consequence of excitation of the respiratory center, which is provoked by disruptions in the functioning of the heart. The vagus nerve transmits impulses to respiratory tract and a characteristic clinical picture appears.

Effective folk remedies

Heartbeat irregularities are a consequence of a number of factors. Without eliminating them, it will not be possible to fully recover. Folk remedies for the treatment of atrial fibrillation allow you to stop attacks at home. They must be used in combination with basic methods of therapy. They are based on tablets with antiarrhythmic and heart-supporting effects. In severe cases, doctors will recommend surgery. This method is used when there is no effect from the main course of treatment and often saves the patient’s life.

Folk remedies for attacks of atrial fibrillation are prepared from natural ingredients. The most relevant recipes are those made with viburnum, dill seeds, dried apricots, honey, rose hips and mint. If desired, you can purchase medicinal fees at the pharmacy. The duration of the course is usually 1-2 months, followed by a break.

Phytotherapy

Traditional medicine and herbal medicine are two interrelated concepts. The essence of the latter lies in the use of plants with a healing effect and medicines based on them. As a treatment for atrial fibrillation, you must purchase (or prepare yourself) a collection of the following components:

Mix all components in equal proportions and pour a glass of boiling water over 60 g of the prepared mixture. The product will need to sit for 1-2 hours, and then you can remove the raw materials from it. Drink ½ cup morning and evening for 1 month.

Honey therapy

Honey has an invaluable composition, so it is often added to various decoctions and infusions used for atrial fibrillation. As a treatment, you can prepare the following medicine based on this component:

• grind 1 kg of lemons;
• mix the resulting pulp with 200 ml of honey;
• Use the finished product 30 ml 2 times a day.

If honey is used as a component various decoctions or infusions, you will need to wait until they cool down. Otherwise, it will lose its healing properties.

Kalina. Viburnum berries help saturate the heart with essential substances. Getting ready useful decoction of which as follows:

• 200 g of viburnum pour 500 ml of boiling water;
• place the container on low heat;
• after 5 minutes, remove from the stove;
• drink ½ cup of decoction in the morning and evening.

Dill seeds. Dill seeds stabilize blood pressure and reduce the severity of arrhythmia. You can make a decoction from them according to the recipe below:

• pour 50 g of dill seed with 250 ml of water;
• place the container on the stove and bring to a boil;
• take out the raw materials and drink 70 ml 3 times a day.

Medicinal properties of rose hips. You can prepare a heart-healthy rosehip decoction using the recipe below:

• remove seeds from 50 g of rose hips;
• pour 700 ml of boiling water over the purified ingredient;
• place the container in a water bath;
• after 10 minutes, remove the broth from the heat and strain;
• add 60 ml of honey to the cooled product;
• drink the medicine before meals, 0.5 cups.

A mixture of dried apricots, nuts and raisins. You can stop atrial fibrillation and improve heart function with a gruel made from dried apricots, nuts and raisins. Her recipe looks like this:

• Mix 20 g raisins, 50 g nuts and 200 g dried apricots together;
• add 1 grated lemon and 150 ml of honey to the pulp;
• let the medicine brew for 2-3 hours;
• Take 60 ml after meals in the morning.

A combination of mint and calendula. Mint and calendula relieve nervous tension, stabilize heart rate and dilate blood vessels. A medicine is prepared from them according to the following recipe:

• mix mint and calendula in equal parts;
• pour 500 ml of boiling water over 50 g of collection;
• After cooling, strain the product and add 30 ml of honey;
• drink 1 glass 3-4 times a day.

Diet for arrhythmia

For any type of heartbeat abnormality, it is necessary to observe strict diet. It is advisable for the patient to refuse fatty foods in favor of vegetable. The daily diet should contain more foods rich in magnesium and potassium (cocoa, nuts, cereals, sorrel, legumes, seaweed, beans). They will stabilize the electrolyte balance and improve impulse conductivity.

List of tips for correct drafting diet for arrhythmia can be seen below:

• Fruits and vegetables should be on the daily menu. It is advisable to use them fresh.
• Experts recommend reducing the load on the stomach and heart by grinding the ingredients in a blender.
• Cooking should only be done by boiling, stewing or steaming. Canned food, as well as fatty and smoked foods should be avoided.
• It is advisable to replace coffee with herbal decoctions (valerian, hawthorn, motherwort) or green tea.
• Quantity consumed confectionery needs to be reduced.
• It is recommended to stop using spices and salt or reduce them to a minimum.

The daily diet should be structured in such a way that plant food was approximately 60%, and protein and carbohydrates were 20-30%. By following the recommendations, you can reduce the likelihood of attacks by improving the degree of absorption of foods and metabolic processes generally.

Atrial fibrillation often occurs in adults due to various irritating factors. Its attacks can be fatal, as severe disruptions in hemodynamics occur. As a treatment, doctors recommend sticking to traditional methods in combination with folk remedies. They will saturate the body with useful substances and improve the functioning of the heart muscle.