What are atrial fibrillation symptoms? Atrial fibrillation. Causes, symptoms, diagnosis and treatment of the disease. Such heart pathologies include

Atrial fibrillation(MA) is a disease caused by wear and tear of the heart muscle and the development of various pathological conditions of other organs and systems. Like most other diseases, atrial fibrillation is associated with age: its prevalence increases after 40 years.

An important age milestone is the seventh decade of life. If about 2% of the population under the age of 65 suffers from MA, then in the group after 65 years the figure gradually increases to 10%.

Closer to the age of 80, signs of atrial fibrillation are present in every fifth elderly person, that is, in 25% of this age group.

The causes, symptoms and treatment of atrial fibrillation are well known and discussed in detail in articles on our website. All this will be discussed in general below.

Atrial fibrillation: what is it?

The term “atrial fibrillation” is traditionally used not only by patients, but also by cardiologists. Although in latest version There is no international classification of diseases (ICD 10) under this name. Instead, the term “atrial fibrillation” is used, which more accurately reflects the essence of the disease.

What is atrial fibrillation?

The impulse that controls the contraction of the heart is called sinus and originates in the sinus node, which is also called the main pacemaker. Further along the conduction system of the heart, the impulse passes through the atria to the ventricles, leading to their sequential contraction.

With arrhythmia, some impulses are blocked, some are looped, which leads to their repeated entry into the same area (“reentry”). As a result, the heart stops contracting normally: instead of a full 60-70 contractions, it begins to “flicker” at a frequency of up to 600 times per minute.

It is wrong to think that in patients with MA the heart contracts at a frequency of several hundred times per minute. This would cause it to stop instantly. The conduction system of the heart is designed in such a way that it cannot transmit such frequent impulses. The so-called atrioventricular node, which transmits impulses from the atria to the ventricles of the heart, reduces their number.

Thus, only the atria are affected by atrial fibrillation; ventricular fibrillation does not occur. It is for this reason that the term is gradually falling out of use. The modern code for atrial fibrillation according to ICD 10 is I48 - Atrial fibrillation and flutter. This state of affairs will continue in ICD 11, which will be released in 2017, and in subsequent classifications.

In this article, we will use the terms atrial fibrillation (AF) and atrial fibrillation (AF) interchangeably.

A heart with atrial fibrillation is unstable. There are many reasons for impaired electrical conductivity of the heart muscle. These are, first of all, diseases caused by the condition of blood vessels and the heart:

• atherosclerosis and hypertension;
• cardiac ischemia;
• heart attack;
• sclerotic changes in the heart muscle;
• heart defects;
• heart failure.

Other body systems also influence the functioning of the heart. Such causes are usually classified as non-cardiac (extracardiac). Among them:

• endocrine disorders;
• metabolic disorders;
• chronic lung diseases;
• neurogenic causes.

Attacks (paroxysms) of MA can be provoked by the following factors:

• stress;
• excessive alcohol consumption.

Can atrial fibrillation be caused by allergies? The role of autoimmune diseases in the development of atrial fibrillation is unknown.

Classification of atrial fibrillation is carried out on two grounds:

• possibility of restoring the correct sinus rhythm;
• change in heart rate.

Based on the first, paroxysmal, persistent, long-persistent and permanent atrial fibrillation are distinguished.

Forms of atrial fibrillation, in accordance with the second basis of classification, are divided into:

• accompanied by rapid heartbeat (tachysystolic form of atrial fibrillation);
• accompanied by a slow heartbeat (bradycardia);
• occurring against the background of a normal heart rhythm (normosystolic type).

In most cases, paroxysms are accompanied by atrial fibrillation with a heart rate of more than 90 beats/min.

The mildest form of atrial fibrillation is the paroxysmal form. The leading feature of the clinical picture of atrial fibrillation of this type is the spontaneous restoration of sinus rhythm without taking medications.

Why does the rhythm spontaneously restore during MA? As a rule, this is due to the cessation of exposure to the factor that provoked the attack of atrial fibrillation: for example, a decrease in stress, emotional or physical stress.

Atrial fibrillation is an abnormal heart condition. If possible, it will try to return to normal impulse conduction.

People suffering from atrial fibrillation are advised to take herbal-based sedatives: hawthorn, motherwort, valerian.

Radish, as well as its juice and infusion, have a positive effect on the heart. peppermint. Rose hips and viburnum have a general strengthening effect on the heart muscle.

Nevertheless folk remedies cannot replace visiting a doctor and receiving adequate drug therapy.

Since in most cases people suffering from atrial fibrillation have other cardiovascular pathologies (in particular, hypertension), the diet should be based on the exclusion of foods that negatively affect the condition of blood vessels. This primarily concerns:

• sugar and everything that contains it in high concentrations, including sweet fruits;
• salt and prepared products with high content salts (vegetable pickles, sausages and other processed meat products, overly salted cheeses);
• any fatty meat and fatty broths (including chicken);
• butter, margarine, bread and culinary products containing them.

Atrial fibrillation suggests an increase in the consumption of raw and cooked vegetables. Vegetables contain virtually no sugar (unlike fruits), usually contain little acid (unlike berries), and at the same time are a reliable source of vitamins and antioxidants. Vegetables should be present in the diet all year round.

Lifestyle with atrial fibrillation

All heart diseases require leading a lifestyle that is traditionally characterized as healthy. Atrial fibrillation is no exception.

Standard recommendations include mild physical exercise for atrial fibrillation: morning exercises, daily walks in the fresh air. A person should maintain natural mobility and should not lie down all the time (except during periods of an arrhythmic attack).

A separate issue is the combination of the diagnosis of atrial fibrillation and alcohol.

People with heart disease should not abuse alcohol.

At the same time, it is known that in small quantities alcohol can have positive influence, in particular: on the nervous system (calming effect), on digestive system(stimulates digestion), on blood vessels (dilates blood vessels). IN exceptional cases a person suffering from atrial fibrillation can drink no more than 50 g of a drink with 40% alcohol and no more than 150 g of a drink with 12% alcohol per day.

When choosing a tonometer for atrial fibrillation, it should be taken into account that not all devices are capable of correctly measuring blood pressure in patients with abnormal heart rhythm.

The main danger of atrial fibrillation is that each attack carries a risk of death.

The form of the disease does not have a significant impact on the prognosis and complications of MA. Thus, the prognosis for a permanent form in a person who follows the doctor’s instructions and correct image life may be more favorable than that of a patient with rare paroxysms who does not pay attention to his health.

Why is cardiac MA dangerous?

• development of ventricular fibrillation;
• development of heart failure.

Many patients are interested in whether atrial fibrillation gives disability. As a rule, they don't. The exception is cases of cardiac ablation followed by implantation of an artificial pacemaker (pacemaker).

Useful video

For more information about atrial fibrillation, watch the following video:

Conclusion

Atrial fibrillation - dangerous pathology. People who encounter it should follow the doctor’s instructions and also follow the basic recommendations:

• adhere to moderation in everything;
• do not overexert yourself physically and emotionally;
• lifestyle with atrial fibrillation should not change dramatically.

Remember that all changes, even healthy ones, should happen slowly. This is especially true for older people, whose adaptive capabilities of the body are reduced.

Our heart is forced to contract by electrical impulses. Typically, the “generators” of these impulses operate rhythmically. When the impulses arrive irregularly, chaotically, then arrhythmia occurs. The most common type is atrial fibrillation.

What is atrial fibrillation? With this rhythm disturbance, atrial fibrillation (fibrillation) occurs, that is, uncoordinated twitching of the atrium muscle bundles, as a result of which it cannot fully contract.

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Consequences of atrial fibrillation

Atrial fibrillation causes the heart to be unable to pump blood normally. That is, other organs do not receive enough nutrition and oxygen, some of the blood may remain in the heart, and the risk of blood clots increases.

In 35% of cases, atrial fibrillation leads to a heart attack.

For these reasons, consequences such as ischemic stroke and myocardial infarction occur. Every sixth stroke develops in a patient with this diagnosis, and 35% of patients experience heart attacks during their lifetime.

Atrial fibrillation can transform into ventricular fibrillation, leading to heart failure and even sudden cardiac arrest and death.

Why is atrial fibrillation dangerous? Possible consequences:

• Ischemic stroke,
• Myocardial infarction,
• Ventricular fibrillation,
• Heart failure,
• Arrhythmogenic shock (cardiac arrest).

Look at the requirements for . Proper rehabilitation can almost completely restore body functions.

Find out in advance the cost of heart surgery to replace a valve.

Causes of atrial fibrillation

Extracardiac causes (general causes)

• Diseases thyroid gland,
• Nervous stress
• Intoxication medicines, drugs, alcohol,
• Viral infections
• Chronic obstructive pulmonary diseases,
• Electrolyte disorders, in particular a lack of potassium in the body.

Cardiac causes (heart)

• High blood pressure,
• Coronary artery lesions
• Heart defects
• Cardiomyopathy,
• Heart failure,
• Pericarditis,
• Irregularities at work sinus node,
• Complications after heart surgery.

Leading specialists from clinics abroad

Classification of atrial fibrillation

Depending on the clinical picture, paroxysmal and permanent atrial fibrillation are distinguished.

Paroxysmal atrial fibrillation

The paroxysmal form of atrial fibrillation means its paroxysmal course.

An attack (paroxysm) of arrhythmia can last from one to several days. It consists of an interruption in the rhythm of heart contractions. The heart works under increased load, so the attack is usually difficult to bear.

Diagnosis of paroxysmal atrial fibrillation is based on an electrocardiogram. On ECG signs atrial fibrillation have their own characteristics.

Permanent form of atrial fibrillation

In case of chronic disturbance of the heart rhythm, long periods of its chaotic contraction, constant atrial fibrillation is diagnosed.

In addition to irregular heartbeat, weakness, trembling, sweating are noted, and a feeling of fear may occur. This form of arrhythmia is dangerous due to the progression of heart failure and the formation of blood clots.

Most often, a permanent form of arrhythmia is observed in people over 60 years of age.

Depending on the heart rate there are:

• Normosystolic arrhythmia, in which the number of heart contractions remains normal (60-90 beats).
• Tachysystolic arrhythmia when, in addition to disturbances in the rhythm of heart contractions, their acceleration is observed (over 90 beats per minute).
• Bradysystolic arrhythmia, during an attack of which the heart contracts less frequently (less than 60 contractions).

Signs of atrial fibrillation

• An attack (paroxysm) of atrial fibrillation is accompanied by heart pain, shortness of breath, muscle weakness, and tremor.
• Symptoms such as increased sweating and frequent urination are common.
• Dizziness and even fainting may occur.
• In addition to everything, the patient feels a strong inexplicable fear.

The signs are most pronounced in the tachysystolic form of atrial fibrillation.

• During normal heart function, P waves are present on the ECG (see Fig. “a”). In atrial fibrillation, P waves are absent; instead, f waves of different shapes and heights are recorded (see Fig. “b”).
• R-R intervals of different durations (see Fig. “b”), in contrast to normal ECG, where the R-R intervals are the same (see Fig. “a”).
• Subject to slight change S-T segment and T wave.

ECG with normal heart function (a) and ECG with atrial fibrillation (b).

Treatment of atrial fibrillation

Treatment is aimed at restoring the rhythm and normalizing the heart rate (in tachysystolic and bradysystolic forms of the disease). The cardiologist will draw up a diagram of how to treat atrial fibrillation and make the necessary appointments.

First aid for paroxysmal atrial fibrillation

How to relieve an attack of atrial fibrillation? If, despite following the instructions, an attack begins, you should immediately take the medicine prescribed by your doctor for atrial fibrillation. This may be enough to relieve paroxysm.

An attack of atrial fibrillation must be stopped within 48 hours.

If your health has sharply worsened, you feel pain in the chest, shortness of breath, there is no need to wait for the medicine to take effect - you need to call urgently ambulance. While you are waiting for an ambulance, you should ensure access fresh air, if you feel weak and dizzy, you need to lie down.

One of the most dangerous complications of atrial fibrillation is cardiac arrest. In this case, we are talking not so much about relieving an attack, but about treating paroxysmal atrial fibrillation to save the patient’s life. You may have to do this before the doctor arrives. indirect massage heart and artificial respiration. It is important not to panic, because someone’s life may depend on your actions.

In any case, stopping an attack of atrial fibrillation must be done within 48 hours, otherwise blood clots will form and the risk of complications such as heart attack and stroke significantly increases. The attack is usually controlled by administering antiarrhythmic drugs If the effect does not occur, electropulse therapy is performed.

Treatment of atrial fibrillation with folk remedies

In the early stages of the disease and with mild symptoms, as well as as an additional therapy, folk remedies can be used for treatment.

Mostly, traditional treatment is a herbal medicine aimed at supporting and nourishing the heart. The most commonly used plants are:

• hawthorn,
• lemon,
• celery,
• adonis grass

The action of plants is based on their high content of potassium, magnesium and other substances that have a beneficial effect on the heart muscle.

• Hawthorn is used fresh, in the form alcohol tinctures and water decoctions.
• Lemon and onion are most often used pureed.
• Celery can simply be eaten regularly.

Treatment methods prescribed by a cardiologist

• Drug therapy,
• Surgical treatment: pacemaker implantation, catheter ablation.

1. Drug therapy

Drug treatment of a permanent form of atrial fibrillation involves the use of antiarrhythmic drugs, beta-blockers, anticoagulants and metabolic drugs. Each group of drugs has its own goals for influencing the body.

Drugs for the treatment of atrial fibrillation:

• Antiarrhythmic drugs(Verapamil, Cordarone) - with their help, normal heart rhythm is maintained. At intravenous administration the action can begin within 10 minutes.
• Beta blockers(Atenolol, Sotalol, Bisoprolol) is a large group of drugs used to regulate blood pressure and reduce heart rate. These drugs prevent the development of heart failure.
• Anticoagulants- needed to thin the blood, respectively, to prevent the formation of blood clots.
• Metabolic drugs- nourish and protect the heart muscle. These include ATP, potassium and magnesium preparations, Riboxin, Mexicor and others.

1. Surgical treatment of atrial fibrillation

Surgery involves implantation of a pacemaker and catheter ablation, which can be performed using:

• laser,
• chemical substances,
• cold
• radiofrequency method.

Operations on open heart are practically a thing of the past.

Open heart surgery is virtually a thing of the past. Today surgery arrhythmias are minimally invasive operations performed under local anesthesia, through small incisions and punctures in the collarbone area or abdominal cavity, as well as by inserting a catheter through femoral vein.

Implantation of a pacemaker for atrial fibrillation is a fairly effective treatment when the patient has a bradysystolic form. The device sends signals to the heart at the desired frequency, doing this only when the heart needs it.

Ablation is a kind of “cauterization” of the part of the heart that is responsible for delivering the electrical impulse. A microscar is formed, due to which the affected area loses conductivity. Thus, it is possible to eliminate the cause of heart rhythm disturbances.

Radiofrequency ablation (RFA) is most widely used. This operation is performed quite quickly and has no age restrictions.

Immediately before the radiofrequency ablation operation, a thorough examination is carried out, special preparation is performed: a drug is administered to prevent thrombosis.

The electrode used to perform the procedure is brought to the heart through the femoral vein. The entire course of manipulation is controlled using visualization on the monitor. Thanks to this, the likelihood of the surgeon making mistakes is minimized.

The success rate of the operations is about 85%. A significant portion of patients today prefer to undergo such an operation instead of being on pills for many years.

Where to treat atrial fibrillation?

Extensive experience in performing operations to treat atrial fibrillation has been accumulated in clinics in Germany and Israel. Many of them have the most modern equipment, which helps to carry out diagnosis and treatment in the most short time. As for pacemakers, Israeli clinics have been using them for the treatment of arrhythmias for more than 50 years.

How much should you expect to receive qualified help from foreign cardiologists? Diagnostics will cost approximately 2,000-3,000 US dollars, and treatment in Germany will cost about 25,000 dollars. Israeli medicine is in many cases 30-50 percent cheaper.

Treatment in an Israeli clinic

Oncogynecology in Israel

Is it possible to prevent atrial fibrillation?

If there is no arrhythmia yet, then no special prevention other than a reasonable lifestyle is required.

You need to be able to relieve nervous tension without harm to your health.

How to live with atrial fibrillation? If arrhythmia already exists, then to prevent its attacks it is necessary:

• quit smoking
• establish weight control,
• learn to shoot nervous tension without harm to health.

Vigorous physical activity for atrial fibrillation can be helpful, but it should be discussed with your doctor. Older patients are unlikely to start active physical training.

Nutrition for atrial fibrillation is an important factor in prevention

What should be the diet for atrial fibrillation?

• Food should not be fatty,
• more plant components,
• For electrolyte balance, you need to regularly consume foods rich in potassium (honey, walnuts, dried apricots, pumpkins, zucchini).

You should not eat at night; it is better to take food in small portions.

A disease called atrial fibrillation manifests itself in the form of a chaotic disturbance in heart rhythm. But it is not the disease itself that is scary, but its complications, which is why it is so important to diagnose it in time.

According to statistics, atrial fibrillation is the most common reason for hospitalization with heart rhythm disturbances, accounting for 30% of such cases. There is a picture of an increase in the proportion of this pathology with age: people under 60 years of age suffer from it in 1% of cases, and older than this milestone - already in 6%.

What is atrial fibrillation?

Atrial fibrillation is expressed by characteristic disturbances of the heart rhythm, which become characteristic randomness in the frequency of contractions and excitations experienced by the atria, or twitching and fibrillation of individual groups of myocardial muscles. The heart rate in this condition can reach 600 beats per minute.

Prolonged paroxysm of atrial fibrillation, lasting up to 2 days, threatens the formation of a blood clot and ischemic stroke. Persistent atrial fibrillation leads to a rapid increase in the chronic form of blood supply failure.

Video about what atrial fibrillation is:

Causes of atrial fibrillation

The most common causes of atrial fibrillation are included in the group of cardiovascular diseases:

• chronic ischemic heart disease (coronary heart disease);
• hypertension;
• cardiomyopathy;
• heart defects resulting from a history of rheumatic disease.

At the time of heart surgery or immediately after surgery, attacks of paroxysmal atrial fibrillation are often observed. When such atrial fibrillation occurs, its causes are usually not related to drug intervention.

Other causes of atrial fibrillation:

• Frequent use of not only medications, but also drinks containing caffeine, as it activates myocardial contractility.
• Systematic consumption of alcohol, which causes intoxication and alcoholic cardiomyopathy.
• In patients with thyroid pathology complicated by signs of hyperthyroidism, atrial fibrillation occurs in a quarter of cases. This frequency is explained by the fact that catecholamines have a potentiated effect on the excitability of the atrial myocardium.
• Taking certain groups of medications (atropine, adrenaline, diuretics) increases the risk of rhythm disturbances, since these drugs directly affect the functioning of the myocardium and change the balance of microelements involved in the generation of electrical impulses.

Atrial fibrillation in young people most often occurs due to congenital prolapse mitral valve. Diseases occurring with high temperature, increase heart rate and cause a malfunction of the autonomic nervous system, and this causes a disruption in the functioning of the primary pacemaker - the sinus node. With an acute lack of electrolytes in the body, automaticity is disrupted and the myocardial conduction system fails.

An important factor in the manifestation of atrial fibrillation is the state of the human nervous system. With the activity of certain of its links, various variants of arrhythmia arise, among which hyperadrenergic and vagal varieties of atrial fibrillation are distinguished. The vagal variety is more common in men; it is provoked by overeating, a horizontal position when resting, and wearing tight clothing. The other type is more often characteristic of women, and here the relationship between the occurrence of an attack and the emotional state is clearly visible.

With the idiopathic variant of atrial fibrillation, it is not possible to reliably determine the cause of the attack. This form of arrhythmia occurs in 30% of cases.

Forms of atrial fibrillation

Forms of atrial fibrillation may differ in the characteristics of the clinical manifestation of the disease, etiological factors or electrophysiological mechanisms.

Persistent atrial fibrillation is divided into:

• Paroxysmal - lasts up to 1 week, divided into daily periods.
• Persistent.
• Chronic.

The last two types of atrial fibrillation last more than 1 week.

Such types of cardiac arrhythmias as persistent and paroxysmal can be recurrent. In this form, an attack can either appear for the first time or return as a relapse; in the latter case, a second and subsequent cases of fibrillation appear.

Classification of atrial fibrillation by type of rhythm disturbance:

• Atrial fibrillation or fibrillation caused by contraction of isolated groups of muscle fibers, which does not allow the atrium to contract in a coordinated manner. Electrical impulses are volumetrically concentrated in the atrioventricular node, which is why some of them are delayed, and the rest are sent to the myocardium, causing the ventricles to contract in a certain rhythm.
• Atrial flutter. In this case, heart contractions increase to 200-400 per minute, while the atrial rhythm remains clear and coordinated. In this case, the following picture is observed: myocardial contractions follow one after another, almost without any pauses, and there is also no diastolic pause. At the same time, relaxation of the atria also does not occur, this is explained by the fact that they are in a systolic state most of the time. Since the atria are hardly filled with blood in this mode, it enters the ventricles in noticeably smaller quantities. With this form of atrial fibrillation, impulses propagating along the atrioventricular connections reach the ventricles only in every second, third and fourth case, due to which the correct ventricular rhythm is maintained, which is characterized by the term “ correct flutter" If for one reason or another there is a blockade and conduction is impaired, then the ventricles begin to contract chaotically. The result of this is that atrial flutter takes on a distorted form, which is called “irregular flutter.”

Classification of arrhythmia by contraction frequency:

• Bradysystolic arrhythmia is when the ventricles beat no more than 60 times per minute. During paroxysm, blood is not pumped into the ventricles, since the atria work ineffectively, the diastoles of the ventricles are filled naturally and only partially. As a result, the ejection of blood into the aortic system practically stops.
• Tachysystolic arrhythmia - contractions occur with a frequency of 90 beats.
• Normosystolic arrhythmia - ventricular contractions can be kept within 60-90 beats.

Symptoms of atrial fibrillation

Symptoms of atrial fibrillation depend on its form (bradysystolic, tachysystolic, constant or paroxysmal). In addition, the picture of the disease changes the state of the myocardium, its valve system, and the mental state of the patient.

The most dangerous condition is characterized by tachysystolic symptoms of atrial fibrillation, in which the following is observed:

• dyspnea;
• cardiopalmus;
• heart pain and interruptions in heart function;
• any physical stress increases these symptoms.

Atrial fibrillation occurs in paroxysms, with progression of paroxysms. In this case, their duration and frequency are always individual. Some patients may develop a chronic (persistent) form of the disease after just a few attacks, while others experience only rare and short-term paroxysms throughout their lives, without a tendency to progress - the prognosis for such atrial fibrillation is favorable.

The sensations during paroxysms of atrial fibrillation are also individual. Some patients may not notice them at all and learn about them by chance during an ECG.

Concerning typical signs atrial fibrillation then it could be:

• chaotic heartbeat;
• fear;
• polyuria (more urine is produced than usual);
• weakness and trembling.

If the heart rate is excessive, the patient may experience fainting and dizziness, and in more severe cases, signs of Morgagni-Adams-Stokes syndrome (loss of consciousness, convulsions, breathing problems, pallor, drop in blood pressure and even temporary cardiac arrest).

When sinus rhythm is restored, atrial fibrillation immediately loses its symptoms and no longer requires treatment. Patients often do not notice persistent atrial fibrillation. Auscultation (listening) of the heart can determine the presence of tones of varying degrees of loudness in its work. Amplitude pulse waves varies and the pulse is arrhythmic. With atrial fibrillation, there is a pulse deficiency, which is caused by the peculiarities of the heart: not every contraction leads to the release of blood into the aorta.

In the case of atrial flutter, the symptoms will be as follows:

• dyspnea;
• increased perceived heart rate;
• pulsation of veins in the neck;
• sometimes some discomfort in the cardiac region.

A clear and accessible video about atrial fibrillation (why and how it manifests itself, what to do about it):

Diagnosis of atrial fibrillation

Before determining what treatment atrial fibrillation requires, it will need to be diagnosed, for which the following are used:

• Holter monitoring – round-the-clock recording of ECG in a patient leading a normal rhythm of life;
• recording of paroxysms in real time (when the Holter monitor is capable of transmitting signals via telephone in the event of an attack).

Atrial fibrillation is reflected on the ECG as follows:

• There is no P wave in all leads.
• Irregular frequent f-waves of atrial fibrillation appear, which reflect their chaotic contractions and excitations. The amplitude of the coarse f-wave shape exceeds 1 mm and has a frequency of 350 to 450 waves per minute. This form of atrial fibrillation is characteristic of atrial hypertrophy; it occurs in patients with chronic pulmonary heart and mitral stenosis.
• The amplitude of the fine-fiber f-wave is so small that it is sometimes invisible on the ECG, and its frequency reaches 600-700. A similar form occurs in elderly people who have survived a heart attack, suffering from atherosclerotic cardiosclerosis, myocarditis, thyrotoxicosis, and intoxication with cardiac glycosides.
• The arrhythmia of the ventricular QRS complexes is expressed by different durations of the R-R intervals. The size and shape of the QRS complexes are usually normal.

Treatment of atrial fibrillation

When diagnosed with atrial fibrillation, treatment is determined by a cardiologist, taking into account clinical picture diseases. Initially assigned pharmacological treatment atrial fibrillation, the drugs of which have an antiarrhythmic effect.

On this moment There are a number of ways to treat this pathology.

Conservative treatment (with an effectiveness of 10-15%)

On early stages atrial fibrillation, treatment with heart rate control tablets can eliminate symptoms and progression of the disease.

The following drugs are used for atrial fibrillation:

• Beta blockers(betaxolol, carvedilol, nebivalol, metoprolol, pindolol, propraolol, celiprolol, esmolol) and calcium blockers (verapamil, diltiazem) - they slow down the heart rate. These medications for atrial fibrillation prevent the ventricles from contracting too quickly, but do not regulate the heart rhythm.
• Also, when diagnosing atrial fibrillation, medications are used that prevent the formation of blood clots and strokes(warfarin, Pradaxa).
• For antiplatelet therapy are prescribed anticoagulants, which do not exclude the formation of blood clots, but reduce the risk of this, and, consequently, the occurrence of strokes (heparin, fondaparinux, enoxaparin).
• Blood thinners prevent the formation of blood clots - disaggregants.
• Antiarrhythmic drugs(amiodarone, dronedarone, ibutilide, procainamide, propafenone, sotalol, flecainide).

Regular blood tests are required to monitor the effects of medications. Only a doctor can choose the right pills for atrial fibrillation, since many of them have serious contraindications, as well as proarrhythmic activity, when taking the drug itself can unexpectedly provoke atrial fibrillation.

Before treating atrial fibrillation, you should consider accompanying illnesses available to the patient. Sometimes medication is started in a hospital, where doctors can more easily monitor the body's response and heart rate. With this therapy, in 30-60% of cases the patient's condition improves, but over time the effectiveness of the drugs may decrease. In this regard, doctors often prescribe several antiarrhythmic drugs at once.

Surgical intervention (with effectiveness up to 85%)

Surgeries for atrial fibrillation are performed only if drug therapy is ineffective:

With catheter ablation, myocardial cells that provoke atrial fibrillation are neutralized. During the procedure, the surgeon separates the fused fibers that disrupt the conductivity and heart rhythm. There is no need to completely open the chest: small incisions are made in it, through which the catheter penetrates to the myocardium.

There are several options for influence:

• laser;
• cold;
• chemical;
• electrical impulse.

Implantation of an artificial pacemaker (pacemaker) - a special device that maintains the correct heart rhythm in people suffering from atrial fibrillation. This compact device is sewn under the skin in the collarbone area. An electrode is connected to it, penetrating into the heart cavity through the subclavian vein. The pacemaker periodically generates impulses that cause the heart muscle to contract at the required frequency. During implantation, the ribs are not affected, and only the skin is cut, so this operation is minimally traumatic.

Traditional medicine methods (with effectiveness up to 50%)

Sometimes the doctor besides pharmacological drugs can recommend alternative treatment for atrial fibrillation:

• Decoction of viburnum berries. They are pre-dried, after which a glass of dried berries is poured with a glass of boiling water, and the container is set on low heat, brought to a boil, after which it is removed from the heat, covered with a lid and cooled. A similar viburnum decoction for the prevention of atrial fibrillation should be taken in the morning and before bed, approximately 150 g.
• Yarrow tincture. Fresh yarrow herb is collected and crushed, then poured into a liter bottle (up to half the volume) and filled with ethyl alcohol. The bottle is tightly closed and placed in a dark place for 10 days. For preventive purposes, you should take 1 teaspoon of infusion in the morning and before lunch.
• Infusion of dill seeds. A third of a glass of these seeds is poured into a glass of boiling water (it is best to do this in a thermos). The infusion is kept for 20 minutes, after which it is filtered. Prevention of atrial fibrillation consists of taking the infusion 3 times a day before meals, a third of a glass.

Why is atrial fibrillation dangerous? Possible complications

Most often, when answering the question of why atrial fibrillation is dangerous, you will hear one thing - it leads to complications in the form of heart failure or thromboembolism.

Mitral stenosis complicated by atrial fibrillation can cause blockage of the atrioventricular opening by an intraatrial thrombus, cardiac arrest and sudden death.

If intracardiac thrombi enter the arteries of the systemic circulation, they can lead to organ thromboembolism, and 2/3 of them enter the cerebral vessels with the blood flow. Therefore, patients with atrial fibrillation account for 15% of ischemic strokes.

Elderly patients (after 65 years of age) are most susceptible to peripheral and cerebral thromboembolism, and in addition to them, those suffering from congestive heart failure, diabetes mellitus, systemic arterial hypertension and those who have previously suffered any type of thromboembolism. With atrial fibrillation, heart failure develops in patients suffering from impaired ventricular contractility and heart defects. With hypertrophic cardiomyopathy and mitral stenosis, heart failure can manifest as pulmonary edema and cardiac asthma.

Acute left ventricular failure occurs against the background of poor emptying of the left chambers of the heart, which leads to a sharp increase in pressure in the pulmonary veins and capillaries.

In atrial fibrillation, the most severe manifestation of heart failure is the development of arrhythmogenic shock due to too low cardiac output. Sometimes atrial fibrillation ends in ventricular fibrillation and complete cardiac arrest.

More often, chronic heart failure develops against its background, which can progress to dilated arrhythmic cardiomyopathy.

Life prognosis for atrial fibrillation

Many people ask the question, how long do they live with atrial fibrillation? In fact, the prognosis for life with atrial fibrillation depends on the causes of the rhythm disturbance and complications from it.

Caused by severe myocardial lesions (large focal infarction, dilated cardiomyopathy, diffuse or extensive cardiosclerosis), atrial fibrillation leads to the rapid development of heart failure. Speaking about how long people live with atrial fibrillation, the thromboembolic complications caused by it give unfavorable prognoses.

Mortality from cardiac diseases complicated by atrial fibrillation increases 1.7 times.

But with a satisfactory condition of the ventricles and the absence of severe pathologies, the prognosis becomes more favorable, but even at the same time, the frequent occurrence of paroxysms significantly reduces the patient’s quality of life.

Idiopathic atrial fibrillation usually does not affect the well-being of patients who can do any work feeling healthy.

Have you or your loved ones experienced atrial fibrillation? Did this disease cause any complications, and how did you fight it? Share your experience in the comments - help others.

The human heart is capable of generating and conducting electrical impulses. This may be due to the conduction system of the heart. Normally, the organ generates impulses with equal frequency from 60 to 90 per minute. Atrial fibrillation is a heart disease in which the atrium fibers, for certain reasons, contract faster than necessary. As a rule, this pathology is a symptom of another disease and requires treatment.

What is atrial fibrillation

Atrial fibrillation and flutter is a complication that appears against the background coronary disease heart along with other types of heart rhythm disorders. Symptoms of arrhythmia can develop due to the relevance of thyroid pathologies, a number of associated factors, which manifests itself in the form of heart contractions, in rare cases they are in the range of 400-600 beats per minute. According to ICD-10, the disease has code I48.

What happens with atrial fibrillation

To understand the mechanism of the disease, you need to understand the physiological structure of the heart muscle. Myocardium – complex structure, which contains electrical fibers throughout its thickness. Sinus node - the main electrical bundle is located where the upper vena cava flows into the right atrium. This is where a normal heart rate of 60-80 beats is created. Some myocardial pathologies provoke chaotic electrical waves, which causes problems with the passage of impulses from the sinus node to the heart.

Due to such disorders, the atria contract at a frequency of up to 600 per minute, but they are not full, rapid depletion of the myocardium occurs, so the walls “flicker” and fluctuate. Electrical impulses from the atrium are sent to the ventricles, but the atrioventricular node on their way passes only half - 150-200 per minute. Because of this, ventricular contractions occur unevenly, and the patient feels interruptions in the heartbeat.

Symptoms

In 30% of cases, the disease is asymptomatic and does not cause discomfort. Pathology is usually discovered by chance. Patients with atrial fibrillation have the following main complaints:

• sudden attacks irregularly rapid heartbeat, pulsation of the veins in the neck - this is the main complaint;
• increased fatigue, general weakness;
• pain in the heart area like angina pectoris (compressive);
• increased sweating;
• unsteadiness of gait, dizziness;
• shortness of breath during exercise, difficulty breathing;
• fainting or semi-fainting;
• in rare cases, polyuria (increased urine) due to the release of natriuretic hormone.

Signs

Manifestations of the disease depend on the form of the pathology and, depending on this, they will differ. Atrial fibrillation of the vagal type has the following symptoms:

• the pathology is characteristic of the male half of the population;
• attacks begin at night or during meals;
• flickering is provoked by the following factors: rich food, horizontal position of the body, bloating, tight tie, bending of the body, rest, tight belt;
• no arrhythmia during physical or emotional stress.

Signs of atrial fibrillation in the hyperadrenergic type:

• diagnosed more often in women;
• attacks occur more often in the morning, and can occur throughout the day and in the evening;
• flickering is provoked by physical and emotional tension, stress;
• with normalization of the emotional state, rest, and horizontal position of the body, the attack passes.

Causes

Pathology becomes a consequence of the patient developing other diseases of systems and organs in the body, including the heart. The following is a list of basic conditions that cause a complication in the form of atrial fibrillation:

• syndromes of weak sinus rhythm, Wolf-Parkinson-White;
• mitral valve defects;
• coronary heart disease (CHD);
• hypertension;
• diabetes;
• alcohol poisoning in acute or chronic form (alcoholic myocardial dystrophy);
• thyrotoxicosis;
• lack of potassium and magnesium in the body.

Classification of atrial fibrillation

In medical practice, there are two types of division of pathology. The first is based on clinical manifestations, and the second on the frequency of ventricular contraction. According to the course of the disease, the following options are distinguished:

• persistent form of atrial fibrillation – lasts longer than 7 days, goes away only after use medicinal drugs;
• paroxysmal form of atrial fibrillation - begins suddenly, attacks last from 5 minutes to a week (the average value does not exceed 24 hours), stops independently and without medical care;
• chronic form - not amenable to cardioversion or drug therapy, observed over a long period.

Separation by contraction frequency:

• tachysystolic form - over 90 beats;
• normosystolic form - in the range from 60 to 90 beats;
• Bradysystolic form – less than 60 beats.

Why is atrial fibrillation dangerous?

When an outbreak lasts more than 48 hours, the risk of myocardial infarction, ischemic stroke, severe cardiovascular failure and thromboembolism of peripheral vessels and various organs increases. Another danger to human life are complications that develop due to atrial fibrillation:

• intracardiac blood clots leading to blockage;
• heart failure;
• arrhythmogenic shock due to low cardiac output;
• arrhythmic dilated cardiomyopathy.

Treatment of atrial fibrillation

To treat the disease, several methods are used that are aimed at restoring the correct rhythm and preventing recurrence of attacks. Treatment of atrial fibrillation is carried out using electrical cardioversion and medications. If these directions do not give the desired positive result, then surgical methods are prescribed:

• implantation of a pacemaker;
• catheter ablation.

Pills

If heart failure, atrial fibrillation, or other organic pathologies of the heart develop, the attending physician will prescribe injections and tablets to eliminate symptoms and treat the disease. The following medication options may help:

• beta-blockers to reduce stagnation in the small, big circle blood circulation;
• cardiac glycosides, which are needed for the prevention and treatment of heart failure;
• thrombolytic enzymes if thrombosis already exists;
• anticoagulants that thin the blood and prevent thrombosis;
• diuretics, vasodilators for cardiac asthma, pulmonary edema.

Antiarrhythmic drugs for atrial fibrillation

These medications help reduce the excitability of the heart muscle and conductivity in the atria. After taking them, uncontrolled areas of excitation that caused atrial flutter disappear. They help increase the pause between heartbeats, normalizing the rhythm, and lowering blood pressure is achieved by relaxing blood vessels. The following options may be assigned:

1. Quinidine. You need to take 2 tablets every 6 hours until the attack stops. If the desired effect is not achieved, the doctor may double the dosage. For prevention, the specialist selects the dose individually. You need to swallow the tablet whole without chewing. The pain subsides, the rhythm and pressure decreases.
2. Novocainamide. Available in the form of a solution, administered intravenously during an attack in a volume of 100 to 50 mg. After this, the drug is taken in the form of tablets every 3-5 hours, 3 pieces. The dosage should be determined by a doctor.
3. Cordaron. The dosage is selected individually. As a rule, for the first 2 weeks they drink 3-4 tablets per day. Then the dose is reduced to maintain the rhythm - 0.5 tablets 1 time per day. Helps cope with arrhythmia that has shown resistance to other medications.

Therapy with Warfarin and new anticoagulants

This type of medication is prescribed to reduce blood clotting and prevent the occurrence of blood clots. The active components of drugs prevent cells from sticking together, which leads to the formation of blood clots. During administration, thrombin activity and the production of prothrombin by the liver decrease. The following popular medications are prescribed:

1. Warfarin. Take, as a rule, 1 tablet per day. The dose will depend on the characteristics of the disease and should be prescribed by a doctor. You need to take the medicine after meals and wash it down boiled water. Average duration treatment for 8 months. The main task of warfarin is to prevent the formation of blood clots.
2. As an alternative to the drug described above, Apixaban, Dabigatran, Rivaroxaban can be prescribed. These are modern anticoagulants that do not interact with other drugs and do not require a blood test. Clinical researches confirm effectiveness when it comes to preventing stroke.

Electrical cardioversion

This is one of the options for surgical intervention, which is relevant when reducing the output as a result of tachyarrhythmia. This special device is a substitute for a pacemaker. It sends electrical impulses to the heart at the correct frequency during an attack. This helps bring the rhythm back to normal. If there is no attack, then the pacemaker does not work and has no effect.

Radiofrequency catheter ablation

This method is considered low-traumatic because it does not require a large incision. The operation is performed under local anesthesia according to the following algorithm:

1. The surgeon inserts electrodes into the heart through the femoral/subclavian vein.
2. At this time, the entire process is monitored using x-rays.
3. First, research is carried out using special sensors that determine the areas causing flicker.
4. The reaction of the heart is shown by an ECG (intracardiac cardiogram).
5. Next, the doctor treats the areas of the atria that flicker. Performs this step using radiofrequency energy and one of the electrodes. Can be applied chemicals and laser.
6. These manipulations help destroy small groups of cells that create the impulse that triggers atrial fibrillation.

Surgical methods for correcting atrial fibrillation

If stopping paroxysms of flickering fails and observed frequent relapses, then surgery is prescribed. The surgical intervention consists of laser cauterization of foci of pathological myocardial contraction. The manipulation is carried out using a puncture through the artery and special catheters. This technique has an effectiveness of over 80%; if necessary, the operation can be repeated after some time. But this cannot replace the correction of the underlying disease.

Nutrition

The treatment regimen for arrhythmia is complex, and dietary adjustments are part of it. A diet is drawn up that does not contain fatty foods and contains more foods with potassium and magnesium. There are many of these components in wheat bran, peanuts, spinach, white beans, oat bran. The most potassium is found in prunes, peas, dried apricots, raisins, lentils, and hazelnuts. To prevent attacks, you need to avoid:

• alcohol;
• coffee;

Life forecast

With this form of pathology, it is necessary to determine the cause that led to the development of arrhythmia and possible complications. If the main pathology is heart defects, severe myocardial damage (general or diffuse cardiosclerosis, dilated cardiomyopathy, myocardial infarction). There is a high risk of developing heart failure. The mortality rate of such pathologies with atrial fibrillation increases 1.5 times.

The prognosis is unfavorable when the disease develops against the background of complications and the risk of thromboembolism. If the condition of the myocardium and ventricles is satisfactory, then the prognosis will be better. If ventricular paroxysms occur frequently, the quality of life of patients deteriorates significantly. Idiopathic atrial fibrillation, as a rule, does not lead to a worsening of the condition; patients do not suffer from pain, feel well, and lead a normal lifestyle.

general description

• Age
• Alcohol consumption.

chronic . persistent . and paroxysmal

first appeared or recurrent

atrial flutter or their flicker

tachysystolic normosystolic Bradysystolic

Atrial fibrillation: causes

• diabetes;
• hypertonic disease;
• thyrotoxicosis;

• Electrocardiogram (ECG);

Treatment of atrial fibrillation

If you think that you have Atrial fibrillation

Atrial fibrillation: symptoms and treatment

Atrial fibrillation - main symptoms:

Atrial fibrillation, which is also defined as atrial fibrillation, is one of the types of complications that arise against the background of coronary heart disease in parallel with other types of heart rhythm disturbances. Atrial fibrillation, the symptoms of which can also appear as a result of the relevance of thyroid diseases and a number of associated factors, manifests itself in the form of heart contractions reaching a limit of 600 beats per minute.

general description

Atrial fibrillation, in its characteristic cardiac arrhythmia, is accompanied by chaoticity and frequency of excitation and contraction experienced by the atria, or fibrillation and twitching occurring with individual groups of atrial muscle fibers. As we have already noted, the actual heart rate in this state can reach about 600 beats per minute. In the case of a long paroxysm of atrial fibrillation, lasting about two days, there is a risk of blood clot formation, as well as ischemic stroke. Against the background of the persistence of atrial fibrillation, rapid progression of the state of circulatory failure in its chronic form can also be noted.

Notably, atrial fibrillation is the most common type of heart rhythm disorder, accounting for 30% of arrhythmia-related hospitalization rates. As for the prevalence of this type of pathology, its increase occurs in accordance with increasing age. Thus, among patients under the age of 60, the incidence rate is 1%, among patients after this age limit - 6%.

Risk factors for developing this condition include the following:

• Age . Age-related structural and electrical changes occurring in the atria become relevant; this, in turn, provokes the development of fibrillation in them.
• Availability organic diseases hearts. This also includes heart defects and open-heart surgery performed by patients.
• The presence of another type of chronic disease. These are thyroid diseases, hypertension and other pathologies.
• Alcohol consumption.

Atrial fibrillation: classification

Atrial fibrillation in determining one or another form of its classification involves focusing on the features clinical manifestations this condition, the mechanisms of electrophysiology, as well as etiological factors.

Atrial fibrillation can be constant in its manifestation, that is chronic . persistent . and paroxysmal . Paroxysmal atrial fibrillation lasts for seven days, mostly ending within a period of 24 hours. Chronic atrial fibrillation and persistent atrial fibrillation, on the contrary, lasts more than 7 days. The paroxysmal atrial form of the disease, as well as the persistent form, can be recurrent.

Attack of this disease May be first appeared or recurrent . which in the latter case implies the occurrence of a second and subsequent episodes of fibrillation.

In addition, atrial fibrillation can manifest itself in accordance with two types of rhythm disturbances, that is, it can be atrial flutter or their flicker . Atrial fibrillation (fibrillation) occurs with the contraction of individual groups of muscle fibers, due to which there is no coordinated contraction of the atrium. There is a volumetric concentration of electrical impulses in the atrioventricular connection, as a result of which one part of them is delayed, and the other is switched to the myocardium, causing the ventricles to contract in one rhythm or another.

According to the frequency of contractions, atrial fibrillation, in turn, may be tachysystolic . which implies reductions within the indicator of 90 and above, as well as normosystolic . in which ventricular contractions can correspond to an interval of 60-90 per minute and Bradysystolic . where ventricular contractions reach a maximum of 60 per minute.

During paroxysm, blood is not pumped into the ventricles, atrial contractions are ineffective, and therefore the filling of ventricular diastole occurs freely and not in full. Ultimately, there is a systematic lack of release of blood into the aortic system.

As for a condition such as atrial flutter, it consists of an increase in contractions within the range of 200-400 per minute while maintaining this process coordinated and clear atrial rhythm. In this case, myocardial contractions follow each other, which occurs almost continuously, there is no diastolic pause, and at the same time, the atria do not relax, because for most of the time they are in a systolic state. Due to the difficulty of filling the atria with blood, less blood enters the ventricles.

The arrival of impulses to the ventricles along the atrioventricular connections occurs in every second, third and fourth case of them, which ensures the correct ventricular rhythm, that is, determines the correct flutter. If a disturbance in conduction occurs, the contraction of the ventricles is characterized by chaotic behavior, as a result of which atrial flutter, accordingly, occurs in an irregular form.

Types of atrial fibrillation depending on concomitant pathology

Atrial fibrillation: causes

The pathology under consideration appears as a result of the relevance for the patient of diseases of various systems and organs in the body, as well as diseases directly related to the heart. Let us highlight the main conditions and diseases, the course of which may be accompanied by a complication in the form of atrial fibrillation:

• heart defects (mostly affecting the mitral valve);
• IHD (coronary heart disease);
• syndromes: Wolf-Parkinson-White, weak sinus node;
• diabetes;
• acute alcohol poisoning or chronic alcohol poisoning (alcoholic myocardial dystrophy);
• hypertonic disease;
• thyrotoxicosis;
• electrolyte-type disorders (mainly reduced to a lack of magnesium and potassium in the body).

Atrial fibrillation extremely rarely appears “for no reason”, being idiopathic; moreover, it is possible to assert that this is precisely this form only if the patient is thoroughly examined in the absence of any diseases that provoke the arrhythmia.

It is noteworthy that in some cases, just the slightest impact is enough for an attack to occur. Sometimes a clear set of reasons can be identified that determined the patient’s subsequent occurrence of an attack of atrial fibrillation. We can also highlight a certain part similar reasons: physical or emotional overload, drinking alcohol or coffee, eating too much food, etc.

Recently, observations indicate a significant role of the nervous system in the occurrence of arrhythmia. Yes, due to increased activity its individual links often provoke an attack. In case of influence of the parasympathetic link, also related to nervous system, we are talking about the vagal type of arrhythmia, but if the effect is on the sympathetic side, then the arrhythmia corresponds to the hyperadrenergic type.

Vagal type of atrial fibrillation characterized by the following features:

• manifests itself predominantly among men;
• the onset of attacks occurs at night or during meals;
• The following factors were identified as provoking the attack: horizontal position occupied by the patient, rich food, rest, bloating, bending of the body, tight tie or collar, tight belt;
• This condition does not occur during periods of emotional stress and physical activity.

Hyperadrenergic type of atrial fibrillation

• This condition manifests itself much more often among women;
• attacks predominantly appear in the morning; it is possible that they may appear during the day or in the evening;
• stress, emotional tension and physical activity provoke the occurrence of this condition;
• this type of arrhythmia goes away during exercise horizontal position, when calming down and during rest.

Atrial fibrillation: symptoms

Peculiar to the subject pathological condition manifestations are determined based on the form that is relevant to it, that is, we are talking about the state of tachysystolic, bradysystolic, constant or paroxysmal atrial fibrillation. Besides important role plays and general state valve apparatus, myocardium, mental state.

The most severe condition is the condition provoked by tachysystolic atrial fibrillation. In this case, there is an increase in heart rate and shortness of breath, and the intensification of these symptoms occurs as a result of physical stress, interruptions in the functioning of the heart and pain in it.

As a rule, the course of atrial fibrillation occurs in paroxysms, with the progression of paroxysms. The frequency, as well as their duration in this case, is determined exclusively individually. Some of the patients, after just a few attacks of flickering, are faced with the establishment of a chronic or persistent form, while others experience short-term and rare paroxysms throughout their lives; in this case, there may be no tendency for subsequent progression.

Paroxysm during atrial fibrillation can be felt most in various ways. Thus, some patients may not notice their arrhythmia at all, learning about it by chance, at the time of a medical examination.

If we consider the typical course of atrial fibrillation, it can manifest itself in the form of chaotic heartbeat, polyuria, fear, trembling and weakness. Excessive heart rate can cause dizziness and fainting in the patient. In addition, Morgagni-Adams-Stokes attacks may also occur (convulsions, loss of consciousness, pallor, breathing problems, inability to determine blood pressure, heart sounds).

Symptoms of atrial fibrillation disappear almost immediately when cardiac sinus rhythm is restored.

With constant atrial fibrillation, patients often simply do not notice it.

Auscultation (listening to the heart for sound phenomena relevant to it) of the heart determines the presence of tones in it that appear with varying degrees volume. The pulse is arrhythmic, the amplitude of the pulse waves is different. Atrial fibrillation is characterized by a pulse deficiency, which is caused by the peculiarities of the condition, as a result of which blood is not released to the aorta with every contraction of the heart.

If patients experience atrial flutter, this condition is usually accompanied by a characteristic increase in palpitations, shortness of breath, pulsation of the veins of the neck and, in some cases, a certain discomfort in the heart area.

Atrial fibrillation: complications

Most often, complications of this condition manifest themselves in the form of heart failure and thromboembolism.

Mitral stenosis, when complicated by atrial fibrillation, may be accompanied by blockage of the atrioventricular (left) opening by an intraatrial thrombus, which, in turn, may cause sudden stop heart function and, accordingly, death against the background of these processes.

When intracardiac blood clots enter the arterial system, concentrated in the systemic circulation, thromboembolism occurs in a variety of organs, with 2/3 of the blood clots ending up due to blood flow in the cerebral vessels. Thus, almost every sixth case of ischemic stroke occurs precisely in those patients who have been previously diagnosed with atrial fibrillation.

The group of patients most susceptible to peripheral and cerebral thromboembolism are those over 65 years of age. In cases of thromboembolism previously suffered by patients, regardless of the characteristics of its concentration, with diabetes mellitus, congestive heart failure and arterial hypertension the chances of developing the listed variants of thromboembolism also significantly increase.

The development of heart failure against the background of atrial fibrillation occurs in those patients who have heart defects, as well as disturbances in the contractility of the ventricles.

One of the most severe manifestations relevant to heart failure in the presence of atrial fibrillation is arrhythmogenic shock, which occurs due to low and inadequately produced cardiac output.

In certain situations, a transition from atrial fibrillation to ventricular fibrillation with subsequent cardiac arrest may also occur. Most often, atrial fibrillation accompanies the development of chronic heart failure, as a result of which its progression is possible up to the state of dilated arrhythmic cardiomyopathy.

Diagnosis of atrial fibrillation

The following main methods are used:

• Electrocardiogram (ECG);
• Holter monitoring (24-hour recording ECG indicators during the patient’s usual rhythm of life and its conditions);
• Real-time recording of paroxysms (one of the variants of the previous diagnostic method, in which a portable device provides signals via telephone in the event of an attack).

Treatment of atrial fibrillation

The determination of appropriate treatment tactics occurs in accordance with the specific form of the disease, and in each case it is focused on restoring normal sinus rhythm and its subsequent maintenance, as well as preventing recurrence of attacks of fibrillation. It also ensures adequate control of heart rate while simultaneously preventing thromboembolic complications.

Relief of paroxysms is carried out intravenously and internal reception drugs novocainamide, cordarone, quinidine and propanorm, which is determined by the appropriate dosage in combination with control over the level of blood pressure and ECG.

The absence of a positive trend in changes in the condition of patients when using drug therapy suggests the use of electrical cardioversion, with whose help paroxysms are relieved in more than 90% of cases.

Atrial fibrillation in mandatory requires treatment of the underlying disease as a result of which the rhythm disorder developed.

As radical method to eliminate atrial fibrillation, a method of radiofrequency provision of isolation is used, aimed at pulmonary veins. In particular, in this case, the focus of ectopic excitation, concentrated in the area of ​​the mouths of the pulmonary veins, is isolated from the atria. The technique is invasive in nature, and the effectiveness of its implementation is about 60%.

Frequent repetition of attacks or the persistence of a particular form of atrial fibrillation may require an RFA procedure of the heart, that is, radiofrequency ablation, which implies a “burning” process performed by the electrode when creating a complete type of blockade and implantation of a permanent type of pacemaker.

If symptoms appear that indicate the possible relevance of atrial fibrillation, you should consult a cardiologist.

If you think that you have Atrial fibrillation and symptoms characteristic of this disease, then a cardiologist can help you.

We also suggest using our online disease diagnostic service. which, based on the entered symptoms, selects probable diseases.

Symptoms of atrial fibrillation - why they occur and how to avoid them?

The main causes of atrial fibrillation.

Each heart beat entails a contraction of its main parts, and in a certain order. First the atria, then the ventricles. Only this order of contractions can guarantee high efficiency of the heart muscle. Ciliated arrhythmia characterized by the disappearance of one of the phases cardiac cycle, we are talking about contraction of the atria, the fibers of which lose the ability to work synchronously. The result is a kind of chaotic twitching of the atria - flicker. Hence the beautiful name. In addition, such flickering significantly disrupts the rhythm of ventricular contraction.

Symptoms of atrial fibrillation are different, therefore, at their first manifestations, attention should be paid Special attention the health of your heart. Here, perhaps, key reasons that can lead to this disease: hypertension, some types of heart defects, heart failure. and one of the serious complications of coronary artery disease is a heart attack. Often, for young man, one of the reasons for the appearance of arrhythmia is the fragile condition of one of the valve leaflets between the left atrium and the ventricle. The process of such a phenomenon occurs most often secretly and reveals itself completely by accident. This type of arrhythmia may be the first harbinger of this cardiac pathology.

It is worth noting that not only heart problems can cause arrhythmia. A variety of diseases can provide the starting signal for its spread to begin. I will say more, not only diseases are the causes. Quite often, the provocateur of an attack can be safely called excessive abuse of alcoholic beverages.

People who have thyroid diseases in their “arsenal of ailments” should not lose their vigilance. In addition to the above, the causes of cardiac arrhythmia can form quite an impressive list. Undoubtedly, these include: emotional and psychological stress on the body, stroke, and even surgical intervention. Chronic constipation, uncomfortable clothing, insect bites, a large number of consumed food. A very high percentage has a risk of developing atrial fibrillation for people with high blood sugar, especially if the person has a combination of obesity and diabetes. high performance blood pressure.

How to recognize the disease?

There are plenty of obvious and clear signals. For example, heart rhythm disturbances when heart“threshing” at an incredibly breakneck speed. At times it feels as if the chest is about to burst open and it will jump out. Or completely opposite sensations when there are heart failures. Finally, there are situations when the process of arrhythmia is almost silent and unnoticeable. Irregular heartbeats can only be determined by feeling the pulse. Sometimes it is possible to identify only with the help of an ECG.

What is the main danger?

Often, tachycardia is observed along with atrial fibrillation. With it, the load on the heart muscle increases many times over, and as a result of all this, “chest pains emerge” - symptoms of angina pectoris. Arrhythmia also makes a negative contribution to the efficiency of the heart muscle. Which inevitably leads to another big problem - heart failure. The patient feels colossal suffocation and is desperately short of air.

It won't go away on its own!

If the time interval of arrhythmic processes is calculated at more than one hour, then it is strongly recommended to immediately seek help from doctors. I would like to add that the disappearance of arrhythmia on its own is not a reason to cancel an appointment with the doctor. At any time, a recurrence of heart rhythm disturbances is possible. which this time could end much sadder.

Conclusion: self-medication has minimal chance of significant success. It is considered optimal to return to a normal rhythm within the first 24 hours, from the moment of the “start of arrhythmia.” Of course, it can be eliminated later, but then additional measures are necessary.

Due to disruption of the processes of contraction of the atria, the rate of blood flow in them slows down at lightning speed. This serves as a strong argument for the formation of blood clots, that is, blood clots. This phenomenon is observed the very next day after the onset of arrhythmia. If the treatment of arrhythmia is started late, on the 3-4th day, then after the completion of the restoration processes of the heart rhythm, the resumption of contractions atria. there is a considerable probability that particles of blood clots will break off and completely clog the vessels of one of the organs. Often, the final stop for such detached particles is the blood vessels of the brain, which leads to a stroke.

Taking this into account, almost all patients who seek help during the first two days, from the moment the arrhythmia appears, are prescribed medications that in every possible way prevent blood clotting. Certain positive results and bringing rhythm return to normal can only be expected in a few weeks.

Techniques for putting rhythm in order.

There are a lot of them. Restoration by electric discharge is highly efficient. Let me make a reservation right away: they are carried out under anesthesia, so discomfort practically excluded. Sometimes, success can be achieved through drug injections. Selection can bring more significant difficulties drug therapy, to maintain a normal heart rhythm at an appropriate level. In these circumstances, a lot depends on the patient himself: strict adherence to the doctor’s recommendations is a significant guarantee for the success of treatment. Considering the fact that the severity of attacks usually increases.

The two most common forms of arrhythmia are called paroxysmal, characterized by isolated, infrequent attacks, and regular, when the process of atrial fibrillation can last for years. Naturally, the second case is more dangerous, especially if it is accompanied by tachycardia. This situation requires strict adherence to all medical prescriptions of the doctor, taking medications that make the heart rate slower. In addition, regular moderate physical activity can help lower your heart rate, of course, after consulting with your doctor. This is an extremely favorable circumstance for improving the health of the heart, since its performance becomes more economical. At the same time, the stroke volume of blood increases, the pauses between beats increase.

It is necessary that your knowledge about the basic symptoms of atrial fibrillation were as complete as possible, since this will help you in the future try to avoid encountering serious heart diseases.

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