Classification of forms of atrial fibrillation is carried out taking into account electrophysiological mechanisms, etiological factors and clinical features.
According to the duration of the pathological process, the following forms of atrial fibrillation are distinguished:
- paroxysmal (transient) – an attack in most cases lasts no more than a day, but can last up to a week;
- persistent – signs of atrial fibrillation persist for more than 7 days;
- chronic – its main distinguishing feature is the inefficiency of electric cardioversion.
Persistent and transient forms of atrial fibrillation can have a recurring course, i.e., atrial fibrillation attacks can occur repeatedly.
Depending on the type of atrial rhythm disturbance, atrial fibrillation is divided into two types:
Atrial fibrillation (fibrillation). A coordinated atrial contraction is absent, as there is an uncoordinated contraction of indiv >
During paroxysm of atrial fibrillation, the atria contract inefficiently. In this case, the ventricles are not completely filled, and at the time of their reduction, there is periodically no ejection of blood into the aorta.
The frequency of seizures in patients with paraxismal arrhythmia can be different. Sometimes seizures occur several times in life, and sometimes they occur several times a day.
In medical practice, there are various ways of classifying a disease such as atrial fibrillation.
- Atrial cardiac arrhythmia: causes, symptoms, treatment and prevention
- What’s this
- What it is?
- Classification of atrial fibrillation
- Symptoms of atrial fibrillation
- What it is?
- Atrial fibrillation treatment
- What it is?
- Folk remedies
- Complications, consequences
- Diet for atrial fibrillation
- Prognosis for atrial fibrillation
Atrial fibrillation (atrial fibrillation) is a violation of the heart rhythm, accompanied by frequent, chaotic arousal and contraction of the atria or twitching, fibrillation of certain groups of atrial muscle fibers. The heart rate for atrial fibrillation reaches 350-600 per minute. With prolonged paroxysm of atrial fibrillation (exceeding 48 hours), the risk of thrombosis and ischemic stroke increases. With a constant form of atrial fibrillation, a sharp progression of chronic circulatory failure can be observed.
Atrial fibrillation is one of the most common variants of rhythm disturbances and accounts for up to 30% of hospitalizations for arrhythmias. The prevalence of atrial fibrillation increases according to age; it occurs in 1% of patients under 60 years of age and in more than 6% of patients after 60 years of age.
Atrial cardiac arrhythmia: causes, symptoms, treatment and prevention
The cause of atrial fibrillation can be both heart disease and a number of other pathologies. The most common occurrence of atrial fibrillation occurs against the background of severe heart failure, myocardial infarction, arterial hypertension, cardiosclerosis, cardiomyopathies, myocarditis, and rheumatic heart diseases.
Other causes of atrial fibrillation are:
- thyrotoxicosis (thyrotoxic heart);
- intoxication with adrenergic agonists;
- overdose of cardiac glycosides;
- alcoholic cardiopathy;
- chronic obstructive pulmonary disease;
- pulmonary embolism (pulmonary embolism).
If the cause of the development of atrial fibrillation cannot be established, the diagnosis of an idiopathic form of the disease is made.
What is atrial fibrillation? Often patients complain that the heart is a little “naughty.”
They feel it in the form of a strong heartbeat, which seems like a heart will jump out of the chest.
Sometimes the sensations become more strange – in the heart it stops, there is a trembling or even a slight tingling sensation.
This disease is not so rare. Let’s understand what it is and what is dangerous atrial cardiac arrhythmia, what are the causes of its occurrence, symptoms and treatment with medications.
Detonic – a unique medicine that helps fight hypertension at all stages of its development.
The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.
Detonic not addictive and withdrawal syndrome, since all components of the product are natural.
Detailed information about Detonic is located on the manufacturer’s page.
The normal functioning of the heart muscle is the reduction of the atria and ventricles in the correct sequence. With violations, the heart begins to contract in the wrong rhythm, so the medical name for this phenomenon is arrhythmia.
Most often, people have a type of disease such as atrial fibrillation. At the same time, the phase at which the atria is contracted disappears in the work of the heart muscle. Instead of contractions, twitching or flickering occurs, which affects the functioning of the ventricles.
The disease has been known for a long time, and according to statistics, heart rhythm disturbances are given to every two hundredth visitor of a clinic.
Often atrial fibrillation (MA) appears as a consequence and complication of coronary artery disease or hypertension.
MA includes both atrial flutter and fibrillation.
Various studies of this disease have been conducted in the UK and the USA, which show that this disease occurs in 0,4 – 0,9% of the adult population.
An attack of MA at the beginning is usually pronounced, then relapses begin to occur (periodic ejection of blood into the aorta).
The disease has 3 stages:
- Discontinues without any treatment. It is not particularly dangerous and has a favorable prognosis.
- It does not stop on its own. The heart rhythm is restored due to medical or physiotherapeutic effects.
- Constant. There is a need to constantly monitor the work of the heart in order to avoid thromboembolism.
There are several forms of cardiac muscle rhythm disturbances. These include: a form with an undisturbed rhythm of the ventricles, a form with wide QRS complexes, a bradysystolic form.
Atrial cardiac arrhythmia can be paroxysmal (paroxysmal) and constant (prolonged), the treatment of both forms is similar.
Most often, this disease of the heart muscle occurs as a result of its rheumatic fever, as well as in obesity or diabetes (sugar), myocardial infarction (find out what it is and what are the consequences), alcohol damage.
It affects the heart muscle and the intake of various medicines, smoking, strong psycho-emotional stress, the frequent use of caffeinated drinks – coffee, strong tea, energy.
Surgery carried out on the heart, congenital heart defects can also be attributed to risk factors.
Cardiac pathology is one of the most common causes. Often this disease occurs if the patient has ever been diagnosed with a disease or malfunction of the thyroid gland.
The risk factor in young people is bad habits. Drinking unlimited amounts of alcohol and smoking greatly increase the likelihood of getting MA.
How is arrhythmia manifested? It depends on the form in which the disease occurs, as well as on the characteristics of the human psyche and the general condition of the myocardium.
The initial signs of this heart disease should include periodically occurring shortness of breath, which does not stop after sports, a frequent heartbeat, pain, or other unpleasant sensations. All this occurs in the form of seizures.
Not everyone has a disease that becomes chronic. Attacks can begin and occasionally recur throughout life. In some patients, 2 or 3 episodes of atrial fibrillation pass into a chronic form. Sometimes a disease is detected only after a thorough medical examination.
Symptoms also include: for no reason, palpitations, weakness throughout the body, trembling, increased sweating, a feeling of fear, and the occurrence of fainting.
Atrial fibrillation is manifested by a fragmented, chaotic contraction of the atrial muscle tissue (myocardium) at a speed of 350-600 impulse waves per minute. As a result, the atria are not fully reduced, the presence of blood in the ventricles is weakened.
Part of the blood is retained in the atria, which increases the risk of blood clots.
The presence of an outbreak of atrial fibrillation for more than 48 hours leads to a high risk of developing ischemic stroke, myocardial infarction, thromboembolism of various organs and peripheral vessels, and severe cardiovascular failure.
What it is?
Atrial fibrillation in Latin means “madness of the heart.” The term “atrial fibrillation” is a synonym, and the definition of the disease is as follows: atrial fibrillation is a type of supraventricular tachycardia characterized by chaotic activity of the atria with their reduction at a frequency of 350-700 per minute.
Both cardiac pathology and diseases of other organs can lead to the development of atrial fibrillation. Most often, atrial fibrillation accompanies the course of myocardial infarction, cardiosclerosis, rheumatic heart diseases, myocarditis, cardiomyopathies, arterial hypertension, severe heart failure. Sometimes atrial fibrillation occurs with thyrotoxicosis, intoxication with adrenergic agonists, cardiac glycosides, alcohol, and can be triggered by neuropsychic overloads, hypokalemia.
Idiopathic atrial fibrillation also occurs, the causes of which remain undetected even with the most thorough examination.
All the many reasons that can cause an attack of atrial fibrillation can be divided into two large groups:
- Cardiac or cardiac causes.
These include the presence of high blood pressure, diseases of the arteries of the heart, valvular and congenital heart defects, heart failure, pericarditis and myocarditis, heart tumors, diseases of the sinus node.
- Extracardial (non-cardiac) causes.
Excessive consumption of alcoholic beverages and the presence of other bad habits can have a big impact on the development of atrial fibrillation. Stress, physical exertion, taking a large dose of caffeine, and taking certain medications have a harmful effect on the human nervous system and on the rhythm of heart contractions.
Among non-cardiac reasons, the presence of thyroid gland diseases, chronic lung disease, diabetes mellitus, and electrolytic disorders should be mentioned. In some cases, the development of the disease is associated with a hereditary predisposition.
The risk of death from heart disease in the presence of atrial fibrillation increases by 1,7 times. Specify your pressure Move the sliders
There are several causes of pathology:
- Diseases of the cardiovascular system, such as hypertension, coronary heart disease, heart failure, cardiomyopathy.
- Diseases of the endocrine system, in particular, hyperteriosis.
- Pathologies of the autonomic nervous system, stress, frequent mental overwork.
- Abuse of alcoholic beverages and caffeinated products.
- The use of certain drugs that affect the work of the heart and the concentration of trace elements in the blood, for example, uncontrolled intake of diuretics.
With atrial fibrillation, the following symptoms are observed:
- Heart rate ranges from 80-150 bpm, in severe cases, heart rate exceeds 300 bpm;
- feeling of heaviness and chest pain;
- excessive sweating;
- general weakness;
- shortness of breath, shortness of breath;
- loss of consciousness;
- often, profuse urination;
- unexplained anxiety, fear.
For the timely detection of the presence of the disease, knowledge of the main symptoms and signs of its manifestation is necessary.
It should be noted that atrial fibrillation is a difficult to detect disease, since in some forms of its course the heart rate remains at a normal level.
However, symptoms are distinguished by which you can diagnose this disease yourself:
- Pain in the heart associated with malfunctions in the rhythm of the heart, pallor of the skin.
- The appearance of general weakness due to impaired functioning of the nervous system and deterioration of the blood circulation of the brain.
- Shortness of breath and dizziness, the cause of which is, as a rule, oxygen “starvation” of the brain.
- Rapid urination is associated with intense kidney function due to increased blood pressure and active nervous system.
- Fainting condition.
- Attacks of nausea and sweating.
- A feeling of panic and inexplicable anxiety.
- Pulse deficiency.
The manifestation of symptoms occurs differently depending on the individual characteristics of the person: some people do not have pronounced symptoms, the disease is detected only during a routine examination or examination; in others, the manifestation of the disease contributes to a noticeable decrease in the quality of life.
Classification of atrial fibrillation
The basis of the modern approach to the classification of atrial fibrillation includes the nature of the clinical course, etiological factors and electrophysiological mechanisms.
Permanent (chronic), persistent and transient (paroxysmal) forms of atrial fibrillation are distinguished. With a paroxysmal form, the attack lasts no more than 7 days, usually less than 24 hours. Persistent and chronic atrial fibrillation lasts more than 7 days, the chronic form is determined by the inefficiency of electric cardioversion. Paroxysmal and persistent forms of atrial fibrillation can be recurrent.
Distinguish the first detected attack of atrial fibrillation and recurrent (second and subsequent episodes of atrial fibrillation). Atrial fibrillation can occur in two types of atrial rhythm disturbances: atrial fibrillation and atrial flutter.
Atrial fibrillation (atrial fibrillation), certain groups of muscle fibers contract, resulting in a lack of coordinated atrial contraction. A significant amount of electrical impulses is concentrated in the atrioventricular junction: some of them are delayed, others spread to the ventricular myocardium, causing them to contract with a different rhythm. According to the frequency of ventricular contractions, tachysystolic (ventricular contractions of 90 or more per min.), Normosystolic (ventricular contractions of 60 to 90 per min.), Bradysystolic (ventricular contractions of less than 60 per min.) Forms of atrial fibrillation are distinguished.
During paroxysm of atrial fibrillation, there is no injection of blood into the ventricles (atrial supplementation). Atria contract inefficiently, therefore, in the diastole, the ventricles are not completely filled with freely flowing blood in them, as a result of which blood is not periodically ejected into the aortic system.
Atrial flutter – it is rapid (up to 200-400 per min.) Atrial contractions while maintaining the correct coordinated atrial rhythm. Myocardial contractions with atrial flutter follow each other almost without a break, there is almost no diastolic pause, the atria do not relax, being in a state of systole most of the time. Atrial filling with blood is difficult, and, consequently, the flow of blood into the ventricles is also reduced.
Through the atrioventricular connections to the ventricles, every 2nd, 3rd or 4th impulses can arrive, providing the correct ventricular rhythm – this is the correct atrial flutter. In case of atrial-ventricular conduction disturbance, a chaotic contraction of the ventricles is noted, i.e., an irregular form of atrial flutter develops.
Symptoms of atrial fibrillation
What it is?
Manifestations of atrial fibrillation depend on its form (bradysystolic or tachysystolic, paroxysmal or constant), the state of the myocardium, valvular apparatus, and individual characteristics of the patient’s psyche. The tachysystolic form of atrial fibrillation is much more severely tolerated. In this case, patients feel a rapid heartbeat, shortness of breath, aggravated by physical exertion, pain and interruptions in the heart.
At first, atrial fibrillation occurs paroxysmally, the progression of paroxysms (their duration and frequency) is individual. In some patients, after 2-3 attacks of atrial fibrillation, a persistent or chronic form is established, in others – rare, short paroxysms without a tendency to progression are noted during life.
The occurrence of paroxysm of atrial fibrillation can be felt in different ways. Some patients may not notice it and learn about the presence of arrhythmia only during a medical examination. In typical cases, atrial fibrillation is felt by chaotic palpitations, sweating, weakness, trembling, fear, polyuria. With an excessively high heart rate, dizziness, fainting, and attacks of Morgagni-Adams-Stokes can be observed. Symptoms of atrial fibrillation disappear almost immediately after the restoration of sinus heart rhythm. Patients suffering from a constant form of atrial fibrillation cease to notice it over time.
During auscultation of the heart, random tones of various volumes are heard. An arrhythmic pulse with a different amplitude of the pulse waves is determined. With atrial fibrillation, a pulse deficiency is determined – the number of minute heart contractions exceeds the number of pulse waves). The deficiency of the pulse is due to the fact that not every heartbeat causes a release of blood into the aorta. Patients with atrial flutter feel palpitations, shortness of breath, sometimes discomfort in the heart, throbbing neck veins.
The clinical picture of atrial fibrillation depends on the state of the valvular apparatus of the heart and myocardium, the form of the disease (persistent, paroxysmal, tachysystolic or bradyisystolic), as well as the characteristics of the patient’s psychoemotional state.
The most severely tolerated by patients is tachysystolic atrial fibrillation. Its symptoms are:
- interruptions and pains in the heart;
- shortness of breath, aggravated by physical exertion.
Initially, atrial fibrillation is paroxysmal in nature. Further development of the disease with a change in the frequency and duration of paroxysms in each patient occurs in different ways. In some patients, seizures occur extremely rarely, and there is no tendency to progression. In others, on the contrary, after 2-3 episodes of atrial fibrillation, the disease passes into a persistent or chronic form.
Patients and bouts of atrial fibrillation feel differently. In some, the attack is not accompanied by any unpleasant symptoms, and such patients will only learn that they have arrhythmias when they undergo a medical examination. But most often, symptoms of atrial fibrillation are intensely pronounced. These include:
- sensation of chaotic palpitations;
- muscle tremors;
- severe weakness;
- fear of death;
- excessive sweating.
In severe cases, severe dizziness, fainting occurs, attacks of Morgagni-Adams-Stokes develop.
After the restoration of normal heart rhythm, all signs of atrial fibrillation cease. With a constant form of the disease, patients eventually cease to notice manifestations of arrhythmia.
With atrial fibrillation during auscultation of the heart, random tones are listened to at various volumes. The pulse is arrhythmic, pulse waves have different amplitudes. Another symptom of atrial fibrillation is a pulse deficiency – the number of pulse waves is less than the number of heart contractions. The development of pulse deficiency is due to the fact that not every ventricular contraction is accompanied by an outflow of blood into the aorta.
With atrial flutter, patients complain of a pulsation of the cervical veins, discomfort in the heart, shortness of breath, a feeling of palpitations.
Diagnosis of atrial fibrillation is usually not difficult, and the diagnosis is made during a physical examination of the patient. On palpation of the peripheral artery, the disordered rhythm of the pulsation of its walls is determined, while the voltage and filling of each pulse wave are different. During auscultation of the heart, significant fluctuations in volume and irregular heart sounds are heard. The change in the volume of the I tone following a diastolic pause is explained by the different size of the diastolic filling of the ventricles with blood.
To confirm the diagnosis, an electrocardiogram is recorded. Atrial fibrillation is characterized by the following changes:
- chaotic arrangement of QRS ventricular complexes;
- absence of P waves or determination of atrial waves in their place.
If necessary, conduct daily ECG monitoring, which allows to clarify the form of atrial fibrillation, the duration of the attack, its relationship with physical activity. To select antiarrhythmic drugs and identify symptoms of myocardial ischemia, physical activity tests are performed (treadmill test, bicycle ergometry).
Echocardiography (Echocardiography) makes it possible to assess the size of the cardiac cavities, detect the presence of intracardiac blood clots, signs of possible damage to the pericardium and valvular apparatus, cardiomyopathy, and evaluate the contractile function of the left ventricle. Echocardiography results help in the selection of drugs for antiarrhythmic and antithrombotic therapy.
For the purpose of a detailed visualization of the structures of the heart, multispiral or magnetic resonance imaging of the heart is performed.
The method of transesophageal electrophysiological research helps to determine the mechanism of the formation of atrial fibrillation. This study is performed for all patients with atrial fibrillation who are planning to implant an artificial pacemaker (pacemaker) or perform catheter ablation.
In order to identify what caused the deterioration of health and make a diagnosis, determine the prognosis for atrial fibrillation, a cardiologist should prescribe an ECG to the patient – an electrocardiogram.
This method fixes the strength and frequency of contractions of the atria and ventricles, the length of the pauses between them. P waves (responsible for atrial contraction) are low, but their number is much larger than T waves, which show how the ventricles work.
In case of paroxysmal atrial fibrillation, a Holter mount is used – the ECG is recorded over a long period of time – from 2 to 7 days. In this case, the patient carries with him a recorder – a device that measures the activity of the heart chambers.
Atrial fibrillation is a dangerous disease.
Due to the fact that the blood becomes viscous and low-flowing, blood clots can form in the vessels. A blood clot, moving with a blood stream, can clog a blood vessel and cause it to rupture.
In this case, the supply of blood to the organ in which the vessel burst worsens. This is fraught with serious diseases such as a heart attack – it occurs when the blood vessels of the heart rupture – and a stroke – it happens due to rupture of the blood vessels supplying the brain.
What diseases cause atrial fibrillation? Coronary heart disease, heart defects, sinus node weakness, hypertension, diabetes mellitus, alcoholism, an excess of thyroid hormones or a lack of salts in body fluids are the most common causes of heart rhythm disturbances.
The prognosis for atrial fibrillation is very important, the following methods are used to determine it:
- Palpation of the pulse. Atrial fibrillation is often accompanied by a pulse deficiency, since inconsistent atrial work leads to insufficient blood flow into the ventricles.
- The method of electrocardiography will reveal such characteristic signs of atrial fibrillation, such as:
- the absence of teeth, indicating a reduction in atria,
- chaotic arrangement of ventricular complexes,
- the presence of atrial waves instead of teeth.
- Echocardiography helps to identify certain signs of atrial fibrillation, namely:
- the presence of a thrombus in the left atrium of the heart;
- determination of valve damage;
- the presence of pericardium;
- left ventricular hypertrophy;
- determination of peak pressure in the ventricles;
- revealing the size of the atria.
- Chest x-ray is required in order to assess the condition of the pulmonary vessels and to identify possible lung pathology. It also helps to detect signs of heart failure and an increase in the size of the heart chambers.
- Daily monitoring of the electrocardiogram is necessary to determine the heart rate for a certain period;
- A transesophageal examination is prescribed to diagnose the disease if surgery is required.
Atrial fibrillation is usually diagnosed during a physical examination. On palpation of the peripheral pulse, the characteristic disordered rhythm, filling, and tension are determined. During auscultation of the heart, the irregularity of heart sounds, significant fluctuations in their volume are heard (the volume of the tone following the diastolic pause I varies depending on the size of the diastolic filling of the ventricles). Patients with identified changes are referred to a cardiologist for advice.
Confirmation or clarification of the diagnosis of atrial fibrillation is possible using data from electrocardiographic studies. Atrial fibrillation on the ECG, there are no P waves recording atrial contractions, and the ventricular QRS complexes are located randomly. With atrial flutter, atrial waves are determined at the site of the P wave.
With the help of daily ECG monitoring, heart rhythm is controlled, the form of atrial fibrillation, the duration of paroxysms, their relationship with exercise, etc. are specified. Exercise tests (bicycle ergometry, treadmill test) are performed to detect signs of myocardial ischemia and in the selection of antiarrhythmic drugs .
Echocardiography allows you to determine the size of the heart cavities, intracardiac thrombi, signs of valve damage, pericardium, cardiomyopathy, to evaluate the diastolic and systolic function of the left ventricle. Echocardiography helps in deciding on the appointment of antithrombotic and antiarrhythmic therapy. Detailed heart imaging can be achieved using an MRI or MSCT of the heart.
Transesophageal electrophysiological examination (CPECG) is performed to determine the mechanism of development of atrial fibrillation, which is especially important for patients who are planning to have catheter ablation or implantation of a pacemaker (artificial pacemaker).
Atrial fibrillation treatment
Treatment of atrial fibrillation is aimed at restoring and maintaining the correct heart rhythm, preventing the occurrence of repeated paroxysms, preventing the formation of blood clots and the development of thromboembolic complications.
To interrupt an atrial fibrillation attack, an antiarrhythmic drug is administered intravenously to a patient under the control of an ECG and blood pressure level. In some cases, cardiac glycosides or slow calcium channel blockers are used, which contribute to improving the well-being of patients (reducing weakness, shortness of breath, sensation of heartbeat) by reducing the heart rate.
If conservative therapy is ineffective, the treatment of atrial fibrillation is carried out by applying an electric pulse discharge to the region of the heart (electric cardioversion). This method allows you to restore heart rate in 90% of cases.
If atrial fibrillation lasts more than 48 hours, the risk of thrombosis and the development of thromboembolic complications increases sharply. Anticoagulant drugs are prescribed for their prevention.
After the heart rhythm is restored, prolonged use of antiarrhythmic drugs is indicated in order to prevent repeated episodes of atrial fibrillation.
In the chronic form of atrial fibrillation, treatment consists of the continuous use of anticoagulants, calcium antagonists, cardiac glycosides and adrenergic blockers. Active therapy of the underlying disease that caused the development of atrial fibrillation is carried out.
In order to radically eliminate atrial fibrillation, radiofrequency isolation of the pulmonary veins is performed. During this minimally invasive procedure, the focus of ectopic excitation located at the mouth of the pulmonary veins is isolated. The effectiveness of radiofrequency isolation of the pulmonary veins reaches 60%.
With a constant form of atrial fibrillation or frequently recurring paroxysms, there are indications for radiofrequency ablation (RFA) of the heart. Its essence lies in cauterization of the atrioventricular node using a special electrode, which leads to complete AV blockade with the further installation of a permanent pacemaker.
The choice of therapeutic tactics for various forms of atrial fibrillation is aimed at restoring and maintaining sinus rhythm, preventing repeated attacks of atrial fibrillation, controlling heart rate, and preventing thromboembolic complications. To stop paroxysms of atrial fibrillation, it is effective to use novocainamide (intravenously and orally), quinidine (inside), amiodarone (intravenously and orally) and propafenone (inside) under the control of blood pressure and electrocardiograms.
A less pronounced result is the use of digoxin, propranolol and verapamil, which, however, reducing the heart rate, contribute to improving the well-being of patients (reducing shortness of breath, weakness, palpitations). In the absence of the expected positive effect of drug therapy, they resort to electric cardioversion (applying a pulsed electric discharge to the heart region to restore heart rate), stopping paroxysms of atrial fibrillation in 90% of cases.
With atrial fibrillation lasting more than 48 hours, the risk of thrombosis increases sharply, therefore, warfarin is prescribed to prevent thromboembolic complications. To prevent the re-development of attacks of atrial fibrillation after restoration of the sinus rhythm, antiarrhythmic drugs are prescribed: amiodarone, propafenone, etc.
When establishing the chronic form of atrial fibrillation, a constant intake of adrenergic blockers (atenolol, metoprolol, bisoprolol), digoxin, calcium antagonists (diltiazem, verapamil) and warfarin (under the control of coagulogram indicators – prothrombin index or INR) is prescribed. With atrial fibrillation, treatment of the underlying disease, which led to the development of rhythm disturbance, is necessarily necessary.
A method that radically eliminates atrial fibrillation is radiofrequency isolation of the pulmonary veins, during which the focus of ectopic excitation located at the mouth of the pulmonary veins is isolated from the atria. Radiofrequency isolation of the mouth of the pulmonary veins is an invasive technique, the effectiveness of which is about 60%.
With often repeated attacks of atrial fibrillation or with its constant form, it is possible to perform RFA of the heart – radiofrequency ablation (“cauterization” with the electrode) of the atrioventricular node with the creation of a complete transverse AV block and implantation of a permanent pacemaker.
What it is?
In order to get rid of arrhythmia, it is necessary, first of all, to cure the disease that caused it. Since arrhythmia is characterized by a decrease in the concentration of potassium and magnesium salts in the internal environment of the body, patients are recommended a diet that includes bananas, raisins, dried apricots, pumpkin, squash.
Panangin, aspartame – drugs that contain a large amount of potassium and magnesium.
The definition of a method for treating atrial fibrillation is determined by an experienced specialist (cardiologist), and is based on the symptoms and complaints of the patient.
The goal of treatment is to restore and subsequently maintain heart rate, as well as to prevent the recurrence of seizures.
Here you will find detailed information about effective tuning fork pills for the heart.
Surgery for ciliary therapy is required in cases where conservative medication does not lead to a positive result:
- Catheter ablation is a minimally invasive treatment. Such a procedure involves the separation of fused fibers of the heart by surgical intervention using a laser, cold or electric current.
- The implantation of a pacemaker is required for the chronic form of atrial fibrillation and consists in placing a medical device to maintain heart rate under the patient’s skin.
The principle of operation of such a drug is to provide impulses to the heart and thereby cause its contractions. The possibility of injuries is minimal.
In the second form, the priority is the appointment of rhythm-reducing therapy with the constant use of medications. The persistent form can be subject to both rhythm-restoring therapy, and, in case of failure of the latter, to the transfer of the persistent form into a permanent one using rhythm-reducing drugs.
The most common complications of atrial fibrillation are thromboembolism and heart failure. In mitral stenosis, complicated by atrial fibrillation, blockage of the left atrioventricular opening by the atrial thrombus can lead to cardiac arrest and sudden death.
Intracardiac thrombi can enter the arterial system of a large circle of blood circulation, causing thromboembolism of various organs; 2/3 of them with blood flow enter the cerebral vessels. Every 6th ischemic stroke develops in patients with atrial fibrillation. The most prone to cerebral and peripheral thromboembolism are patients older than 65 years; patients who have previously undergone thromboembolism of any localization; suffering from diabetes mellitus, systemic arterial hypertension, congestive heart failure.
Heart failure with atrial fibrillation develops in patients suffering from heart defects and impaired ventricular contractility. Heart failure with mitral stenosis and hypertrophic cardiomyopathy can manifest as cardiac asthma and pulmonary edema. The development of acute left ventricular failure is associated with impaired emptying of the left heart, which causes a sharp increase in pressure in the pulmonary capillaries and veins.
One of the most severe manifestations of heart failure in atrial fibrillation may be the development of arrhythmogenic shock due to inadequately low cardiac output. In some cases, the transition of atrial fibrillation to ventricular fibrillation and cardiac arrest is possible. Most often with atrial fibrillation, chronic heart failure develops, progressing up to arrhythmic dilated cardiomyopathy.
The most common complications of atrial fibrillation are progressive heart failure and thromboembolism. In patients with mitral stenosis, atrial fibrillation often causes an atrial thrombus, which can clog the atrioventricular opening. This leads to sudden death.
The resulting intracardiac thrombi with a flow of arterial blood are carried throughout the body and lead to thromboembolism of various organs. In approximately 65% of cases, blood clots enter the vessels of the brain, causing the development of ischemic stroke. According to medical statistics, every sixth ischemic stroke is diagnosed in patients with atrial fibrillation. Factors that increase the risk of developing this complication are:
- old age (older than 65 years);
- previously transferred thromboembolism of any localization;
- the presence of concomitant pathology (arterial hypertension, diabetes mellitus, congestive heart failure).
The development of atrial fibrillation amid impaired contractile function of the ventricles and heart defects leads to the formation of heart failure. With hypertrophic cardiomyopathy and mitral stenosis, developing heart failure proceeds as cardiac asthma or pulmonary edema. Acute left ventricular failure always develops as a result of impaired blood outflow from the left heart, which leads to a significant increase in pressure in the pulmonary vein and capillary system.
The most severe manifestation of heart failure due to atrial fibrillation is arrhythmogenic shock due to low cardiac output.
Most often, atrial fibrillation is complicated by the formation of chronic heart failure, which progresses at one rate or another and leads to the development of dilated arrhythmic cardiomyopathy.
Among the complications that affect the prognosis of atrial fibrillation, the following should be highlighted:
- the formation of blood clots in the heart chambers;
- heart failure;
- arrhythmogenic shock.
The formation of blood clots that enter the bloodstream is dangerous because it can lead to thromboembolism. With heart failure, the risk of arrhythmic dilated cardiomyopathy is high.
Arrhythmogenic shock can provoke phenomena such as a sharp decrease in pressure, loss of consciousness, and even cardiac arrest. However, these complications are not recorded at all: many patients live with atrial fibrillation for many years without any serious consequences.
Of the complications, pulmonary thromboembolism (PE), acute heart attack and acute stroke, as well as arrhythmogenic shock and acute heart failure (pulmonary edema) are most common.
Prevention of thromboembolic complications (stroke and pulmonary embolism) is the constant use of anticoagulants and antiplatelet agents. However, here there are some nuances.
So, for example, with an increased risk of bleeding, the patient has a chance of hemorrhage in the brain with the development of a hemorrhagic stroke. The risk of developing this condition is more than 1% in patients in the first year from the start of anticoagulant therapy.
Prevention of increased bleeding is the regular monitoring of INR (at least once a month) with timely dose adjustment of the anticoagulant.
Diet for atrial fibrillation
In the complex treatment of atrial fibrillation, an important role is given to proper nutrition. The basis of the diet should be low-fat protein and vegetable products. Food should be taken often in small portions. Dinner should be no later than 2,5-3 hours before bedtime. This approach helps to prevent excessive stimulation of the vagus nerve receptors, which affects the function of the sinus node.
Patients with atrial fibrillation should give up strong tea, coffee, alcohol, as they can provoke an attack.
With atrial fibrillation, the diet should include a large number of foods rich in potassium and magnesium. These products include:
- soya beans;
- nuts (cashews, almonds, peanuts);
- wheat germ;
- wheat bran;
- Brown rice;
- oat flakes;
- baked potato;
To preserve the maximum amount of trace elements and vitamins in dishes, it is best to steam or bake them. It is useful to include vegetable, fruit or berry smoothies on the menu.
Prognosis for atrial fibrillation
No doctor can give a general prognosis of life with MA. The prospect of recovery of the patient is determined in each case individually.
Indicators may vary depending on the degree of development of the disease:
- Transient. This type is characterized by seizures lasting from 24 hours to 5-6 days. Sinus rhythm is replaced by atrial fibrillation with a frequent rhythm of the ventricles. Heart rhythm can recover on its own. With timely treatment, the prognosis for the patient is favorable.
- Persistent. The attack lasts more than 7 days. This type is recurrent in nature. It is impossible to restore the heart rate without medical intervention. The prospect of recovery depends on the well-being of the patient and the presence of concomitant pathologies.
- Constant. The attack lasts a long time. To restore sinus rhythm, an electric cardioversion or surgery is performed. The prognosis of life is not always favorable.
The prospects for recovery also depend on the form of MA:
- Tachysystolic. exceeds 90 per minute.
- Normosystolic. 65–90 beats per minute are recorded.
- Bradisystolic. A heart rate of less than one per second.
The first attacks of the disease can occur several years before the transition of the pathology to the chronic stage.
In the case of surgical initiation of treatment, relatively rapid positive dynamics is observed in patients who do not have concomitant serious heart problems. However, atrial fibrillation is most often manifested precisely in those who have already survived a heart attack or suffer from certain myocardial pathologies.
Attacks of atrial fibrillation in such a patient are often a symptom of a deterioration due to the underlying disease.
It is impossible to independently cope with the deviation, folk methods are not able to have the necessary effect. For patients with atrial fibrillation, a specific treatment is being developed.
This includes not only drug therapy, but also diet. The lack of proper treatment leads to a complication of the situation and the development of a chronic form of the course of the disease.
If atrial fibrillation manifests itself in the form of paroxysmal fibrillation, you can normalize the heart rhythm without the use of medications. With a constant malfunction in the heart, taking medications is mandatory.
The action of medicines is aimed at eliminating existing problems and preventing them in the future. The first attacks of atrial fibrillation can manifest themselves several years before the transition of the disease into a chronic form of the course.
If surgical intervention is necessary, positive dynamics is observed in almost all cases. People manage to defeat the disease and lead their usual lifestyle. The development of arrhythmia is often recorded in patients who have previously suffered a heart attack or other myocardial pathology. Timely treatment and drug therapy allow a person to live for more than one year.
For people with atrial fibrillation, not accompanied by drug therapy, the prognosis is disappointing. In this case, the disease may be accompanied by the following complications:
- the formation of blood clots in the heart chambers;
- arrhythmogenic shock;
- heart failure.
The main prognostic criteria for atrial fibrillation are the causes and complications of rhythm disturbance. Atrial fibrillation caused by heart defects, severe myocardial damage (large focal myocardial infarction, extensive or diffuse cardiosclerosis, dilated cardiomyopathy) quickly leads to the development of heart failure.
Thromboembolic complications due to atrial fibrillation are prognostically unfavorable. Atrial fibrillation increases mortality associated with heart disease, 1,7 times.
In the absence of severe cardiac pathology and a satisfactory condition of the ventricular myocardium, the prognosis is more favorable, although the frequent occurrence of paroxysms of atrial fibrillation significantly reduces the quality of life of patients. With idiopathic atrial fibrillation, health is usually not disturbed, people feel almost healthy and can do any job.
In most cases, the prognosis of life with extrasystole is favorable. The patient’s performance usually remains, unless the disease is associated with severe myocardial damage (heart attack, myocarditis, cardiomyopathy, cardiosclerosis). Sometimes attacks spontaneously stop for several months or years, but if the cause remains, the disease can recur. The most unfavorable in terms of prognosis is malignant ventricular extrasystole.
The risk of developing concomitant diseases
Atrial fibrillation. Regular atrial extrasystoles, especially in patients prone to bradycardia, as well as with mitral valve defects, increase the risk of atrial fibrillation.
Ventricular fibrillation. With ventricular extrasystole of high degrees (III-V according to Launa’s classification), the risk of ventricular fibrillation increases. First of all, patients with severe myocardial damage (especially in combination with heart failure) are at risk. Regular prophylactic administration of drugs prescribed by a doctor significantly reduces the risk, even if extrasystole cannot be completely eliminated.
Risk of sudden death
Long-term follow-up of patients showed that the presence of ventricular extrasystoles increases the risk of sudden death. In patients with coronary heart disease and heart failure, heart rhythm disturbances worsened prognosis. When determining the likelihood of sudden death, doctors distinguish three groups of patients with extrasystole:
- Patients without organic heart disease. The risk of sudden death is minimal.
- Patients without pronounced organic lesions of the heart, but with group, frequent and polytopic extrasystoles. The prognosis depends on the absence or presence of paroxysmal tachycardia. as well as the patient’s response to medication.
- Patients with pronounced organic heart lesions. The risk of sudden death is maximum. The prognosis depends on the degree and nature of the organic lesions of the heart, as well as on the patient’s response to medical treatment.
Atrial fibrillation is characteristic mainly for severe myocardial diseases. The prognosis of atrial fibrillation is essential in assessing the patient’s condition. Its very appearance indicates a deterioration in the genesis of the disease.
Particularly serious is the prediction of atrial fibrillation, which occurs during the acute phase of myocardial infarction. Only rare cases are known when arrhythmia lasted a long period of time, and did not significantly affect the patient’s condition or his ability to work. Note that arising atrial fibrillation adversely affects blood circulation, which contributes to the development of heart failure.
Atrial fibrillation contributes to thromboembolic complications (their source is thrombi in the atria).
The prognosis of atrial fibrillation is particularly dependent on what disease caused this type of arrhythmia. So, if heart defects are present, then its occurrence leads to fulminant development of heart failure; the same can be observed in diseases that are accompanied by the most extensive and most severe heart lesions (large-focal myocardial infarction, extensive or diffuse cardiosclerosis, dilated cardiomyopathy, and others).
Thromboembolic complications are dangerous. If there are no heart defects, abnormal pathways between the ventricles and atria, and a good functional state of the myocardium, the prognosis is favorable. But frequent attacks of atrial fibrillation can significantly reduce the patient’s quality of life. For example, if a person is sick with idiopathic atrial fibrillation, this may absolutely not affect the patient’s condition and well-being, while its cause remains unknown.
Does atrial fibrillation always lead to a stroke?
No, not always, but the risk of this disease is greatly increased. The thing is this: when there is no full-blown systole (contraction) of the atria, this leads to a violation of blood circulation. Blood fluid passes through the vessels not quite evenly, nonlinearly. If somewhere it stagnates, a clot (thrombus) is formed.
There is a possibility of its separation from the walls of blood vessels and “flow” along with blood – this is called embolism. If a blood clot enters the vessels of the brain, then a stroke develops. A blood clot can also “clog” the vessels of the heart muscle, spleen, legs, and kidneys. To avoid this, the patient, who has a stable form of atrial fibrillation, must necessarily take medications that promote blood thinning and prevent blood clots.
As depressing statistics indicate, the number of people suffering from bouts of atrial fibrillation is growing annually. And this applies to residents of both the western and eastern hemispheres, including Russia, where, according to official information, this diagnosis was made to 2-2,5 million citizens.
The huge problem is that many simply do not pay attention to the first signs, such as a rapid heartbeat, incomprehensible anxiety, lack of air and chest pain. Instead of seeking qualified help, the majority prefers to wait out the attack, not suspecting that he has tachyarrhythmia, the prognosis of life in which is directly related to the timeliness of diagnosis and the appointment of a treatment program.
In order to prevent atrial fibrillation, it is necessary to identify and actively treat diseases of the cardiovascular and respiratory systems in a timely manner.
Secondary prevention of atrial fibrillation is aimed at preventing the occurrence of new episodes of heart rhythm disturbance and includes:
- long-term drug therapy with antiarrhythmic drugs;
- cardiac surgery if indicated;
- refusal to drink alcohol;
- restriction of mental and physical overload.
To prevent attacks of atrial fibrillation and to prevent the disease from developing into more severe forms, the use of preventive measures is necessary:
- Firstly, it is important to treat the diseases that caused the cause of atrial fibrillation.
- Secondly, it is recommended to limit the impact of factors that adversely affect overall health and aggravate the disease, such as: drinking alcohol, smoking, staying in nervous and physical stress.
Traditional preventative measures include:
- Healthy lifestyle, including:
- Serious loads with atrial fibrillation are not recommended, but moderate physical activity is necessary, for example, conducting morning exercises, taking walks in the fresh air;
- Minimizing stressful situations;
- Maintaining normal cholesterol and glucose, as well as reducing body weight by following a low-calorie diet in the presence of excess weight.
Thus, atrial fibrillation is a disease, the consequences of which can be very dangerous for human health and life, as a result of which it is necessary to know the main symptoms of this disease and, when they occur, immediately determine the treatment method.
Do not forget to follow the general recommendations aimed at preventing the disease.
The goal of primary prevention is the active treatment of diseases that are potentially dangerous in terms of the development of atrial fibrillation (arterial hypertension and heart failure).
Measures of secondary prevention of atrial fibrillation are aimed at compliance with recommendations for anti-relapse drug therapy, cardiac surgery, limiting physical and mental stress, and abstaining from alcohol.