Disruption of intraventricular conduction – what is a local violation of intraventricular

Elements of the conduction system of the heart

The intraventricular conduction system is an integral part of the conduction system of the heart. The main function of the system is to conduct an impulse from the place of its formation to the final destination. Normally, formed in the sinus node (SU), an electrical impulse runs from the atria to the ventricles, alternately exciting them. So, first the right and left atria are excited, then the right and left ventricle. Each chamber of the heart has its own time for receiving a charge.

Having contracted, the atria push blood into the ventricles. At a time when the ventricles are preparing to expel blood into large vessels to deliver it to the entire body, the atria are “stocked” with a new portion of blood in order to give it to the ventricles. The intraventricular conduction system is represented by conduction paths that form the so-called bundle of His (GH). This bundle collects in itself all the pathways going from the atria.

It departs from the atrioventricular node and is located at the junction of the right fibrous triangle with the upper membranous part of the interventricular septum. Its length is from 8 to 20 mm, and the width is only 2-3 mm. After passing some distance from its beginning, the bundle of His is divided into right and left legs.

The intraventricular conduction system is represented by a bundle of His, the main, anterior and posterior branches of the left leg, right leg. Gradually branching into smaller ones, the branches of the legs pass into the network of Purkipye fibers, which passes through the heart muscle.

Heart contractions occur due to nerve impulses that occur in the sinus node and pass through the entire conducting system. A normal impulse causes the left and right ventricles to contract simultaneously. The entire process of passing the pulse lasts 0,12 seconds. If any obstacles arise in the system, then the path of the impulse and the heart rate go astray.

Obstacles in the intraventricular conduction system are called blockages.

Focal violations of intraventricular conduction is a failure in the passage of an impulse that occurs distally from the legs of the bundle of His. At the same time, conductivity in the Purkipie network is disrupted and an asynchronous contraction of muscle cells in the walls of the ventricles is observed.

Focal blockade occurs in a limited area and it is in this place that conductivity is disturbed. Often focal disorders are observed together with blockade of the left leg, especially its anterior branch. The combination of blockades creates difficulties in diagnosis, has a negative effect on the course of the underlying disease.

To understand exactly how such pathological conditions develop, you need to know what exactly the conductive system consists of, which is responsible for transmitting impulses through the ventricles. So, the leading role in this process belongs to the so-called bundle of His, consisting of two structural parts:

  • Left leg. It is represented by the anterior and posterior branches, each of which is responsible for its wall in the left ventricle. Their branches form a system of Purkinje fibers.
  • Right foot. It is represented by one bundle branching in the lower parts of the right ventricle.

For the occurrence of excitation in the ventricles, an impulse from the pacemaker passes through the interventricular septum and then the simultaneous excitation of both ventricles occurs. For this to happen, the pulse needs approximately 0,12 seconds.

In the event that blockages are noted on one of the paths, not only the path along which the impulse passes, but also the time during which the ventricles are excited, changes.

Pathology in children

The term “violation of intraventricular conduction of the heart” means that one to three bundles of the system do not function properly. Cardiac blockades appear – barriers that interfere with the normal passage of nerve impulses of the main muscle of the body. For example, the processes of the heart slow down, the rhythm becomes less frequent, in special cases a complete stop may occur.

In addition, such a disease, depending on the site of the lesion is divided into:

  • blockade of the Guiss bundle legs;
  • intraatrial block;
  • AV blockade;
  • proximal;
  • distal.

Permanent single-beam blockade of the right leg and individual branches of the left leg in people without cardiac pathology do not affect health and life expectancy. The prognosis for the first occurrence of conduction disturbances resulting from organic damage to the heart depends on the severity of the underlying disease.

There are different opinions about the degree of influence of the left leg blockade on mortality rates. Some researchers do not consider single- and double-beam blockades as risk factors that reduce patient survival. According to other sources, a constant or recurring form of pathology can increase the likelihood of death from cardiac complications by 5 times.

If the pathology is detected in the child, then most often this indicates congenital malformations or violations against the background of heredity. With a partial violation, panic is not worth it, since more often it appears within the normal range. There are no other specific features of the pathology in children and adolescents. Symptoms by which a pathology in a child can be identified are as follows:

  • Memory impairment
  • Inattention.
  • The occurrence of shortness of breath.
  • Deterioration in school performance.
  • Chest pain.
  • General malaise.
  • Fatigue at low physical exertion.

The choice of therapy, as in adults, directly depends on the reasons that provoked this condition. The first stage does not need treatment, but the child is taken under medical supervision. In the second case, medications are prescribed, and a more advanced degree requires surgical intervention, that is, implantation of ECS – an artificial pacemaker. It is impossible to leave the manifestation of symptoms without attention, an extensive blockade can cause death.

A similar disease can manifest itself in a woman during pregnancy. Often the symptoms are unclear, but if there is an unreasonable weakness, dizziness, shortness of breath, unstable mood, you need to consult a doctor without fail. Before prescribing therapeutic measures, a thorough examination is necessary to establish an accurate diagnosis. To begin with, a woman is sent to an ECG.

In some cases, the disease can develop in completely healthy people. Such a pathology is congenital in nature and does not depend on external factors or occurs under unknown circumstances. Specialists identify the following reasons that provoke a violation and a slowdown of atrial conduction:

Cardiac. Myocardial infarction, heart failure, cardiomyopathy, myocarditis, congenital and acquired heart defects, a sharp increase in blood pressure, and autoimmune disorders are included. The disease can also appear due to surgical operations and injuries.

  • Non-cardiac. It can be of neurogenic (vegetovascular dystonia), hypoxic (bronchial asthma, anemia) and endocrine (diabetes mellitus, thyroid disease) origin.
  • Medicinal. It develops due to prolonged intake of a large number of drugs. The main drugs that provoke the appearance of pathology are diuretics, cardiac glycosides and drugs that stop arrhythmia.
  • Electrolyte. They arise due to an imbalance of potassium, magnesium and sodium salts in the body.
  • Toxic. The cause of the appearance is the excessive use of alcohol and toxic substances.
  • Excessive amounts of caffeine and energy drinks, as well as disturbance of sleep and diet can provoke the onset of the disease. Stress, depression and increased nervousness increase the risk of developing the disease. In children, an open oval window on the heart muscle after a year can lead to local conduction disturbance.

    The term “violation of the intraventricular conduction of the heart” means that one to three bundles of the system malfunction. Cardiac blockades appear – barriers that interfere with the normal passage of nerve impulses of the main muscle of the body. For example, the processes of the heart slow down, the rhythm becomes less frequent, in special cases a complete stop may occur.

    The main characteristic that tells us about the presence of a violation is the appearance of a heart block (complete or partial). In the first case, the nerve impulse is completely absent and the contractile work ceases. With partial blockade, slow activity is observed, the frequency of the pulse decreases.

    All possible causes of failure can be divided into two large groups: cardiac – caused by pathology of the heart and non-cardiac – provoked by other disorders.

    • heart defects;
    • myocardial infarction;
    • myocarditis;
    • cardiac ischemia;
    • cardiomyopathy;
    • coronary arteriosclerosis;
    • the consequences of surgical interventions (for example, due to valve prosthetics, radiofrequency catheter ablation).
    • vascular dystonia;
    • endocrine problems: hypothyroidism, diabetes mellitus;
    • disorders of the respiratory system with tissue hypoxia – bronchospasm, chronic inflammation;
    • irrational medication;
    • arterial hypertension;
    • alcohol poisoning;
    • taking drugs;
    • pregnancy.

    Failure of the signal does not always indicate pathology. For example, a partial violation of conductivity along the right leg of the bundle of His is considered a variant of the norm, characteristic of individual young people.

    Violation of the conductive function of the myocardium can be permanent and transient. Temporary “malfunctions” are detected against the background of physical activity (for example, in training and competitions). If after rest the situation normalizes, there is no cause for concern. But if the problem persists, and changes are visible on the ECG, you need to be examined by a specialist.

    If a person has symptoms of these diseases, then an urgent examination by a cardiologist or arrhythmologist is necessary. After preliminary external examination, recording of patient complaints, they will direct the patient to undergo laboratory tests for the purpose of making a diagnosis. The following types of checks and tests are usually assigned:

    1. 1.
      Electrocardiograms are monitored using the Holter method. It is needed in order to detect impulse transmission for 24 hours.
    2. 2.
      The patient must undergo special tests with the results recorded on an electrocardiogram. For these purposes use exercise bikes, treadmill – testing. The patient can walk on a treadmill or pedal on a standing bicycle, and electrodes from an electrocardiogram will be attached to it at this time. This allows you to establish the exact relationship between impaired conductivity and the load on the patient.
    3. 3.
      At the next stage, an examination of the heart muscle is carried out using ultrasound equipment, which can reveal a pathology in the structure of the heart, evaluate the performance of the myocardium.
    1. 1.
      Vitamin and mineral complexes.
    2. 2.
      drugs that significantly improve the nutrition of the heart with blood, for example, ATP, Preductal and others.

    If the patient is diagnosed with a complete blockage of the ventricles due to the impulse not passing through, then a pacemaker may be required, otherwise bradycardia occurs in the heart muscle, which can lead to complications, and even death.

    With non-specific impairment of the passage of impulses, no drugs usually help. Therefore, doctors prescribe a special diet for patients and a long rest. This inhibits negative processes, which allows to lengthen the patient’s life

    If a non-specific lesion is not treated, then the disease progresses rapidly, and this can cause the following consequences:

    1. 1.
      Sudden death (with complete blockade).
    2. 2.
      The development of heart failure.
    3. 3.
      The appearance of other serious diseases.
    4. 4.
      Impaired blood circulation in the brain. In this case, a stroke develops.
    5. 5.
      Surgery may be required.
    6. 6.
      Thrombi begin to form in large quantities on the vessels.

    If the disease is detected on time, then when a person switches to a healthy lifestyle (diet, quitting cigarettes, stopping the use of alcohol, medications may sometimes be needed), the development of the disease can be stopped.

    With complete blockage in any part or throughout the heart muscle, sudden cardiac arrest can occur with a fatal outcome. In some cases, ventricular fibrillation occurs. Therefore, the prognosis is unfavorable.

    For any disturbance of intraventricular conduction, interruptions in the passage of pulses to a greater or lesser extent are characteristic. Such interruptions are called blockages. In most cases, obstruction of the ventricular direction characterizes the level of myocardial damage.

    For the normal functioning of the heart and the maintenance of vital processes, the normal conductivity of the heart muscle is a prerequisite. For each patient, the causes of intraventricular conduction disorders are different.

    There is a standard list of causes of pathology:

    • a change in processes in the cardiovascular system without accompanying organic abnormalities;
    • a person has suffered ischemia, myocarditis, cardiomyopathy or had a congenital defect;
    • surgery and complications;
    • side effect and negative effect of taking medication.

    Blockade factors

    Depending on how difficult the impulse passage through the legs of His is, a complete and incomplete blockade of the legs of the bundle of His is isolated. If the changes are permanent, the blockade is called a stand. If the blockade appears under the influence of certain factors, they speak of a transient blockade. There is also a classification that distinguishes conduction disturbances depending on the number of beams involved. In Latin, the sheaf is spelled “fasciculus”, therefore the synonym for sheaf is the adjective “fasciculus”.

    Single beam (monofascicular) – one beam is partially or completely blocked. This can be a blockade of the right leg of the bundle of His, anterior or posterior branch of the left leg.

    Two-kidney (bifascicular) – two beams are involved in the process. It can be the left leg, so it consists of two bundles: the front and rear branches; the right leg and the front or rear branch of the left leg.

    Three-beam (trifascicular) – completely blocked the left leg and partially right leg, complete blockade of the right leg and incomplete blockade of the front and rear branches of the left leg.

    Types of violations are divided depending on the place of occurrence of blockades:

    • focal – damage is not always visible on the ECG;
    • arborization are formed at the ends of the Purkinje fibers;
    • focal – not always detected by ECG;
    • transient – there is an alternation of conductivity changes;
    • persistent;
    • complete.

    With complete blockade, muscle contraction does not occur, there is a complete absence of a nerve impulse. This often leads to cardiac arrest and death.

    Incomplete – there is a slowdown in the passage and decrease in the frequency of the impulse to the heart muscle. With this problem, the function of an individual part of the heart is impaired. This type of violation is not deadly.

    Alternating symptoms of one or another blockade – pathology causes blocking of impulses anywhere in the heart.

    Depending on the place of occurrence, blockades are divided into several types:

    • monofascicular (single-beam): the left front or rear is blocked, only the right branch;
    • bifascicular (two-beam): the left branch is blocked or the right one with the left front branch. Left back with right;
    • trifascicular (three-beam).

    And also a non-specific violation of intraventricular conduction is often found, in which the normal functioning of the heart is impossible.

    There is a likelihood of focal disorders. Non-specific impairment is called impulse blocking in the most remote part of the myocardium.

    The reason is the same disease as with blockade, ECG values ​​are insignificant, and clinical symptoms do not appear.

    Intraventricular blockade alone does not cause serious harm, however, it entails a complication of the underlying disease, produces a negative effect on other processes of the heart muscle.

    Incomplete blockade can occur in a healthy person, in this process there is a local violation of intraventricular conduction. In a child, the cause of internal disturbance may be an open oval window in the heart.

    The appearance of a complete blockade is evidence of heart disease:

    • hypertrophy;
    • ischemic disease;
    • acute myocardial infarction;
    • myocardial hypertrophy in bronchopulmonary disease;
    • postinfarction cardiosclerosis;
    • cardiomyopathy.

    With the appearance of suddenly arising intense pressing pains behind the chest, a sharp weakening or decrease in the pulse rate, the ECG shows a complete left block. In this case, an acute myocardial infarction develops, which is “disguised” as a blockade. Since with a single electrocardiography, the definition of a heart attack is impossible, with these indicators the patient is left in the hospital.

    In most cases, a blockage of the right bundle occurs in children, which may appear due to pathologies of the heart. Pathologies of the left bundle rarely occur, more often pathology manifests itself in the form of congenital blockade. In this case, a violation of intraventricular conduction in a child does not give characteristic symptoms.

    Types of heart block

    The classification of intraventricular conduction disorders is based on the internal structure of the His bundle. The number of bundle elements that fall out of the conducting system and determines the types of intraventricular blockades:

    • conductivity is broken in the right leg (PNPG);
    • conduction is partially disturbed, only at the level of the anterior branch of the left leg (while the impulse passes, but through the lower wall of the ventricle);
    • local disturbance only at the level of the posterior branch of the left leg (this means that Purkinje fibers are used to reduce the ventricle, the impulse reaches the posterior wall through them).
    • prolapse of the left leg, that is, conduction on both branches of the left ventricle is impaired;
    • conduction in the right leg and in the front, or rear branch of the left is violated;

    if conduction disturbance has arisen due to myocarditis, aortic defect, pulmonary embolism – treatment of these pathologies is organized. Often, transient blockades develop due to myocardial ischemia. In this case, therapeutic measures are carried out aimed at improving the blood supply to the myocardium, the treatment of atherosclerosis. Treatment of the underlying pathology can lead to the elimination of the problem of impulses.

    With myocardial infarction, intensive therapy is carried out to limit the area of ​​necrosis, reduce the area of ​​ischemia and combat complications of pathology, including life-threatening ones. The danger is a complete three-beam blockade, as a result of which asystole (cessation of heart contractions and electrical activity) can develop. Treatment is carried out using external and intracardiac pacing.

  • Blockade of two legs of the bundle of His, manifested by a rare frequency of heart contractions, congestive heart failure, angina attacks.
  • The combination of conduction pathology in the left or right leg of the bundle of His and atrioventricular block.
  • The termination of the passage of pulses along the right leg and the posterior branch of the His system.
  • Persistent conduction disturbance of both legs, persisting 3 weeks after a heart attack.
  • The attacks of Morgagni-Adams-Stokes.
  • Sinoatrial. It appears in the corresponding node of the right atrium. The impulse is not able to pass due to a small force or because the atrium cannot accept it. Such a blockade has three degrees:
    • There is a delay in the pulse conductivity.
    • It is determined by the frequency of deterioration.
    • The last, third degree is determined by weak impulses or the complete absence of their receipt.
  • Slowing down intraventricular conduction. It is observed from the sinoatrial node to the left atrium or to the node of the atrioventricular zone. It is characterized by inhibition of impulse conduction.
  • AV blockade. Several degrees are highlighted:
    • Slow conductivity.
    • The stopping of individual pulses is carried out in periods.
    • From the atrium, impulses cannot pass to the ventricles, while the latter and the atria live, independent of others.
  • Blockade of the legs of branch block and branches (left, right, front bundles). Pulses arrive more slowly or do not pass at all.

    The presence of such a pathology is determined by a violation of one of the ventricles. This type provokes the formation of AV blockade. The first degree refers to partial deviations, the second and third to complete. The former do not belong to the category of diseases, but can serve as the reason for the formation of a complete blockade. And the latter in turn provokes dangerous complications.

    With such violations, conductivity deterioration occurs in certain sections of the bundles of His, each of which is divided into right and left legs. The latter has an anterior and posterior branch. Three types of disorders are distinguished:

    • Single beam – feed stops on one branch.
    • Two-beam – deterioration on two branches.
    • Three-beam – blocking on three branches.

    What is a conduction disturbance of the heart? The disease can be characterized as a change in the normal sequence of heart contractions due to the inability of the conducting system to perform its functions. Blockades can be classified according to different characteristics. Depending on the location, the following forms are distinguished:

      Violation of intraventricular conduction of the heart. The reason is the formation of an obstacle to the movement of the impulse along the left or right leg of the bundle of His. The path and time of excitation passing through the ventricles changes. This is the most common type of violation.

    Sino-arterial (sinus) block. Conducting an electrical impulse from the sinus node to the atrium is lost.

  • Intertrial block. It develops by slowing the passage of the impulse from the sinoatrial node to the left atrium.
  • Atrioventricular block. The passage of an electrical impulse localized at the level of the bundle of His bundle and atrioventricular node is disrupted.
  • Complete blockade. The frequency of contractions of the ventricles drops to 30 per minute (at a rate of 65-85), and there is completely no conduction. If the interval between them is several seconds, a person may lose consciousness, pallor and cramps appear (Morgagni-Adams-Stokes attack syndrome). This may result in the death of the patient.
  • Partial blockade. Some pulses are not carried out, or their conduction is significantly slowed down. Pathology does not lead to death, but causes severe pain.

    Treatment of cardiac intraventricular obstruction

    Of course, a person wonders about the cause of the violation of intraventricular conduction. What could it be? There are a number of prerequisites for the development of pathology:

    1. Changes in the cardiovascular system, not accompanied by organic deviations.
    2. Patient-borne diseases such as congenital malformations, ischemia, myocarditis, cardiomyopathy.
    3. The effect of the operation on the vessels of the heart.
    4. The negative impact of drugs, side effects.

    In order to accurately determine the violation of patency at the first stage, doctors use an electrocardiograph. If rhythmic inconsistencies are detected, Holter monitoring is performed – a specialized kind of ECG. The third stage will be the study of the locality of pathology with the help of the electro-Hiss beam.

    Some medical tests that determine local violation of intraventricular conduction, suggest tests with physical exertion. Thanks to them, it is possible to establish an accurate picture of the course of the disease and find out what kind of heart block accompanies pathology. On how competently carried out the diagnosis will depend on the treatment.

    To cure the intraventricular blockade, most patients prescribe cardiac glycoside. The exception may be patients suffering from atrioventricular blockade of the first or second degree, they prescribe the drug with extreme caution. To reduce the risk of cardiac arrest in patients who are afraid to inject glycoside into the cavity of the right ventricle, doctors inject a probe electrode. This is a preventative measure.

    When exacerbation of the situation, for example, the occurrence of myocardial infarction, promptly injected probe. At first, treatment is reduced to eliminating the cause of the disease, and only then begins work to alleviate the symptoms.

    In order to accurately determine the violation of patency at the first stage, doctors use an electrocardiograph. If rhythmic inconsistencies are detected, Holter monitoring is performed – a specialized kind of ECG. The third stage will be the study of the locality of pathology with the help of the electro-Hiss beam.

    Some medical tests that determine local violation of intraventricular conduction, suggest tests with physical exertion. Thanks to them, it is possible to establish an accurate picture of the course of the disease and find out what kind of heart block accompanies pathology. On how competently carried out the diagnosis will depend on the treatment.

    In order to cure intraventricular blockade, most patients are prescribed cardiac glycoside. An exception may be patients suffering from atrioventricular blockade of the first or second degree, they are prescribed the drug with extreme caution. To reduce the risk of heart failure in patients who are afraid to inject glycoside, a probe electrode is introduced into the cavity of the right ventricle.

    What is the disease expressed

    In those situations where a complete block of the right leg is noted, the excitation of the right ventricle is carried out in another way. An impulse to the right ventricle comes from the left parts of the interventricular septum. That is, the excitement of the left departments is initially noted, and only then the right. If there is an incomplete block, the excitation of the right ventricle occurs correctly, however, the speed of the impulse will decrease.

    Usually, the following diseases are the causes of blockade of the right leg:

    • Chronic lung pathology.
    • Mitral stenosis.
    • Coronary heart disease.
    • Myocardial infarction with a large area of ​​ischemia.
    • Congenital malformations.
    • Diseases accompanied by damage to the valvular apparatus of the heart.
    • Also among the factors that increase the risk of developing this pathology, we can name hypertension, as well as improper adrenergic blocking. It is also worth noting that in some athletes, a violation of conduction in the right leg may be a variant of the norm.

    One of the features that is necessary for the occurrence of this lesion is an overload of the right ventricle. In healthy people, this type of disease practically does not occur.

    For this violation to occur, it is imperative that there is an obstacle that interferes with the impulse to the side and front wall of the left ventricle. In this case, the excitation passes along a healthy branch and from the lower wall passes to the parts of the heart that are left without an impulse.

    The main cause of the occurrence can be called pathological processes that somehow affect the left parts of the heart, namely:

    • Hypertonic disease.
    • Coronary heart disease.
    • Congenital and acquired heart defects.
    • Inflammatory myocardial diseases.
    • Cardiomyopathy.
    • Myocardial dystrophy.

    As an independent disease, this blockade does not occur.

    The following pathologies lead to the development of this condition:

    • Myocardial infarction.
    • Atherosclerosis.
    • Inflammatory myocardial diseases.
    • Sclerosis of the conductive system.

    With complete blockade, the impossibility of an impulse to go along a typical path is noted, therefore, as in the case of blockade of the anterior branch, the excitation passes from the bottom up, through the Purkinje fibers. Most often, a combined lesion of both the left posterior branch and the right leg is observed.

    The causes of blockades with the defeat of two bundles are diseases such as:

    • Rheumatic carditis.
    • Myocarditis of diphtheria nature.
    • Severe atherosclerosis.
    • Myocardial infarction.

    The following variants of two-beam blockades are distinguished:

    1. Complete blockade of the left leg.
    2. Blockade of the posterior branch of the left leg with complete blockade of the right.
    3. Blockade of the anterior branch of the left leg with complete blockade of the right.

    Most often, two-beam blockades are a harbinger of the defeat of all beams and the occurrence of a three-beam blockade.

    The formation of a blockade of all three beams is caused by the same lesions as in the case of two-beam ones. When there is a complete loss of the possibility of conducting bundles in the His, there are pauses in the work of the ventricles. Thus, there comes an independent rhythm of excitation of these parts of the heart. At the same time, the atria continue to work as usual. This can lead to a complete atrioventricular block.

    The main signs of the disease

    Electrocardiography is the main diagnostic method for the pathological process. Violation of intraventricular conduction on the ECG will manifest itself with specific signs.

    Blockade on the right leg of the heart leads to expansion and deformation (the appearance of chipping) in the QRS complex. Such changes are determined through the right chest leads.

    The blockade of the left leg of the heart also expands and deforms the QRS, but pathological signs are detected through the left chest leads. If the left anterior branch is affected, then a deviation of the electrical axis of the heart to the left is observed. The diagnosis can be confirmed by comparing the ECG waves – in the second and third leads S will be higher than R. If the pulses do not go through the left posterior branch, then the axis deviates to the right, S is higher than R in the first lead.

    Particularly noteworthy are cardiac blockades of a non-specific format. ECG reveals changes that do not correspond to a specific pathology. For example, the QRS complex changes – it splits and deforms without expansion. Such symptoms are noted with local damage to the heart tissue against a background of a heart attack, inflammatory process, etc.

    Additional information is provided by such research methods:

    • cardiac echocardiography;
    • radiography of the lungs;
    • functional tests;
    • CT scan.

    We obtain significant information on the work of the heart muscle during Holter ECG monitoring. The study lasts 24 hours. This method allows you to continuously record signals and identify abnormalities that are not visible on a regular cardiogram. On such a record, changes are noted that occur not only at rest, but also during movement, physical activity. The compact recorder is attached to the belt. The patient leads a familiar lifestyle, and the system captures the work of the heart in a continuous mode.

    Suspicions of impaired intraventricular conduction in adults and children can cause the following health problems:

    • palpitations – tachycardia;
    • skipping beats in a heart rhythm;
    • the heart muscle contracts randomly;
    • heart pain (similar to angina pectoris);
    • poor circulation of the brain, due to which there may be shortness of breath dizziness, fainting.

    The main characteristic that indicates the appearance of a violation is cardiac blockade.

    It is possible to suspect a violation of intraventricular conduction in a child and an adult when the following problems are detected:

    • palpitations become more frequent – tachycardia detected;
    • heart rate skips beats;
    • cardiac muscle contraction chaotic;
    • heart pains like angina pectoris;
    • shortness of breath, fainting, dizziness – poor blood supply to the brain.

    If such symptoms bother you, you should immediately contact a specialist and sign up for a check, where the diagnosis can be refuted or confirmed, depending on what the cardiac ECG shows and other tests.

    Determination of intraventricular conduction is performed by decoding the ECG. The main element indicating a violation is the QRS complex, which characterizes the work of the ventricles. With complete blockade of the right leg of the bundle of His, the impulse reaches the right ventricle late, using the interventricular septum. In this case, the asynchronism of repolarization is manifested – the rise of the ST complex, which is responsible for showing the heart rate (repolarization is not a pathology, it is a cardiogram phenomenon that disappears if the patient does several physical exercises).

    Therefore, the QRS complex on the electrocardiogram is expanded, its length exceeds 0,12 seconds. In the pectoral leads, the complex is split and consists of R1 teeth (the work of the interventricular septum) and R2 (excitation of the right ventricle). Between two teeth, strongly lowered in relation to them, there is a tooth S, showing how the left ventricle works.

    The axis of the heart is usually located vertically. With complete blockade of the left leg, there is also repolarization. On the results of the cardiogram, the state is expressed by deformation of the QRS complex, it splits into two teeth or has a wide top, the duration of the complex gt; 0,12 sec. The indicator of the right ventricle is not formed – the S wave is absent on the graph.

    Indicators of incomplete blockades of the anterior or posterior branches of the left ventricle are similar to those for complete blockade, but their expression is minimal and is determined by the values ​​of the S and R. teeth. When the pathology of the left heart region is visible, the S indicator increases, this indicates impaired patency of the anterior branch.

    If there is more R wave during the pathology of the right part, then the blockade of the posterior branch is diagnosed. Also pay attention to the time spent by the impulse when moving from the sinus node to the walls of the ventricles. Normally, the reduction should take place in 0,07-0,09 seconds (the upper limit of the norm is 0,12 seconds). With complete blockages, the diagnosis is made with an increase in this indicator. In cases of incomplete blockade, the QRS is deformed, its length does not exceed 0,12 seconds.

    The main signs of the disease

    The signs of the development of such a lesion with partial or complete non-passage of control impulses along the heart muscle are as follows:

    1. 1.
      With partially impaired conduction, most people can almost feel nothing, since such a condition in many cases does not manifest itself clinically.
    2. 2.
      If a person has a complete blockage of the passage of an impulse on the legs of the bundle of His, then signs such as tenderness in the chest, rare impulses appear, a complete loss of consciousness is possible.
    3. 3.
      When examining a patient who complains of sudden, strongly pressing pain behind the sternum, a sharp, unreasonable weakness, the appearance of a cold sweat, a complete block of the left ventricle is usually detected on the electrocardiogram. This allows you to determine the development of acute myocardial infarction, which is usually disguised as impulse obstruction. The patient has a rare pulse, he often becomes sick. It is quite difficult to determine the presence of a heart attack in a person from an electrocardiogram the first time, therefore, if this lesion is suspected, patients are urgently hospitalized.

    Violation of intraventricular conduction is a condition that does not have pathognomonic signs. So, with a malfunctioning of the His bundle, the following symptoms can be detected in a patient:

    • Dizziness.
    • A feeling of interruption in the work of the heart.
    • General weakness.
    • Dyspnea.
    • Bradycardia.
    • Fainting.

    In any case, it is important to understand that the manifestations of conduction disorders are individual and most often directly depend on the underlying disease. That is why, when the first symptoms appear, indicating a malfunctioning of the heart, it is necessary to seek help from a specialist.

    Forecast

    The prognosis of existing conduction disturbances differs sharply depending on what caused this disorder. Patients with two- and three-beam blockade have a risk of developing complete atrioventricular blockade and ventricular rhythm disturbances. They also constitute a risk of sudden cardiac death of the patient.

    Changes in cardiac activity can occur against the background of conduction inside the ventricles of the heart. First you need to determine what it is – intraventricular conduction.

    Complete blockade leads to serious complications:

    • bradycardia;
    • atrial fibrillation;
    • heart failure;
    • hypoxia of various organs, leading to various pathologies;
    • pulmonary embolism;
    • myocardial infarction;
    • ischemic stroke (dementia, paralysis);
    • sudden cardiac arrest and death.

    The vital functions of the whole organism depend on the correct contractions of the heart muscle. Violations in the signaling system are not always a serious deviation from the norm. But in many cases, they provoke dangerous conditions. Treatment should be carried out after a thorough diagnosis and directly affect the cause of the disease.

    In the event that the blockade of the legs of the bundle of His is asymptomatic, the prognosis is most often favorable. Such patients do not need to undergo treatment measures. It is only important to observe the dynamics of changes at the cardiologist. This will help to identify organic lesions in a timely manner.

    It should be noted that blockades are one of the prognostic factors in the course of major diseases. So, you need to highlight the following points:

    1. Blockade of the left leg increases the mortality of cardiac pathologies by 5 times.
    2. In the event that blockades occur against a background of myocardial infarction, this indicates a large area of ​​necrosis. In this case, mortality can reach 50%.
    3. Blockade of the right leg is not considered a risk factor for cardiac pathologies.

    In any case, any disease is easier to prevent than to treat. As already mentioned, conduction disorders by themselves do not harm a healthy person. Therefore, to prevent the development of serious pathologies, it is important to carefully monitor yourself. Eliminate bad habits, do not lead a sedentary lifestyle, and also follow a diet. All this will help prevent diseases that can lead to the appearance of blocks for conducting an impulse to the ventricles.

    Disorders of intraventricular conduction are not considered as independent diseases. The prognosis can be determined only after clarifying the main diagnosis, against which a specific type of blockade has begun to develop. Blockade of the right leg most often does not cause trouble and requires only observation, while blockade of the left leg aggravates the course of acute forms of cardiac pathologies, requires serious treatment, and may result in death the patient.

    The asymptomatic course of the disease does not require medical or surgical intervention. The cure fully occurs after the elimination of the factors that caused the disease. If they cannot be eliminated or there is a pathology of the heart, then it is necessary to take measures to ensure the normal functioning of the body, in particular, take the necessary medications.

    In the absence of timely treatment, the formation of numerous blood clots, impaired blood circulation in the brain, the development of stroke conditions and sudden death are possible. Violation of conduction increases the risk of death by 2,5 times. In order to minimize the consequences of the disease, it is necessary to adhere to the recommendations of a cardiologist and arrhythmologist. The appearance of symptoms of the disorder cannot be ignored – this can cause the development of a serious pathology.

    Types of disease

    Disruption of ventricular conduction is very dangerous. It is divided into 2 main subspecies:

    1. 1.
      An impulse does not pass through a particular area of ​​the heart muscle. This causes a blockade that is life threatening to the patient.
    2. 2.
      The impulse moves in the right direction, but passes with a certain delay. Slowing causes an incomplete blockage of the heart.

    Such complete or partial blockages appear on the so-called legs of the bundle of His.

    If a local violation of intraventricular conduction occurs on the right side of the bundle of His, then the rhythm of the normal contraction of the right ventricle is disrupted. If this occurs along the left leg of the bundle of His, then the left ventricle suffers accordingly. Along with this, there can be various types of lesions with intraventricular impulse conduction. They are as follows:

    1. 1.
      Weak local lesions.
    2. 2.
      Complete blockage of the left ventricle, characteristic of acute myocardial infarction.
    3. 3.
      Nonspecific lesions with blockade of intraventricular impulses.

    All of them have their own specifics of diagnosis and treatment, and for some forms of diseases of this type, the treatment process is not carried out at all.

    disease prevention

    No wonder the heart muscle is called the motor. It regulates most of the processes and supplies the vital organs with blood. The heart should be treated with special trepidation. While it beats and does not bother, we sometimes do not attach due importance to its little motor. But everyone knows if health problems happen, including a violation of intraventricular conduction, which is just out of balance. Therefore, it would be better not to run your health.

    Whatever the prognosis of the disease, you need to remember that modern medicine helps to cope with almost any disorders, but for this it is necessary to listen to your body and make every effort for the sake of your own health.

    It is very important to make timely preventive measures to strengthen the vascular system, even if you have not found a violation of intraventricular conduction. What does this give? First reduces the risk of disease. It is better to prevent any disturbance in the body than to fight it. The main measures to be followed by people at any age:

    1. Walking in the fresh air is a guarantee of a good blood supply to all vital organs, including the heart. Fresh air oxygenates tissues and cells.
    2. A balanced diet enriched with potassium and vitamins. In general, eating healthy food adds strength, energy and health.
    3. Compliance with the daily regimen – if you get enough sleep, eat at the same time, you feel much better, and the risk of disease becomes much lower.
    4. Non-intensive physical activity, which is very important – daily. Easy jogging, gymnastics, exercises, yoga.
    5. The use of power sports, especially bodybuilding, is undesirable; it rather negatively affects the heart vessels.
    6. No matter how trite, less stress and worries. Constant emotional stress is detrimental to the heart muscle.
    7. Annual vacation at sea. If there is such an opportunity, then it should definitely be used. A two-week trip to pure, salty, mineral-enriched water restores both the physical and psychological state of a person. If you can’t go to the sea, you just need to arrange your own outdoor recreation. A trip to the forest will be a worthy alternative to the sea breeze.
    8. Timely examination at a medical facility. It is better not to ignore even the slightest discomfort when it comes to the health of the heart muscle.

    No wonder the heart muscle is called the motor. It regulates most of the processes and supplies the vital organs with blood. The heart should be treated with special trepidation. While it beats and does not bother, we sometimes do not attach due importance to its little motor. But everyone knows if health problems happen, including a violation of intraventricular conduction, which is just out of balance. Therefore, it would be better not to run your health.

    Even in the absence of intraventricular conduction disturbances, prophylaxis is necessary in a timely manner to reduce the risk of disease. The main measures to prevent pathology in people of any age will be walks in the fresh air.

    This is the key to good blood circulation and oxygen supply to all tissues and cells of the body. You need to eat food that is enriched with vitamins and potassium.

    Compliance with diet and healthy sleep greatly improves the state of health. To do light jogging, gymnastics. Power sports are undesirable, for example, bodybuilding has a negative effect on the vascular system. Stress and anxiety also adversely affect the body.

    The only way to reduce the risk of disease remains a healthy lifestyle. Do not start heart pathologies, as well as overdose with drugs. Constantly, when the corresponding symptom appears, go to the therapist and cardiologist.

    Are intraventricular conduction disturbances dangerous?

    Date of publication of the article: August 24.08.2018, 4.09.2018; Date of the update of the article: September , ; Author of the article: Julia Dmitrieva (Sych) – practicing cardiologist; Violation of intraventricular conduction – a pathology of focal (local) nature, in which the patency of the electrical impulse in the ventricles of the heart (one of the parts of the conducting system) is impaired )

    The impulse originates in the sinus node, which is the source of the sinus rhythm (considered the norm of heart contraction in the range from 60 to 90 beats per minute), passes through the atria and the atrioventricular node and enters the bundle of His, which is divided into the left and right legs. The right is a branching in the right ventricle, and the left is divided into anterior and posterior branches, which are responsible for the contraction of the anterior and posterior walls of the left ventricle. For conduction disorders of this type, the impulse is blocked on the bundles of His, violating the rules ventricular contractions of the ventricles.

    symptomatology

    With such a violation of the passage of pulses, most often there are no signs of the disease, since the shifts on the electrocardiogram are so small that it is very difficult to distinguish them. But still there are some signs, having noticed which, it is urgent to take the patient to the doctor. Typically, a patient has a disease as follows:

    1. 1.
      A person complains of a rather frequent head spin.
    2. 2.
      The patient has a noticeable shortness of breath, which does not disappear even if he is at rest.
    3. 3.
      Often a patient with a nonspecific impulse passage complains of an incomprehensible cold in the region of the heart muscle.
    4. 4.
      Such a person gets tired in a fairly short period of time, and he does not have enough strength to finish the job.
    5. 5.
      If you measure the pulse of such a patient, it turns out that he slowed down greatly.
    6. 6.
      A person begins to complain of memory impairment. He cannot remember much, sometimes even what he did recently.
    7. 7.
      During daylight hours, the patient may experience several mood swings.
    8. 8.
      A sick person suffers from an incomprehensible feeling of fear. He has disturbing thoughts for which there are no prerequisites. Usually the patient complains to his family about the fear of death, which haunts him even in a dream.
    9. 9.
      Nonspecific impairment of impulse conduction in the ventricles of the heart muscle can suddenly manifest itself as a person falling on a completely flat surface.

    If the patient has at least one of these symptoms, then it is urgent to call a doctor, as hospitalization may be required.

    In order to accurately determine patency disorders at an early stage, doctors use an electrocardiograph. When rhythmic failures are detected, Holter monitoring is performed – a special ECG. At the next stage, the location of the pathology is studied with the help of the electrodes of the Giss branch.

    Some medical tests that determine the location of the violation include tests with physical activity. This test establishes an accurate picture of the course of the disease and it turns out which blockade is associated with the pathology. A competent diagnosis is very important, since the further course of treatment will depend on this.

    To determine the pathology of conduction, it is recommended to conduct an electrocardiogram study. The method is able to accurately indicate those areas where pathologies and failures are present. If the cardiogram has confirmed the diagnosis, and the symptoms indicate this, then the patient is recommended to make an appointment with a cardiologist, arrhythmologist and cardiac surgeon.

    But carrying out the study is a complex process, so experts recommend the electrodes of the bundle of His. But sometimes it is additionally worth doing an ultrasound.

    Practice shows that a medical course of treatment does not bring the proper result. And this will continue until the root cause of the blockade is identified and eliminated.

    There are many ways to diagnose cardiac pathologies, and it is not difficult to identify the disorder.

    Studies have shown that about five percent of children who are healthy by the main indicators have myocardial conduction disorders. And if we talk about blockade of the first degree, then with age the situation will worsen. The cause of complications can be various cardiac pathologies and previous operations.

    Symptoms of the disease in children are as follows:

    • problems with memory and remembering;
    • problems with attention;
    • poor performance when it comes to a student;
    • dyspnea;
    • pain in the heart;
    • general weakness;
    • fatigue of the baby after small loads (physical or emotional) and more.

    The course of treatment of intraventricular conduction pathologies, as for adults, depends on the cause of the disease. The first stage of myocardial conduction does not need special treatment. Just an observation. If the situation worsens to the second degree of severity, it is recommended to include supportive drugs, and sometimes set a pacemaker.

    Patient M., 65 years old, was admitted to the therapeutic department. At the time of examination, he complains of shortness of breath during physical exertion, frequent bouts of dizziness, general weakness. Repeatedly there were a loss of consciousness.

    During the survey, it was possible to find out that such symptoms disturb her for more than a year. Over 14 months, marked weakness, headaches, dizziness were noted. For six months, there were loss of consciousness – about once a week. In the last month, fainting occurs almost daily. The patient faints for one minute, then general weakness is noted.

    Upon further examination, changes were detected on the ECG. Ultrasound, dopplerography, left ventricular failure, valvular stenosis. Diagnosis: Coronary heart disease; rhythm disturbance as a two-beam blockade and MAC attacks; heart failure I tbsp.

    The patient was given a pacemaker, her condition improved, and she was discharged.

    Symptoms of intraventricular conduction disturbance are less pronounced than in other types of blockade (for example, atrial atrial). One-bundle and two-bundle conduction have nonspecific symptoms. These types of violations do not manifest themselves brightly and can be detected by chance. Two-beam blockade often occurs as a result of large-focal myocardial infarction. Intraventricular blockade of the third type is a serious violation, which is characterized by the following symptoms:

    • sinus arrhythmia (tachycardia, increased heart rate or decreased bradycardia);
    • dyspnea;
    • chest pains;
    • severe dizziness and fainting;
    • worsening heart disease (e.g., ischemia);
    • intolerance to physical exertion;
    • cardiogenic shock.

    In the initial stages of the pathology, it is worth paying attention to light dizziness, a decrease in the pulse rate (not as serious as with the three-beam), general weakness.

    Problems with the conduction system may not be noticeable and may not appear in everyday life. The main symptom may be an accidental decrease in heart rate. In this case, therapy is not required, it is necessary to pay attention to health and general health, as well as to carry out preventive measures.

    • insufficient flow of blood to the myocardium and brain tissue;
    • pressure fluctuation in the arterial system;
    • violation of blood circulation in large and small circles.

    The main manifestations of the disease are as follows:

    irregular heartbeat at a slower pace;

  • pauses in the heartbeat;
  • fatigue and weakness due to physical activity;
  • pressure jumps;
  • lack of air;
  • noise in the head;
  • swelling of the extremities;
  • impaired consciousness, darkness in the eyes and fainting;
  • shortness of breath, appearing independently and after exercise.
  • With atypical forms of the disease, patients may complain of an unexplained cold in the myocardium. Companions of pathology are sharp mood swings, impaired memory and the emergence of an incomprehensible sense of fear. In severe cases, twitching of the muscles of the extremities and the front part, as well as involuntary muscle contraction on the back appears.

    Causes of pathology

    In rare cases, the disease is congenital, and, usually without compromising the quality of life, is accidentally detected during a medical examination. However, more often it is caused by diseases:

    • atherosclerosis;
    • myocarditis;
    • cardiac ischemia;
    • arterial hypertension;
    • heart failure;
    • arterial hypertension;
    • heart defects;
    • cardiomyopathy;
    • myocardial hypertrophy.

    In newborns, infants, children and adolescents, a violation of conduction can provoke:

    • prematurity;
    • an open oval window is an opening between the atria, which serves for blood supply during the development of the embryo. In a born child, it closes during the first year of life;
    • congenital heart disease;
    • diseases of the endocrine system (e.g., thyroid gland, adrenal gland, reproductive system).

    In children and adults, the causes can also be acute cardiac disorders after intoxication with drugs or drugs, surgical interventions.

    Pathology in children

    Conductivity disorders in children may disappear as they grow older. In other situations, the disorder may become chronic. The reasons for the development of ventricular conduction disturbances in children can be the following:

    • premature babies
    • hypoxia of the heart muscle,
    • birth injury,
    • Congenital heart disease
    • medicines
    • open oval window
    • infectious endocarditis,
    • rheumatism and others

    According to studies, approximately 5% of healthy children have some form of myocardial conduction disturbance. If we are talking about AV blockade of 1 degree, then it can progress to subsequent degrees of the disease. The causes are infections, other heart pathologies that may occur in the future. More serious conduction disorders can develop after rheumatism, heart surgery, with congenital malformations, etc.

    Signs of illness in children include decreased memory, attention, poor performance, weakness, shortness of breath, heart pain.

    Treatment in children with malfunctions in cardiac conduction will, like in adults, depend on the cause of the disease. The first degrees of blockade require dynamic observation without treatment. In the second degree, supportive medications may be recommended; the setting of a pacemaker is occasionally recommended. With blockade of grade 3, the child should undergo surgery to implant EX – an artificial pacemaker. Sometimes in children there are cases of spontaneous full recovery as they grow older.

    Pregnant women most often develop functional conduction disorders, which do not require medication and pass spontaneously. But with severe conduction disorders, a woman has to take medications that are selected by a cardiologist together with an obstetrician-gynecologist, taking into account minimal harm to the baby.

    Most often, vitamins, herbal remedies, potassium preparations are recommended. The implantation of ECS should be timely and performed, if necessary, before delivery. Childbirth in women with organic heart pathologies and AV blocks should be planned only by Caesarean section, so as not to provoke serious malfunctions in the rhythms of the heart.

    Open oval window

    How is the treatment?

    Treatment rarely consists in eliminating only the manifestations and consequences of pathology. Therapy is aimed at eliminating the causes that provoked a conduction disturbance. Physiological disorders, characterized only by impulse slowdown and due to congenital features or, for example, sports, do not need treatment (but people with such a diagnosis should undergo routine examinations and receive ECG findings).

    If the condition is caused by acquired heart diseases or serious pathologies, then treatment is necessary. Many heart diseases can be cured or well compensated, in such cases, conduction disorders can disappear. Three-beam blockade is of particular danger. With it, external stimulation of heart contractions and surgical intervention with the installation of a permanent pacemaker are performed.

    Children with incomplete blockages are observed by the doctor, as there is a risk of disease progression. Therapy in a child is carried out as well as in adults. In case of serious deviations, an operation to install a pacemaker can be performed. In women, conduction disorders may be temporary due to pregnancy.

    Treatment is carried out with the participation of obstetrician-gynecologists in order to reduce the risks of injury to the fetus with medications. If surgical intervention is required, then the operation to install a pacemaker should be carried out before childbirth, in case of serious pathologies, natural birth is contraindicated. Drug treatment involves taking:

    • drugs that improve myocardial metabolism (mildronate, riboxin);
    • cardiac glycos >

    Functional, organic, medicinal reasons for the appearance of focal disorders of intraventricular conduction are distinguished:

    1. Functional reasons – in this case, the activity of the conducting system is violated, but its integrity is maintained. The nervous system is affected by the intraventricular conduction system. Her sympathetic department excites cardiac activity, and the parasympathetic – it inhibits. Normally, both departments work balanced. In the event that the activity of the parasympathetic department predominates under the influence of any reason, a blockade may appear.
    2. Organic causes – change the structure of the intraventricular conducting system. Changes may be reversible. They arise as a result of congenital heart defects, cardiomyopathy, coronary heart disease, after surgery.
    3. Medicinal reasons – some medications in case of overdose or when prescribed without taking into account contraindications and individual characteristics of the patient contribute to the appearance of blockade.

    Study of heart disease in childhood

    Violation of intraventricular cardiac conduction – a pathology of one, two or three bundles of the intraventricular cavity, which lead to mono-, bi- or trifashicular block.

    The concept of blockade implies violations of the normal impulse patency through the heart muscle system. But a violation does not mean the complete absence of a nerve impulse. It can simply be a slowdown in the momentum, which will lead to a partial slowdown in heart rate in children, pregnant women and adults. There are signs of the disease, which are accompanied by a lack of nerve conduction, leading to complete cardiac arrest.

    Intracardiac pathologies are accompanied by intraventricular blockade of various forms of abduction. And if there is no impulse, then this is a complete violation of the conductivity. When the interventricular impulse is slowed down, it is called incomplete local pathology (PNPH).

    Violations are divided by the frequency of the lesion: intraventricular block of the left ventricle proximal and distal, bpn.

    Any violations of conduction of the heart are divided into:

    • shortening (slow flow) of nerve impulse conduction, or AV delay, is focal local in nature and can occur in babies;
    • difficulty in conduction or AV block, which is functional in nature or manifests itself against a background of organic heart disease.

    Diagnosis of heart block:

    • AV blockade of the first degree in people professionally involved in sports, in women in position; after surgery in the abdominal cavity;
    • Second-degree AV block is caused by an excess of cardiac glycosides transferred by a microinfarction;
    • AV blockade of the heart of the third degree involves a complete stop of the organ, its conductivity. Severe form of the disease.

    The causes of conduction pathologies in a child, during pregnancy and in other cases are different. Of particular note is the age of the patient or person in need of diagnosis. Acute forms of the disease appear in people over forty years of age for the following reasons:

    • cardiac ischemia;
    • myocardial infarction;
    • cardiosclerosis;
    • pathologies associated with cardiomyopathy;
    • benign tumors of fibrous connective tissue, or fibroma;
    • tumors or metastases in the region of the heart;
    • amyloidosis;
    • manifestations of angina pectoris;
    • high degree of hypothermia.

    Non-specific disturbance of intraventricular conduction in young people occurs after an acute form of myocarditis. Often a failure of the atrioventricular inner conduction nerve, its passage is rheumatic. The causes of the disease in young people are as follows:

    • violation of ventricular conduction in the form of functional blockades;
    • various types of heart disease;
    • unauthorized use of glycosides, beta-blockers, potassium salts, antiarrhythmic drugs, drug overdoses;
    • increased tone of the vagus nerve;
    • deposition of iron or calcium oxalates;
    • injuries and bruises of the chest cavity;
    • syphilis;
    • heart surgery and more.

    In childhood, conducting a cardiac examination on an ECG can show an AV blockade, which manifests itself from birth and does not depend on experienced rheumatism and other external factors. Complete primary blockade – local disturbances in intraventricular conduction, which require surgical intervention.

    It is forbidden to abuse alcohol, smoking, taking medications not for the purpose of a specialist. Traditional medicine deserves special attention. Do not think that tinctures on various herbs will eliminate all the symptoms and consequences of heart disease. Self-medication never led to anything good.

    Violation of the intraventricular conduction of the heart occurs if the time changes pathologically, during which the electrical impulse of the sinoatrial node must pass through the conducting heart system and reach the ventricular myocardium. Atrioventricular conduction and its quality play a huge role in the activity of the heart, therefore, any of its violations entail various diseases and complications.

    Heart contractions in children and adults are provided due to the work of the heart muscle – myocardium. Pulses in the heart are formed in the sinus-atrial (sinoatrial) node and then are sent to the bundles of Torel, Wenckebach, Bachmann, as well as to the atrioventricular node. At the last indicated point, the impulse is slightly delayed so that the atria are normally reduced, and the blood enters the cavity of the left ventricle and the right ventricle.

    Based on the description, it is clear that conduction of the heart muscle and its normal implementation is a prerequisite for the functioning of the heart and the maintenance of life. Currently, many types of impaired conduction of the ventricles and atria are studied – conditions in which impulse conduction along one or more bundles of the system suffers.

    1. Violation of sinoatrial conduction. The impulse does not reach the atria, their excitation slows down.
    2. Slowing atrial conduction. Symptoms of atrial conduction disturbance carry the risk of developing atrial fibrillation in the future, as they disrupt the activity of an important part of the conduction system. Find out what is dangerous atrial fibrillation
    3. Violation of atrioventricular conduction. This includes blockade of 1,2,3 degrees, in which the impulse conduction from the atria to the ventricles changes pathologically. Severe blockade as a disease is most dangerous at the risk of sudden cardiac arrest. This type of conduction disturbance is most common.
    4. Violation of internal ventricular conduction. This pathology involves the blockade of the legs of the bundle of His, from which the contraction of the left or right ventricle suffers.
    5. Nonspecific conduction disturbances – a pathological failure in the most remote areas of the myocardium – Purkinje bundles.
  • 1. An impulse does not pass through a particular area of ​​the heart muscle. This causes a blockade that is life threatening to the patient.
  • 2. The impulse moves in the right direction, but passes with a certain delay. Slowing causes an incomplete blockage of the heart.
  • 1. Weak lesions of a local nature.
  • 2. Complete blockage of the left ventricle, characteristic in the event of acute myocardial infarction.
  • 3. Nonspecific lesions with blockade of intraventricular impulses.

    All of them have their own specifics of diagnosis and treatment, and for some forms of diseases of this type, the treatment process is not carried out at all.

    When patients turn to a cardiologist with pain in the chest area, they are prescribed an ECG. Often this procedure determines violations of the intraventricular conduction of the heart. What is it and why is it developing? This will be discussed further.

    Heart disease can significantly worsen the general condition of the body, reduce its functionality and lead to serious complications. The pathology of the conduction function of the heart is especially dangerous, as it can lead to death.

    Symptoms of impaired conduction

    In violation of cardiac conduction, the following symptoms most often occur:

    • Heart palpitations;
    • Heart rhythm interruptions;
    • Fading of the heart;
    • Dizziness, fainting;
    • Dyspnea;
    • Decreased performance, fatigue, weakness;
    • A rare pulse.

    Treatment depends on several factors:

    • The causes of the violation;
    • The effects of the nervous system on the occurrence of blockades;
    • The level of conduction disturbance.

    First, the disease that caused the blockade is established. It is to eliminate the cause of failures that the action of treatment should be directed. In this case, it is necessary to avoid influence that worsens the passage of a nerve impulse in the heart. Precautions are prescribed drugs that slow down atrioventricular conduction. What it is? This is the length of time during which a nerve impulse from the sinoatrial node reaches the ventricles through the conducting heart system.

    If the effect of the parasympathetic nervous system is established, then drugs are prescribed that reduce its activity.

    No treatment is required in case of blockade of the legs. But they can be the first symptoms of a manifestation of heart disease – coronary artery disease, myocarditis, heart failure.

    If it is not possible to determine the disease and identify the cause of the focal disturbances of intraventricular conduction, then outpatient monitoring is carried out, including ECG monitoring. Due to the fact that the distal type of blockade is dangerous, it is necessary to set up a constant pacemaker.

    Preventive measures for the appearance of intraventricular blockade are the timely treatment of diseases that cause them, and the adequate use of antiarrhythmic drugs.

    The conduction system begins with the sinoatrial node, which is the source of the sinus rhythm. From it, impulses through specialized cells enter the atrioventricular node located in the zone of connection of the atria and ventricles. Further, the passage of pulses is carried out through a system of His fibers.

    Signs of partial blockade of impulses in the region of the right leg are sometimes found against the background of complete health and are considered congenital features. But often the sudden problem of impulses is a consequence of heart disease. Possible causes of intraventricular conduction pathology:

    • myocardial infarction
    • attacks of ischemia
    • atherosclerotic cardiosclerosis,
    • heart failure,
    • myocardial dystrophy,
    • myocarditis,
    • heart defects
    • cardiomyopathy
    • arterial hypertension,
    • hypertrophy of the heart.

    Conduction disorders are sometimes caused by electrolyte imbalance, drug intoxication, thyrotoxicosis, chronic obstructive pulmonary pathology, pulmonary thromboembolism.

    Disruption (and retardation) of intraventricular conduction

    The author of the article: Yachna Alina, oncologist surgeon, higher medical education with a degree in General Medicine. From this article you will learn about a violation of the intraventricular conduction of the heart: what it is, what symptoms this condition manifests itself, what treatment methods are used. areas of the ventricles can exist for a long time and turn out to be an accidental find on the electrocardiogram, or they arise suddenly as a result of heart disease. With this violation, a blockage in the passage of impulses occurs along one of the sections of the His bundle – the conducting system of the ventricles of the heart.

    The bundle is divided into left and right legs. The left forks into the front and back branches. Blockades are:

    • single-fascicular (single-beam), if one branch is blocked;
    • bifascicular – conducting stops on two branches;
    • trifascicular – the impulse does not pass through the three branches of the His system.

    Pathology of the conduction is complete or incomplete (when the conduct is slowed down, but not completely excluded).

    In children, identified problems with intraventricular conduction may indicate congenital malformation or hereditary pathology. A partial blockade of the right leg, found in a child, is often a variant of the norm. There are no other specific differences of this pathology in children. Some types of blockade (for example, partial blockade of the right leg of His) are not dangerous and do not require treatment.

    In other cases, for example, with trifascicular blockade against a background of heart diseases, a blockade can cause very serious conditions, even death, sometimes pathology can be completely eliminated, sometimes it is impossible. A cardiologist is involved in the treatment of pathology. Diagnosis is based on electrocardiography and electrophysiological findings.

    Description of the intraventricular conduction system

    The pathways of the main organ of the circulatory system include the following departments: the synotrial center in the area of ​​the right atrium, the atrial tissues, the atrioventricular center at the junction of the atria and ventricles of the heart, the bundle of His and its right and left branches, the distant area is the branches of the Purkinje bundle.

    The path contributes to the origin and passage of the contractile signal through the heart, so that it performs contractile actions. This activity contributes to the pumping of blood inside the chambers and sending it to the blood vessels. Sometimes there is a violation of the intraventricular conduction of the heart. What it is? This is the suspended passage of the pulse through the wire channels or its complete absence. As a result of such phenomena, arrhythmia develops.

    Symptoms

    The pathology of impulses along the His system, with the exception of the three-beam blockade, does not manifest specific symptoms. But this does not mean that patients with impaired intraventricular conduction feel good and do not have health problems. Diseases leading to impaired conduction can manifest many symptoms.

    One of the main reasons leading to a suddenly developing cessation of impulses along one or several branches of the bundle of His is myocardial infarction. Such a blockade may indicate myocardial ischemia – insufficient blood supply to the heart muscle. Due to the pronounced deformation of the ventricular complexes, the diagnosis of a heart attack by an electrocardiogram is very difficult.

  • The first degree means slowing down the passage of pulses.
  • In the second degree, part of the pulses are blocked, but the rest pass through a pathologically altered portion of the conducting system.
  • The third degree means the impossibility of conducting impulses going to the ventricles.

    With a three-beam blockade of the His system, the natural passage of impulses in the direction of the ventricles is impossible. This leads to the following symptoms:

    • reduction of heart rate;
    • intolerance to physical exertion, even minor, in which shortness of breath, weakness, pain in the heart occur;
    • fainting, intermittent confusion.

    Against the background of severe heart diseases, the sudden development of trifascicular blockade can cause serious complications associated with a decrease in rhythm or a long pause, when contractions of the ventricles are temporarily absent (transient asystole). These complications include:

    • The attacks of Morgagni-Adams-Stokes, in which due to a decrease in cardiac output and, as a result, brain ischemia, the patient turns pale, loses consciousness. After 1-2 minutes, the person comes to his senses, after an attack, redness of the skin often occurs. Repeated attacks can lead to impaired memory and intelligence.
    • Cardiogenic shock.
    • Sudden cardiac death due to asystole (cessation of heart activity).
    • Deterioration of the course of coronary heart disease, aggravation of congestive heart failure, renal pathology.

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    Perhaps you want to know about the new medication - Cardiol, which perfectly normalizes blood pressure. Cardiol capsules are an excellent tool for the prevention of many heart diseases, because they contain unique components. This drug is superior in its therapeutic properties to such drugs: Cardiline, Recardio, Detonic. If you want to know detailed information about Cardiol, go to the manufacturer’s website.There you will find answers to questions related to the use of this drug, customer reviews and doctors. You can also find out the Cardiol capsules in your country and the delivery conditions. Some people manage to get a 50% discount on the purchase of this drug (how to do this and buy pills for the treatment of hypertension for 39 euros is written on the official website of the manufacturer.)Cardiol capsules for heart
  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

    Detonic