Medicines for arrhythmias differ in their points of application, in medicine the pharmacodynamics of each drug must be taken into account. By time are checked:
- absorption capacity when taken orally;
- The rate at which the maximum effective concentration in the blood is reached
- duration of action;
- opportunities for dose accumulation;
- ways to remove from the body.
In this case, the doctor is interested in side qualities, the effect on various organs and systems.
Almost all antiarrhythmic drugs are capable of:
- strengthen coronary circulation, expanding coronary arteries;
- to varying degrees relieve vasospasm;
- block additional foci of excitation in the atria and ventricles and the atrioventricular node in the septum of the heart;
- affect the conductivity of nerve impulses in the conductive system.
This classification is the most common.
It characterizes medicines by the mechanism of action:
- membrane stabilizing agents;
- beta blockers;
- drugs that slow repolarization;
- antagonists of calcium ions.
The process of heart contraction occurs by changing the polarization of cell membranes.
The correct charge is provided by electrophysiological processes and ion transport. All antiarrhythmic drugs lead to the desired therapeutic effect by affecting cell membranes, but the process of influence is different for each subgroup.
Depending on what pathology caused the violation of the heart rhythm, the doctor decides on the appointment of a specific pharmacological group of pills for arrhythmias.
Membrane stabilizing agents fight arrhythmia by stabilizing the membrane potential in the cells of the heart muscle.
These drugs are divided into three types:
- IA. Normalize heart contractions by activating the transport of sodium ions through the channels. These include quinidine, procainamide.
- IB. This includes drugs that are local anesthetics. They influence the membrane potential in cardiomyocytes by increasing the membrane permeability for potassium ions. Representatives – phenytoin, lidocaine, trimecain.
- IC. They have an antiarrhythmic effect, inhibiting the transport of sodium ions (the effect is more pronounced than that of group IA) – Etatsizin, aymalin.
Group IA quinidine drugs also have other beneficial effects for normalizing heart rate. For example, they increase the threshold of excitability, eliminate the conduction of unnecessary impulses and contractions, and also slow down the restoration of membrane reactivity.
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- Types of arrhythmias and their differences
- Types of antiarrhythmic drugs with extrasystole
- Treatment of supraventricular arrhythmias in children
- General principles of drug treatment
- With tachycardia
- With extrasystole
- Other groups of drugs for the treatment of rhythm disturbances
- Drug treatment of supraventricular arrhythmia
- Herbal antiarrhythmic drugs
- What you can apply yourself
- What is good metoprolol
- Why bisoprolol
- Treatment of supraventricular arrhythmias with folk remedies
- What drugs are indicated for sinus arrhythmia?
These drugs can be divided into 2 further subgroups:
- Selective – only beta1 receptors that are in the heart muscle are blocked.
- Non-selective – additionally block beta2 receptors located in the bronchi, uterus and blood vessels.
Selective drugs are more preferable, since they directly affect the myocardium and do not cause side effects from other organ systems.
The work of the conduction system of the heart is regulated by various parts of the nervous system, including the sympathetic and parasympathetic. If the sympathetic mechanism is disrupted, irregular arrhythmogenic impulses can come to the heart, which lead to a pathological spread of excitation and the appearance of arrhythmia.
List of representatives of this group:
- propranolol (additionally has a membrane stabilizing effect as >
Beta-blockers have a positive effect on the functioning of the heart from several sides. Reducing the tone of the sympathetic nervous system, they reduce the adrenaline or other substances entering the myocardium, which lead to excessive stimulation of heart cells. Protecting the myocardium and preventing electrical instability, drugs of this group are also effective in combating atrial fibrillation, sinus arrhythmia, angina pectoris.
Most often, doctors prescribe drugs based on propranolol (Anaprilin) or metoprolol from this group. Drugs are prescribed for prolonged regular use, but can cause side effects. The main ones are difficulty in bronchial obstruction, deterioration of the condition of patients with diabetes mellitus due to possible hyperglycemia.
During the transport of ions through the cell membrane, an action potential arises, which forms the basis of the physiological conduction of a nerve impulse and contraction of myocardial tissue. After local excitation has occurred and a local response has arisen, the repolarization phase begins, which returns the membrane potential to its original level.
The main representative of this class is amiodarone (Cordaron). His cardiologists are prescribed most often because of the wide therapeutic effect. Amiodarone can be used to treat arrhythmias of any origin. He also acts as an ambulance in emergency conditions or worsening the patient’s condition.
Amiodarone exhibits antiarrhythmic and bradycardic effects, slows nerve conduction in the atria, and increases the period of refraction. Important properties are also considered a decrease in myocardial oxygen demand and increased coronary blood flow. As a result of this, the heart is able to function more fully and is not subject to ischemia. Antianginal action has found its application in the treatment of heart failure and coronary heart disease.
In addition to Amiodarone, this group of drugs includes:
Tablets from arrhythmias of the fourth group lead to the desired pharmacological effect due to the ability to block calcium channels. Calcium ions contribute to the reduction of muscle tissue, so when the channel is closed, excess myocardial conductivity is eliminated. The main representative is Verapamil. It is prescribed for the relief of heart palpitations, treatment of extrasystole, prevention of an increased frequency of contractions of the ventricles and atria. All drugs with anti-arrhythmic effect are prescribed only by a doctor.
In addition to verapamil, diltiazem, bepridil, nifedipine belongs to this group.
Types of arrhythmias and their differences
Arrhythmia is conventionally considered to be any heartbeat rhythm that differs from normal. In a healthy person, the ripple is even, in the range of 60-75 beats per minute, tones are heard clearly, loudly, rhythmically without background sounds. Pathological contractions of the atria or ventricles of the heart are:
- changed frequency: stable slow or fast heart rate;
- altered rhythm: flicker, flutter, premature muscle contraction.
Of the natural and not requiring medical care and a thorough examination, a short-term change in the speed of contractions under the influence of heavy physical exertion, adrenaline rush, endurance tests, stress, activation of the underlying disease appears. In this case, arrhythmia is physiological in nature and stops when the provoking factor is eliminated. Also, the frequency and quality of the rhythm may vary due to the use of certain drugs, as well as in women during pregnancy.
Non-physiologically caused arrhythmia always indicates the presence of more serious heart problems than superficial disharmony of rhythm. A person who notes a steady change in heartbeat often observes a decrease in endurance, pain in the heart, shortness of breath, difficulty breathing, and in this case should consult a doctor for an ECG and ultrasound of the heart.
The most commonly diagnosed types of arrhythmias are bradycardia, tachycardia, atrial fibrillation and extrasystole ..
Types of antiarrhythmic drugs with extrasystole
From this article you will learn: what antiarrhythmic drugs exist, which drugs are best suited in each particular case of arrhythmia.
Medication for arrhythmias is the main treatment for this disease. In 90–95%, antiarrhythmic drugs can either completely eliminate arrhythmia, or reduce its severity. They are equally well effective both in emergency care and in systematic administration aimed at preventing repeated breakdowns of the rhythm. But in order to achieve the maximum treatment result, it is important to know which drugs need to be used in certain cases.
The following is a list of the most effective and safe medicines that are most often used to treat cardiac arrhythmias (in decreasing order of effectiveness):
- Potassium channel blockers – Amiodarone (its analogues Kordaron, Aritmil).
- Beta blockers – Metoprolol (Corvitol), Bisoprolol (Concor), Nebivolol.
- Calcium channel blockers – Verapamil (Isoptin, Finoptin).
- Local anesthetics – Lidocaine, Novocainamide.
- Preparations of different groups:
- cardiac glycosides – Strofantin, Korglikon, Digoxin;
- medicines containing potassium – Panangin, Asparkam.
A cardiologist is involved in the selection, prescription of antiarrhythmic drugs and monitoring their effectiveness, but therapist and family doctor can also.
Among all the drugs for the treatment of arrhythmias, amiodarone is considered the number one remedy for any heart rhythm disturbances. It is equally suitable for use in the ambulance mode, when the patient urgently needs to remove the attack, and for maintenance treatment that prevents repeated interruptions in the heartbeat.
Arrhythmia is a rhythm disturbance with which the electrical impulses generated in the sinus node pass. Such disorders can be congenital and acquired.
Various methods can be used to detect arrhythmias, while they can be both non-invasive and invasive (a catheter is inserted through the femoral vein).
Antiarrhythmics can be used only in cases where the violation of the heart rhythm is due to pathological processes. Their reception is relevant when there is a risk of the progression of an existing disease and the development of complications.
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Thanks to the use of antiarrhythmic drugs, it becomes possible to restore rhythm by changing the conductivity of electrical impulses.
Drugs characterized by this action are usually taken for a long time.
Heart rhythm disturbance in some patients is not caused by organic disorders, but develops as a result of psycho-neurotic abnormalities. In such cases, we are talking about benign changes. Patients are prescribed sedatives and tranquilizers.
Violation of the rhythm may be the result of another disease, develop against the background of hypokalemia, medication, cardiac pathologies. In this case, the treatment is aimed at eliminating the root cause.
Anti-arrhythmia drugs are used in the following cases:
- often arising group, early or polytopic extrasystoles that can transform into ventricular fibrillation;
- impaired blood flow, accompanied by symptoms of heart failure;
- identification of the exact cause of arrhythmia with confirmation by the results of an electrocardiogram.
Acceptance of prescribed drugs should be carried out under the supervision of a doctor. It is necessary to monitor the effectiveness of their use and assess the likelihood of side effects.
In addition, tests should be performed to determine the concentration of drug substances in the blood, in order to reduce the risks of complications.
Antiarrhythmic drugs combine various groups of medicines that can be used for various cardiac pathologies. Among these disorders include extrasystoles, tachy and bradycardia, atrial fibrillation.
Since the list of drugs is wide enough, for convenience they are divided into classes.
Regardless of which drugs are prescribed, it is necessary to adhere to certain recommendations:
- The choice of antiarrhythmic drugs can only be done by a cardiologist. This is done on the basis of not only the symptoms, but also the presence of concomitant diseases, the general condition of the patient and an assessment of the likelihood of complications. It is impossible to pick up drugs on your own, as you can significantly aggravate the condition.
- Treatment of pathologies associated with rhythm disturbances is always carried out under the supervision of an ECG, the indicators of which should be taken at least once every 1 weeks.
- During the administration of antiarrhythmics, it is necessary to monitor the work of the respiratory system.
Each of the groups of antiarrhythmics has its own properties. Therefore, they can be appointed after establishing the form of rhythm disturbance. You should not choose the drug yourself.
Antiarrhythmics may have the following effects:
- reduce the excitability of the heart muscle and reduce its automatism;
- lower conductivity in the heart;
- reduce heart rate – can be used for heart palpitations, but are contraindicated in bradycardia;
- reduce the force of contractions of the heart muscle.
There are several classifications of drugs used against arrhythmia.
Used sources: serdce.hvatit-bolet.ru
Antiarrhythmic drugs – drugs used to normalize the rhythm of heart contractions. These chemical compounds belong to various pharmacological classes and groups. They are intended for the treatment of tachyarrhythmias and prevent their occurrence. Antiarrhythmics do not increase life expectancy, but are used to control clinical symptoms.
Cardiologists prescribe antiarrhythmic drugs if the patient has a pathological arrhythmia that affects the quality of life and can lead to the development of serious complications. Antiarrhythmic drugs have a positive effect on the human body. They should be taken for a long time and only under the control of electrocardiography, which is carried out at least once every three weeks.
The cell wall of cardiomyocytes is penetrated by a large number of ion channels through which potassium, sodium, and chlorine ions move. A similar motion of charged particles leads to the formation of an action potential. Arrhythmia is caused by abnormal distribution of nerve impulses. To restore the rhythm of the heart, it is necessary to reduce the activity of the ectopic pacemaker and stop the circulation of the pulse.
The choice of an antiarrhythmic agent is determined by the type of arrhythmia, the presence or absence of a structural pathology of the heart. Subject to the necessary safety conditions, these drugs improve the quality of life of patients.
Antiarrhythmic therapy is primarily carried out to restore sinus rhythm. Patients are treated in a cardiology hospital, where antiarrhythmic drugs are administered intravenously or orally. In the absence of a positive therapeutic effect, they switch to electric cardioversion.
The standard classification of antiarrhythmic drugs is based on their ability to influence the production of electrical signals in cardiomyocytes and their conduct. They are divided into four main classes, each of which has its own path of exposure. The effectiveness of drugs for different types of arrhythmias will vary.
Membrane stabilizing sodium channel blockers – “Quinidine”, “Lidocaine”, “Flecainide”. Membrane stabilizers affect myocardial functionality. Beta-blockers – “Propranolol”, “Metaprolol”, “Bisoprolol”. They reduce mortality from acute coronary insufficiency and prevent relapse of tachyarrhythmias. Medicines of this group coordinate the innervation of the heart muscle. Potassium channel blockers – Amiodarone, Sotalol, Ibutilide. Calcium antagonists – Verapamil, Diltiazem. Other: cardiac glycosides, sedatives, tranquilizers, neurotropic drugs have a combined effect on myocardial function and its innervation.
All information on the site is for guidance only and DOES NOT A guide to action! Only the DOCTOR can deliver the EXACT DIAGNOSIS to you! We kindly ask you NOT to CARE, but to sign up for a specialist! Health to you and your loved ones!
Treatment of supraventricular arrhythmias in children
The children’s body is prone to the development of various kinds of extrasystoles, which is due to the intensity of its growth. The more actively a child grows up, his skeletal and muscle constitution is stretched, the higher the likelihood of developing arrhythmias, including supraventricular.
In most cases, children do not complain of interruptions in the heart, they practically do not feel extraordinary contractions, but when a similar rhythm disturbance is detected, the child is still put on the dispensary account. This is done in order to prevent the development of possible complications, since NLA may be the first manifestation of a serious disease.
There are several key indications when treatment for supraventricular arrhythmias in children is prescribed:
- the child is difficult to tolerate interruptions in the heart, although hemodynamic changes are not observed;
- a child has 15000 or more extrasystoles per day, which is detected using Holter monitoring.
Based on such indications, therapy from antiarrhythmic drugs and metabolic agents can be prescribed.
General principles of drug treatment
All medicines for atrial fibrillation – a list with a huge number of items. The choice of drugs is difficult even for an experienced doctor.
Atrial fibrillation is dangerous with complications, so the doctor should choose the treatment for the pathology.
- Among the general principles that determine which medicine to use for atrial fibrillation, there are several main directions.
- Treatment of the disease that caused fibrillation, if any (hypertension, thyroid dysfunction, pulmonary pathology, diabetes mellitus). Sometimes you need to cancel already taken medications. For example, if Vazobral is prescribed, atrial fibrillation may be more likely due to caffeine.
- Prevention of AF is prescribed for paroxysmal and persistent forms.
- The cessation of an already begun attack of fibrillation is more effectively achieved by intravenous administration of the drug.
- Maintaining a sinus rhythm with a constant type of fibrillation does not always make sense, the need for this treatment is determined by the doctor.
- The prevention of such a dangerous complication as thrombosis is carried out with any type of AF.
In AF, additional nutrition of the heart muscle is performed. This function is performed by metabolic drugs.
Examples of such agents are Panangin and Asparkam, which contain potassium and magnesium asparaginates. They are recommended to be taken 1-2 tablets three times a day in combination with a meal.
It contains inosine, which improves blood supply to the heart muscle.
In the treatment of atrial fibrillation, Riboxin is prescribed one tablet 3-4 times a day at the initial stage.
With good tolerance, a single dose is doubled, and the medicine is taken three times a day. Gradually switch to taking 4 tablets 3 times a day. Treatment lasts from 1 to 3 months.
The drug supports the nutrition of cardiomyocytes, protecting them from destruction, contributes to normal conduction in the heart muscle.
The dose per day for the treatment of atrial fibrillation is 6-9 mg per kilogram of patient weight, it is divided into 3 doses. The maximum permissible single dosage is 250 mg, and the daily dosage is 800 mg.
You need to finish the treatment with Mexicor tablets gradually, reducing the daily dose by 0,1 g.
Among the entire abundance of antiarrhythmic drugs for the treatment or prevention of atrial fibrillation, there are several:
Warfarin is popular among anticoagulants due to its low cost.
In the treatment of cardiac arrhythmias, first of all, includes medical assistance to the patient for his underlying disease, which caused a violation of the heart rhythm. In parallel, medications suitable for a particular type of arrhythmia are prescribed. For the treatment of organic bradycardia, angioprotectors and low-dose acetylsalicylic acid are often prescribed. These drugs improve blood flow in the vessels that feed the heart muscle, due to the reduction of atherosclerotic phenomena.
With arrhythmias caused by taking medications, reduce the dosage or cancel the drug completely. In the case of such a reaction to antihypertensive drugs, it is necessary to choose a replacement.
An attack of arrhythmia during a hypertensive crisis aggravates the risk of the patient’s condition, because it stimulates ventricular fibrillation. It is urgent to call an ambulance. In outpatient treatment, sedatives not only of plant origin, but also synthetic ones are widely used (Seduxen, Elenium, Phenazepam).
Patients with a similar pathology need to control pressure and pulse. They should not cause hypotension. Many drugs for hypertension and arrhythmias reinforce each other. Therefore, the doctor reduces the dosage of both drugs.
The appearance of weakness, dizziness against the background of bradycardia is an indication for drug withdrawal, dosage review.
Due to the high activity of antiarrhythmic drugs and severe side effects, the patient should not use other people’s pills, listen to neighbors, relatives. Even very good medicines have different effects on the body of a particular person. Therefore, the appointment and treatment should be entrusted only to specialists, cardiologists or therapists.
Arrhythmia is called a violation in the work of the heart. Its manifestations are rapid, slow or uneven contraction of the myocardium.
The causes of arrhythmia and the mechanisms of its occurrence may vary. The treatment tactics are selected individually after a detailed examination and determination of the localization of the process that led to incorrect myocardial contractility.
The treatment strategy includes the following steps:
- The doctor assesses the threat of hemodynamics from the presence of arrhythmia and decides on the need for treatment in principle.
- The risk of other complications due to arrhythmia is assessed.
- The subjective attitude of the patient to attacks of arrhythmia and his well-being at these moments are evaluated.
- The degree of aggressiveness of therapy is determined – mild, conservative, radical.
- A thorough examination of the patient is carried out to identify the cause of the disease. After that, the doctor evaluates whether etiotropic therapy is possible. A detailed examination of some patients reveals that the cause of the disease is psychological reasons, so the treatment tactics will change dramatically (sedative sedatives will be used).
- Choosing a treatment strategy, the doctor selects the most suitable medication. In this case, the mechanism of action, the likelihood of complications, the type of arrhythmia detected are taken into account.
Beta-blockers are prescribed primarily for supraventricular arrhythmias, IB class medications for ventricular imbalances, calcium channel blockers are effective for extrasystoles and paroxysmal tachycardia. Class 3 membrane stabilizers and antiarrhythmics are considered more universal and are used for arrhythmias of any origin.
The first couple of weeks of treatment, it is necessary to carefully monitor the patient’s condition. After a few days, a control ECG is performed, which is then repeated several more times. With positive dynamics, the interval of control studies may increase.
Dose selection does not have a universal solution. More often, the dosage is selected in a practical way. If a therapeutic amount of the drug causes side effects, the doctor can use a combined treatment regimen in which the dose of each arrhythmia medication is reduced.
Treatment methods for tachycardia depend on the etiology of the latter. Indications for the continuous use of antiarrhythmic drugs are cardiological reasons. However, before starting treatment, it is necessary to exclude neurological causes (home problems, stress at work) and hormonal disorders (hyperthyroidism).
Medicines that help reduce heart rate:
Most drugs come in the form of tablets or capsules. They are inexpensive and are taken by the patient on their own at home, usually in combination with blood thinners. In case of paroxysms (powerful attacks of a rapid heartbeat or pulse), injection forms of drugs are used.
If systolic contractions occur up to 1200 per day, and they are not accompanied by dangerous symptoms, the disease is considered potentially safe. For the treatment of extrasystole, a group of membrane stabilizers can be prescribed. In this case, the doctor can prescribe funds from any subgroup, in particular, IB class drugs are used mainly for the treatment of ventricular extrasystoles.
A positive effect of calcium channel blockers, which are able to relieve tachyarrhythmia or excessive heart contractions, was also noted.
Names of funds that are recommended for use:
With the ineffectiveness of removing extrasystoles with modern drugs, as well as with a frequency of extrasystolic contractions of more than 20000 per day, non-pharmacological methods can be used. For example, radiofrequency ablation (RFA) is a minimally invasive surgical procedure.
With flutter or atrial fibrillation in humans, there is usually an increased risk of thrombosis. The treatment regimen includes drugs for arrhythmias and blood thinners.
The list of drugs that stop excessive atrial fibrillation and flutter:
Anticoagulants are added to them – aspirin or indirect anticoagulants.
With atrial fibrillation, the main drugs should also be combined with anticoagulant drugs. It is impossible to recover from the disease forever, therefore, to maintain a normal heart rate, you will have to drink medications for many years.
For treatment are prescribed:
- Rhythmorm, Cordaron – to normalize heart rate.
- Verapamil, Digoxin – for a reduced frequency of ventricular contractions.
- Nonsteroidal drugs, anticoagulants – for the prevention of thromboembolism.
There is no universal cure for all arrhythmias. Amiodarone has the broadest therapeutic effect.
It is prescribed only by a doctor, most often a cardiologist, and before that, a comprehensive examination of the patient is required, using electrocardiography and other necessary instrumental diagnostic methods. Drugs should also be prescribed only by a doctor, since self-medication can adversely affect health.
- You can stop an attack of supraventricular arrhythmia using verapamil and ATP.
- Herbal preparations in the form of tinctures of motherwort, valerian will help calm the heart activity. They can be mixed and taken 40-50 drops up to four times a day.
- Arrhythmias associated with osteochondrosis are treated with muscle relaxants, vascular agents in the form of mexidol and mildronate. It is also useful to take drugs with a slight sedative effect. It could be Sirdalud.
- Treatment of supraventricular arrhythmia, which developed against the background of an organic pathology of the heart, should begin with therapy of the underlying disease. Without this, it will not be possible to improve the patient’s condition, unless the symptoms of rhythm disturbance are removed, which again appear in time.
- Subjective intolerance to arrhythmias or a pronounced clinical picture of the disease is treated with beta-blockers. Often appointed Egilok, bisoprolol, metoprolol. Dosage selection is carried out individually, since the physiological parameters of the patient should be taken into account.
Other groups of drugs for the treatment of rhythm disturbances
Atrial fibrillation and fibrillation in case of high frequency requires urgent measures and intravenous administration of drugs. As maintenance therapy, drugs that suppress ectopic foci are used.
The most effective are: Amiodarone, Novocainamide, Aimalin, Disopyramide, Quinidine, a combination of adrenergic blockers with aminoquinoline drugs (Anaprilin Delagil or Plaquenil).
It can be difficult for older people with many diseases to find an effective drug. Typically, the doctor is based on the choice of preventing side effects. A small dosage is prescribed. In this case, it is necessary to monitor the patient’s condition, heart rate, blood pressure.
There are drugs that can regulate heart rate directly or indirectly, but they belong to other pharmacological groups. These are drugs of cardiac glycosides, adenosine, magnesium and potassium salts.
Cardiac glycosides affect the cardiac conduction system by regulating autonomic activity. They often become the drugs of choice in patients with heart failure or hypertension. Adenosine triphosphate is a substance that takes part in many important electrophysiological processes in the human body.
Tranquilizers with sedatives are prescribed for the neurogenic etiology of arrhythmia.
Magnesium preparations with potassium (Panangin) are also used to treat arrhythmias and flicker due to the participation of these elements in the mechanism of muscle contraction. They are called “vitamins for the heart.” Normalization of the concentration of ions inside and outside the cell positively affects the contractility of the myocardium and its metabolism.
Drug treatment of supraventricular arrhythmia
They are prescribed if the patient is diagnosed with supraventricular extrasystole or other cardiac arrhythmias are identified:
- Adenosine drugs. Medicines containing this substance temporarily block the antireventriculatory node and are able to relieve inflammation. They are prescribed when atrial fibrillation and heart failure are detected. Potassium preparations are also prescribed.
- Cardiac glycosides. They have the following types of effects: dromotropic (decreased conductivity), chronotropic (reduces heart rate), inotropic (increased contractility of the heart muscle).
- Bellataminal is prescribed for patients with reduced heart rate, other antiarrhythmic drugs – amiodarone, cordaron, novocainamide can also be used. But due to the frequent development of side effects, they are prescribed only in extreme cases.
- type of extraordinary reductions;
- the presence in the patient of concomitant pathologies of the heart and internal organs;
- probable cause of extrasystole;
- the frequency of seizures and the like.
These criteria will affect the symptoms and treatment of extrasystole, the method of implementing therapy, the need for surgical correction and the possibility of getting rid of extrasystoles at home with the help of alternative recipes.
There are clinical options when an extrasystole does not need medical treatment and can pass on its own, after a certain period of time. Such cases include extraordinary cardiac contractions of neurogenic origin, as well as the so-called medicinal extrasystoles caused by the use of medications.
Neurogenic extrasystole, which develops against the background of nervous overstrain, anxiety, severe stress, as a rule, disappears after normalizing sleep patterns and taking sedatives, which are easy to prepare at home. To save patients from this kind of extrasystole, doctors recommend them swimming in the pool, relaxing massage, yoga and other relaxing techniques.
If extrasystoles are a side effect of the drug, then to eliminate the pathological manifestations, it is enough to cancel the harmful agent and continue to avoid direct contacts with it. Doctors always warn their patients about the possible negative effects of taking a particular medicine.
Extrasystole does not always have a benign course. Some forms of the disease behave quite aggressively and can cause the development of life-threatening conditions, including atrial or ventricular fibrillation, atrial fibrillation, sudden cardiac arrest. Treatment of extrasystolic arrhythmia is indicated for patients who are diagnosed with the following forms of extraordinary contractions:
- the constant appearance of extrasystoles after every 2-4 normal contractions;
- polytopic extrasystoles arising from multiple foci of ectopia, which have a variable nature of generation;
- group extrasystoles in an amount of five or more per minute;
- extrasystole, which is a residual phenomenon after a sudden attack of atrial fibrillation or myocardial infarction.
Modern methods of electrocardiographic studies allow a detailed diagnosis of the patient’s heart rhythm with a determination of the type of extrasystoles that occur, the frequency of their generation, the possible localization of ectopic foci, and the like. Such an examination is known as Holter daily monitoring, which is recorded for 24 hours, after which it is analyzed.
According to the generally accepted rule, extrasystole should be treated if more than 1000 pathological contractions were recorded in the patient during the day, especially when it comes to their ventricular type. Extrasystoles in an amount of not more than 1000 ectopic contractions do not need medical correction.
How to treat extrasystole correctly? Treatment of extrasystole should begin with the implementation of the doctor’s simple recommendations regarding lifestyle and food culture:
- eat healthy foods and avoid greasy, fried, or spicy foods;
- drinking alcohol and coffee is not recommended;
- should stop smoking;
- the patient should normalize the regime of his day, normalize his sleep and ensure a decent rest;
- in stressful situations, it is necessary to take sedative tablets or drops in order to prevent nervous strain;
- Do not expose your body to intense physical exertion.
Doctors always warn their patients with rhythm disturbances so that they do not self-medicate and do not take funds that have not received the prior approval of a specialist. Treatment of cardiac extrasystole should begin with weaker antiarrhythmic drugs, and only if they are ineffective, should they switch to drugs with a stronger effect.
In addition to antiarrhythmic drugs that suppress the activity of ectopic foci, several groups of drugs are used in the treatment of extrasystolic arrhythmias, among which they are particularly effective:
- cardiac glycosides, which allow you to remove excess stress on the heart and normalize the activity of the organ;
- sedatives to relieve nervous tension;
- preparations containing potassium and magnesium that improve metabolic processes in the myocardium and partially suppress the activity of ectopic zones;
- if extrasystole is accompanied by bradycardia, then this is an indication for the appointment of anticholinergics, in particular atropine.
As a rule, extrasystole does not cause urgent and life-threatening conditions for a person, which cannot be said about its complications or extraordinary contractions that arose against the background of acute cardiac disturbances. We are talking about extrasystoles that are generated in acute myocardial infarction, hypertensive crisis, myocarditis and the like.
- lower blood pressure;
- stop pain;
- normalize heart rate.
For the quickest withdrawal of an attack, it is recommended to introduce intravenous antiarrhythmic drugs. When removing an arrhythmic episode, the features of the relief of acute manifestations of the underlying disease should also be considered. In any case, the rapid development of symptoms of rhythm disturbance requires an immediate response and referral of the patient to a specialized medical institution.
Is it possible to treat extrasystole at home using folk remedies based on herbs and other improvised means? The use of traditional medicine recipes for extrasystolic disturbance of the cardiac rhythm takes place only in the case of prevention of the disease, as well as as an addition to classical therapy. Therefore, it is not worthwhile to fully count on the help of herbs for acute or urgent options for the development of the disease.
Herbs such as cornflower, calendula, valerian and the famous hawthorn have excellent antiarrhythmic effects, the decoctions of which are easy to prepare at home. Everyone can also freely purchase tinctures of these medicinal plants in a pharmacy. It should be understood that before using such antiarrhythmic drugs, it is better to first consult a doctor and exclude possible contraindications to their use.
The main thing to remember, drink any remedy only after the permission of the cardiologist!
Used sources: ritmserdca.ru
Herbal antiarrhythmic drugs
Medicines for atrial fibrillation belong to the group of antiarrhythmic drugs. When selecting these funds, you must consider:
- side effects;
- the state of various structures of the heart;
- compatibility of drugs with each other and other drugs used by the patient.
So, patients with diabetes need to clarify whether it is possible to take “Siofor” for atrial fibrillation within the framework of the selected treatment, since this remedy reduces the effectiveness of indirect anticoagulants. In addition, the concentration in the blood of the main substance “Siofora” increases quinidine.
Antiarrhythmic drugs for atrial fibrillation are classified in various ways, but the classification that includes 4 classes is generally accepted. They differ in the type of effect on excitation of a cardiomyocyte and conduction of a cardiac impulse.
Means for the treatment of atrial fibrillation, belonging to this class, are divided into 3 subclasses depending on the intensity of exposure to the conducting channels of the cell wall of cardiomyocytes:
- IA moderate effect on phase 0 (depolarization), can also block potassium channels, prolonging phase 1 (fast repolarization) – quinidine, procainamide, rhythmylene;
- IB slightly slows depolarization and slightly accelerates phase 1 – phenytoin;
- IC intensively inhibit depolarization and do not affect repolarization – lappaconitine, propafenone, etacisin.
The active substance of this drug is the lappaconitine compound.
It not only inhibits depolarization, but also blocks beta-adrenergic receptors. Allapinin also has analgesic and sedative effects.
It should be taken 25 mg every 6-8 hours after eating. Sometimes the dosage is increased.
In tablet form for the treatment of atrial fibrillation is used as follows:
- in the first dose, a maximum of 6 tablets containing 0,25 g of procainamide is prescribed;
- with a single dose inefficiency – 2 more tablets, and every 2 hours – 2-4 tablets.
The tablets contain 150 g of propafenone hydrochloride, which is characterized by the ability to block not only sodium channels, but also to a weak degree – beta-adrenergic receptors.
An AF attack is stopped by a single dose of 600 mg of propafenone. The start of treatment should be carried out in stationary conditions, in the future, the drug can be used by patients to block AF alone at the prescribed dosage. It is recommended to always be with you.
To maintain heart rate, 150 mg is prescribed 3 times a day at regular intervals.
Analogs are Propanorm and Rhythmorm, which are available in the form of tablets containing 150 or 300 g of propafenone hydrochloride.
The common trade name is Diphenin. It is often prescribed in the treatment of epilepsy as an anticonvulsant.
To stabilize the state, it is currently used very rarely, mainly with glycoside intoxication. The treatment regimen is different: 100 mg 3-4 times a day or 200 mg up to 5 times a day with a further dose reduction in tablet form.
The advantage of phenytoin is the ability to stabilize the rhythm of the heartbeat even with hypokalemia.
It is produced in the form of tablets containing 200 mg of quinidine sulfate.
According to studies, it is best to prescribe it for the treatment of atrial fibrillation with a maximum dose (2 tablets).
With the continuation of AF, 1 tablet is then used every hour until the attack is stopped or until the total dose reaches 1000 mg.
Etatsizin tablets contain 50 mg of active ingredient. They are taken 1 piece up to 3 times a day. The dose can be increased individually to achieve the effect. Eating is not important. Supportive treatment for atrial fibrillation is carried out in the minimum dosage selected for each patient.
This group of drugs includes drugs that normalize the heart rate by blocking Na channels and improve the conductivity of impulses. The higher the pulse, the more actively the blockade is created. At the same time, drugs with various effects on repolarization time are isolated.
|Repolarization time||Recommendation||The brightest representatives of the group||Picture||Description and Purpose|
|Increases, moderate blockade of channels||For the treatment of tachycardia of the sinus node, atrial fibrillation||Quinidine||Suitable for the prevention of ventricular fibrillation, reduces blood pressure, weakens the myocardium. Contraindicated in case of quinine intolerance, as well as in the event of thrombocytopenia while taking the drug. The maximum allowable daily dose is 3-4 grams, divided into several doses. Do not use with verapamil, anticoagulants|
|Procainamide||Available in the form of a solution. It is prescribed every 3-6 hours at a dose of 250-500 mg, taking into account the maximum daily dose of 4 grams. It is not prescribed for myasthenia gravis, bronchial asthma, atherosclerosis, severe kidney, liver, and myocardial infarction|
|Disopyramides||The effect of the drug is similar to Quinidine. Increases the tone of arterioles. Perhaps the appearance of a headache during therapy, allergic reactions and dyspepsia|
|Analogs: Aimalin, Novokainamid|
|Reduced, weak blockade of channels||For the treatment of ventricular arrhythmias, extrasystoles, acquired arrhythmias after myocardial infarction. Not suitable for the treatment of atrial fibrillation||Lidocaine||It is successfully used among patients with bradycardia, as well as with a high risk of blockade. Suitable for hypotensive patients. However, on the background of taking the drug, fainting is not excluded, in especially difficult situations – respiratory failure. It is not used orally, does not differ in duration of exposure|
|Phenytoin or diphenin||The dosage is calculated at 4 mg per 1 kg of weight. It slows down psychomotor reactions and is prescribed with caution to persons with epilepsy and seizures. It has an effect on the state of the blood; pregnant is not prescribed due to the risk of fetal pathologies|
|Mexiletine||Does not cause gastrointestinal upset, side effects are possible only due to effects on the central nervous system. It can replace lidocaine for oral use, has a long-term effect, is effective for ventricular extrasystole. It is impossible with parkinsonism|
|Does not change, strong blockade of channels||For the treatment of tachycardia||Propafenone or Propanorm||In addition to Na blockade, it affects both beta-blockers and calcium. With caution, the dose is calculated, since with a quick administration or administration of a higher dose than necessary, short-term cardiac arrest, bronchospasm is possible. Affects blood condition|
|Etatsizin||It has a mild relaxing effect on the myocardium, lengthens the time of contractions, and has anti-ischemic properties. The effect is achieved after 2 doses of Etatsizin, and it should be remembered that there will be no pronounced decrease in heart rate. It is taken three times a day with a gradual increase in dose. up to 200-300 per day. Danger of provoking another type of arrhythmia|
|Analogs: Lappaconitin, Etmosin, Flecainide, Indecainide, Lorkainid|
Due to the blockade of K-channels, this group of drugs is successfully used among patients with a high risk of ventricular fibrillation. In contrast to the group of sodium channels, in which one drug can be replaced by another within the same class, it is unacceptable to do this with potassium channel blockers because of the difference in their mechanism.
- Amiodarone is a universal highly effective drug suitable for normalizing the work of both the atria and ventricles. With prolonged antiarrhythmic therapy, the effect may persist even after discontinuation of the drug for several months. Contraindicated for the treatment of pregnant, lactating, hypotensive, with thyroid disorders. Not applicable for potassium deficiency in the body.
- Ibutilide is a drug with a fairly mild antiarrhythmic effect, but a high load on the liver. Suitable for the treatment of paroxysmal arrhythmias, atrial fibrillation under the supervision of an ECG in a hospital setting.
- Sotalol is an effective drug for the treatment of various types of tachyarrhythmias. It has a low percentage of distribution in tissues and organs. Suitable for the treatment of patients with liver and kidney pathologies. It has beta-blocking activity. The dose – from 80 mg per day with enough water – is selected taking into account the anamnesis and creatinine level.
- Nibentan is a highly effective drug, most often used as intravenous infusion in a hospital setting. It is similar in principle to the action with ibutilide, suitable for the treatment of patients with signs of flutter and fibrillation.
Beta-blockers are unique in preventing unwanted effects that develop from “hit or run” reactions. The actual use of such antiarrhythmic drugs to reduce myocardial arousal, with tachycardia, various types of arrhythmias, in which the central nervous system is damaged. This group of drugs includes Esmolol, Timolol, Nadolol, Carvedilol, but are considered more common:
- Propranolol, sold under the commercial names Anaprilin and Obzidan, is contraindicated in low blood pressure, bradycardia, cardiogenic shock. It is highly effective for reducing heart rate, but often causes a feeling of fluttering heart, fading, turning over. Not used in individuals with depressive disorders.
- Metoprolol is similar in type of action and contraindications to propranolol. According to the testimony, it can be used in pregnant women, hypertensive patients, patients after a heart attack (but not in the acute course of the process). The dose is selected individually, based on the type of arrhythmia, but is used once a day with a small amount of water in any relation to food. Atenolol has a similar effect.
- Bisoprolol is a similar drug to the previous ones, more often prescribed to lower blood pressure. Inexpensive, well tolerated, does not cause peripheral edema, dizziness and heart complications.
- Verapamil is a well-known and widely available drug used for atrial fibrillation. Should not be used with low blood pressure, decompensated heart failure. It is absorbed thanks to proteins, therefore it is taken with food. The dosage of the drug is selected by a gradual increase from 48 mg to the desired amount, while Verapamil is taken several times a day. It is undesirable to use together with other antiarrhythmic drugs. Diltiazem has a similar effect.
- Adenosine and its more preferred form – Adenosine triphosphate – activates potassium channels, thereby suppressing excessive excitation and normalizing heart rate. The action of the drug begins after 10 seconds, it is excreted as uric acid. With Adenosine therapy, it is necessary to prevent a decrease in heart rate to 55, as well as to control the pressure. It can be used in conjunction with Dipyridamole, thereby increasing the amount of Adenosine in plasma. With ventricular tachycardia – not applicable.
- have a mild sedative effect;
- raise the tone of cardiac activity (cardiotonic effect);
- prevent the development of seizures.
often arising group, early or polytopic extrasystoles that can transform into ventricular fibrillation; impaired blood flow, accompanied by symptoms of heart failure; identification of the exact cause of arrhythmia with confirmation by the results of an electrocardiogram.
What you can apply yourself
The meaning in the appointment of beta-blockers for arrhythmias is the mechanism of their action on the heart. These drugs bind to beta group receptors, through which adrenaline exerts its stimulating effects on the myocardium – increases the frequency of contractions. By blocking the receptors with medications, you can eliminate this effect, which is important in the treatment of arrhythmia.
What is good metoprolol
The advantage of Metoprolol (the name of the analog is Corvitol), which makes it one of the main drugs for first aid for arrhythmias, is that the onset of the therapeutic effect is quite rapid – even if such pills for arrhythmia are used. The active substance, when taken under the tongue, already in 30–40 minutes accumulates in the blood at a therapeutic concentration. Therefore, it is mainly used for stopping seizures in the immediate period after it.
The medicine for heart arrhythmia Bisoprolol (list of analogues: Concor, Biprolol) acts slowly, gradually, but for a long time (about 12 hours). This feature, combined with the pronounced effects characteristic of beta-blockers, allows the drug to be used for long-term treatment and prevention of repeated heart rhythm failure.
Antiarrhythmic drugs beta-blockers can not be prescribed for the treatment of arrhythmias in patients:
- Chronic obstructive pulmonary disease and bronchial asthma.
- With low blood pressure. This is very important, since about 50% of heart attacks and 20% of arrhythmic attacks are accompanied by a similar violation.
- Severe heart failure.
- No injectable formulations.
Under normal conditions, we don’t feel how the heart works. With unrest, increased physical activity, the heart rate increases under the influence of catecholamines in the blood. A feeling of palpitations appears. A man complains of strong heart tremors, feels a throb in his temples, in his throat.
If a connection with nervous tension is clearly traced, you can take sedatives of mild action on your own: Corvalol, Valocordin, Persen, Motherwort, Valerian, Novopassit. As a rule, these preparations include combinations of harmless herbal remedies. Motherwort and Valerian are available both in tablets and in drops. You can choose a convenient shape.
Treatment of supraventricular arrhythmias with folk remedies
Medicinal herbs can help establish a disturbed rhythm. In particular, with arrhythmias, a collection of lemon balm, hawthorn, hop, and heather is shown. The composition can be supplemented with motherwort and then a sedative effect will be provided, which is useful for tachycardia.
It is worth noting that any methods of herbal preparations should be coordinated with the attending physician so that undesirable consequences do not arise later.
Video Treatment with folk remedies for cardiac arrhythmias
In conclusion, we can add that arrhythmia harmless in mild forms can be complicated by serious disorders. Therefore, in any condition, you need to contact a cardiologist to undergo an examination and receive appropriate treatment.
What drugs are indicated for sinus arrhythmia?
The source of arrhythmia may not be functional loads, but an acute or chronic pathology that occurs when:
- infectious myocarditis,
- myocardial ischemia,
- decompensation of heart defects.
The problem has gained particular relevance in connection with the fascination with all kinds of exotic diets. Against the background of refusal of food, vegetarianism, an imbalance appears in the vitamin and electrolyte composition of the blood.
The heart is very sensitive to the loss of potassium and magnesium. Hyperkalemia occurs with dehydration after acute blood loss, diarrhea, extensive burns, severe sweating.
In some patients, arrhythmia is associated with impaired thyroid function, hormonal changes in the menopause. In such cases, there are special drugs prescribed by the endocrinologist to correct the level of responsible hormones.
Arrhythmias are temporarily used for the consequences of injuries of the chest, skull, after surgical interventions.
Contraindications to the use of each drug have differences. They should be carefully studied according to the instructions. Here are the most common conditions that require attention before prescribing antiarrhythmic drugs:
- cases of severe heart, liver and kidney failure;
- individual intolerance of components;
- atrioventricular blockades of varying degrees and impaired intraventricular conduction;
- myocarditis, endocarditis;
- low blood pressure, cardiogenic shock;
- acute period of myocardial infarction;
- an attack of bronchial asthma;
- diseases of impaired blood formation;
- diabetes mellitus acidosis;
- overdose of cardiac glycosides;
- aortic aneurysm;
- sinus bradycardia;
- Raynaud’s disease;
- vasomotor rhinitis;
- common cardiosclerosis.
- Subjective intolerance of the patient to arrhythmias. In this case, the main will be the appointment of psychotropic drugs, and AAPs are used according to the situation.
- ES having an unfavorable prognosis, malignant course of ventricular ES. this includes allorrhythmias, frequent lower ventricular ES (above 1,2 thousand when monitored by Holter), ES of organic etiology (defects, heart attack, dilated cardiomyopathy).
- Any ES, the frequency of which exceeds 1,5 thousand, regardless of etiology and tolerance. Such ESs themselves can cause organic damage to the myocardium (arrhythmogenic cardiopathy), a decrease in its contractile function.
You can refrain from prescribing AAP with a rare ES (no more than 300), if the patient tolerates it well, and the myocardium and hemodynamics do not suffer.
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