ECG retardation of atrial conduction treatment

Slowing atrial conduction is a serious pathology that can provoke life-threatening conditions. What is it – everyone who has any dysfunction of the heart should know.

It is diagnosed if the patient has a slow cardiac impulse due to poor automatism, contractility and excitability. With this disease, a change in the rhythm and contraction force of the central organ of blood circulation occurs.

In a certain part of it, such cycles may be completely absent.

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Definition

Classify several stages of development of this pathology. Depending on the nature of the conduction disorder of the heart, such blockades are distinguished:

  • Incomplete. Diagnosed at an early stage of the development of the disease. It is characterized by slow transmission of an impulse along the conducting fibers of the heart.
  • Complete. It occurs in the absence of proper treatment. As a rule, it is not compatible with life, since in this case the passage of pulses through the conducting system is completely stopped.

The reason why such violations occurred may lie in the defeat of the heart, the presence of defects, coronary artery disease.

Not the last role in this is played by bad habits in the form of smoking and alcohol abuse.

An unhealthy lifestyle, frequent stresses, and the use of drugs that have a stimulating effect on the cardiovascular system are not displayed very well on the state of the heart.

ea6b418c2af4de742cc002b79c7fd157 - ECG retardation of atrial conduction treatment

Based on the location of the blockade, the following types of this pathology are distinguished:

  • interatrial;
  • sinoarterial;
  • atrioventricular;
  • intraventricular (right or left leg of the bundle of His).

With a partial disorder of sino-arterial conduction, symptoms do not appear, but with a full adult, a person may experience pain in the chest area and dizziness caused by poor blood flow in the brain against the background of rare heart contractions.

As for interatrial blockade, it does not pose a danger to life. But with its presence, the risk of developing atrial fibrillation increases, which is a serious threat to human health. This disturbance is accompanied by dyspnea at rest and when walking, swelling of the legs, cyanotic staining of the skin, discomfort from the chest.

Atrioventricular block is not always expressed by symptoms, but its combination with bradycardia can lead to an attack of MAS (Morgagni-Adams-Stokes). The patient at this moment can sharply feel weakness in the body.

Inaction can cause cardiac arrest.

The intraventricular type of pathology occurs due to a disorder of ventricular conduction through the legs of the bundle of His. Partial blockade is not always manifested, but complete is accompanied by a rare pulse, loss of consciousness, pain in the chest.

Symptoms

Among typical complaints, patients most often note:

  • heart palpitations;
  • malfunctions of the heart;
  • periodic stopping of contractions;
  • dizziness;
  • fainting;
  • angina pectoris in the heart;
  • shortness of breath.

When intraventricular conduction slows down, symptoms are rarely noted. The clinical picture becomes pronounced only if there are signs of the disease, which became the cause of the violations.

Sometimes, at the same time, patients feel fatigue, weakness in the body and decreased performance. It is possible that memory problems may occur.

Sudden changes in mood, feelings of fear and anxiety may also be disturbing.

Diagnostics

If you have one of these symptoms, you should immediately contact a cardiologist or arrhythmologist. To make an accurate diagnosis and prescribe effective treatment, the patient needs to undergo a series of studies:

  • cardiogram and Holter monitoring;
  • ECG samples in the presence of load;
  • ultrasound of the heart or echocardiography.

If during the diagnosis an intra-atrial defect was confirmed, specialist advice is required as soon as possible in order to prevent serious consequences.

If a young man has an army, then with this diagnosis he can count on his release, especially if conduction disturbance is observed for more than 7 days. Persistent heart rhythm disorders require long-term treatment.

Any malfunctions in the work of the female body during the period of bearing a child are unpredictable, especially when it comes to heart pathologies.

Rhythm disturbances are a serious medical problem, against the background of which the fetal life is at risk.

The development mechanisms of such deviations are usually associated with hormonal changes and functional changes that occur with a pregnant woman.

With any deviation from the work of the cardiovascular system, the patient is referred for diagnosis. Research methods practically do not differ from generally accepted ones. If necessary, medication is prescribed, including the administration of antiarrhythmic drugs.

The danger lies in the development of heart failure, myocardial infarction, atrial fibrillation. This is what threatens to slow the atrial conduction:

  • angina pectoris;
  • pulmonary thrombosis;
  • MES attack;
  • brain ischemia;
  • stroke;
  • sudden cardiac death.

zamedlenie vnutrigeludochkovoi provodimosti rabota - ECG retardation of atrial conduction treatment

The most dangerous for health are MES attacks, loss of consciousness, epileptiform convulsions.

The severity of such phenomena depends mainly on the duration of the stoppage of the ventricles and the level of pulse drop (its performance may decrease by 10-20 beats per minute or even lower).

At the time of the attack, blood pressure almost always reaches critical levels. This condition can be repeated several times a day for more than 5 minutes. Often this ends with a cardiac arrest.

Treatment

The method of treating patients is determined individually for each. In this case, concomitant diseases, body features, lifestyle, health status and age are taken into account.

In the fight against pathology, different treatment regimens are used. The first stage is medication. With its help, you can slow down the development of the disease, if it was detected at the initial stage. To correct the condition, a complex of vitamins, minerals is prescribed.

Among other tools that are recommended to combat impaired impulse conduction, it should be noted:

  • potassium and magnesium preparations;
  • anti-ischemic drugs;
  • beta-blockers and adrenomimetics.

Also, therapy is not complete without drugs whose action is aimed at improving the functioning of the main circulatory organ. In this case, the patient needs to change his lifestyle. A significant point is to follow a special diet to reduce the amount of bad cholesterol in the blood.

The second stage is surgical. It is resorted to in rare cases, when there is no positive dynamics after drug therapy. Surgical intervention is usually performed with an advanced disease.

The most common operation today is the introduction of a small apparatus, which serves to restore heart rate and improve impulse conduction.

Complete blockade in combination with bradycardia requires the use of drastic measures involving the installation of a pacemaker.

A serious form of the disease is treated by the introduction of an artificial implant, which will provide signal transmission to the sinus node. There are times when radiofrequency ablation is performed.

During this operation, a device is placed in a special fiber that contributes to the destruction of pathological nodes of the heart.

Using radiofrequency ablation, a problematic patch is soldered, which was responsible for the delay in the pulse.

prichiny i posledstviya narusheniya provodimosti serdca - ECG retardation of atrial conduction treatment

As for the prognosis, it depends mainly on the severity of the pathology and its reversibility. But with incomplete blockade, it is more favorable than with complete blockade, when the risk of death is high enough. With a complete blockage of any area of ​​the heart, therapeutic actions concern only the elimination of acute symptoms.

It is impossible to completely get rid of this problem. This is due to the close connection between the nervous system and the brain. Therefore, the result is not always successful. Exacerbations of conduction in 70% of cases end in death.

The reason for this is the lack of necessary nutrients and, as a consequence, oxygen starvation of brain regions.

Rarely, this disease appears out of nowhere. Usually it is provoked by a number of specific reasons. These include:

  • High-grade hypertension.
  • Rheumatic fever.
  • Congenital heart diseases.
  • Intoxication of the body.

Wear and tear in the functioning of heart valves due to regular prolonged physical activity of high complexity.

3 Classification

Slowing conduction inside the atria refers to the first degree of blockade. Consider the full classification of the blockade.

  1. 1 degree – slowing of atrial conduction
  2. 2 degree – slowdown with periodic impulse blocking. The second degree has two types. The first type is characterized by an increase in deceleration with the loss of the complex. In the second type, elongation is not observed. The complex drops out suddenly.
  3. 3 degree – complete blockade. There is a disconnected activation of both atria. The impulse does not pass from the right atrium to the left. This phenomenon is called atrial dissociation. The right atrium and ventricles are excited by impulses emanating from the sinus node. The left atrium is excited by impulses that come from the ectopic centers that are activated in this chamber of the heart.

If similar symptoms are found, a person needs to contact a cardiologist or arrhythmologist to determine the course of the examination and decide whether treatment is needed in this case.

Research measures come down to several procedures:

  1. Holter ECG monitoring is the most accurate conduction slowdown diagnosis performed at different times of the day.
  2. ECG with exercise – >zamedlenie vnutrigeludochkovoi provodimosti ibs - ECG retardation of atrial conduction treatment

Coronary heart disease

zamedlenie vnutrigeludochkovoi provodimosti stepeni - ECG retardation of atrial conduction treatment

Atrioventricular block on an electrocardiogram

Definition

ECG and other diagnostic methods

Before we understand the main diagnostic methods, let’s see what the international classification of ICD 10 can tell us about the violation of cardiac conduction. For this ailment, I45 code is allocated. This code is indicated on the cover page of the medical history. Such an encryption system is accepted by all medical institutions, it is considered a single, official standard.

And now we can proceed to the diagnosis. A number of diagnostic methods are used to identify the disease and confirm it. The choice of method depends on the general condition of the body, the type of violation and the degree of its development.

  1. The Holter ECG allows you to see the relationship between conduction disturbances and external factors that occur throughout the day.
  2. An ECG performed with a load involves the use of a simulator, treadmill, jump rope or just squats. The electrocardiogram device detects a violation of the conduction of the ventricles and allows you to draw the appropriate conclusions.
  3. Ultrasound allows you to study the type and structure of the tissues that make up the heart.
  4. Laboratory research.
  5. Blood chemistry.
  6. Hormonal studies.

Diagnostic methods are not limited to this list. The doctor may prescribe other methods to clarify the diagnosis, confirm it, or resolve contentious issues. Parents need to be double cautious and attentive if the child has shortness of breath, distracted attention, pain in the heart. A visit to a cardiologist should not be delayed, otherwise the consequences can be sad and even tragic.

Slowing of atrial conduction is characterized by non-specific symptoms of rhythm disturbances:

  • a feeling of interruption in the work of the heart – additional extraordinary contractions;
  • sudden bouts of palpitations;
  • “Freezing” in the chest;
  • shortness of breath – in the case of prolonged progression of the pathology;

The occurrence of pathology is always associated with organic myocardial damage, therefore, during a clinical examination of a patient, the symptoms of the underlying disease come to the fore:

vegetative-vascular dysfunction – sweating, redness of the face;

  • arrhythmic pulse with satisfactory filling and amplitude characteristics;
  • blood pressure lability;
  • ultrasound – areas of hypokinesia, a significant expansion of the cavity of the left atrium.
  • The criterion for diagnosing intra-atrial block is the result of electrocardiography (ECG), which determines:

    • lengthening of tooth P more than 0,12 s in II, III, aVR;
    • change in the shape of the tooth – splitting, two-phase, flattening.

    Depending on the data of the cardiogram, the degree of (1,2,3) pathology is distinguished. Slowing of conduction along the atrial fibers of the first degree is most often accompanied by other rhythm disturbances – atrioventricular or intraventricular blockade, ectrasystole.

    To detect impaired atrial conduction, the ECG gives the most information. A standard technique is not always sufficient, then Holter monitoring, transesophageal registration, or electrophysiological examination are used.

    The duration of the P wave exceeds the norm (0,12 s). It should be noted that in only 3% of cases it reaches 0,13-0,15 seconds, in the vast majority – about 0,125 s. If the blockade is not constant, then the duration of P is always greater than PR. The atrial tooth can become flat, biphasic, deformed. Often, degree 1 blockade is combined with nodular or intraventricular conduction disturbances, extrasystole.

    Second degree

    Each subsequent contraction has an ever longer P, and then a wave appears, emanating only from the right atrium, and the left does not contract. This corresponds to the first option 2 degrees of blockade. There is also a variant in which there is no gradual increase in P, and the pulses periodically do not reach the left atrium.

    Signals from the right atrium are completely blocked. The left atrium produces its own slow rhythm – about 40 contractions per minute. In shape, the ectopic P is small, the intervals between them and ordinary teeth are not regular. An additional atrial rhythm is atrial fibrillation or atrial flutter, unilateral tachycardia.

    narushenievnutripredserdnoyprovodimostip 5D6A3F61 - ECG retardation of atrial conduction treatment

    If the patient has found such symptoms, he needs to contact a cardiologist, and preferably an arrhythmologist for further examination and to decide on the need for treatment.

    The doctor will prescribe additional research methods:

    • Holter ECG monitoring for more accurate diagnosis of conduction disturbances at different times of the day,
    • ECG tests with load – treadmill – test, bicycle ergometry. Walking on a treadmill or pedaling on a stable bike with superimposed ECG electrodes will help to more accurately identify the connection of conduction disturbances with the load,
    • Ultrasound of the heart (echocardiography) visualizes the anatomical structures of the heart, reveals heart disease, and also allows you to evaluate the function of myocardial contractility.

    An ambulance should be called immediately if the following symptoms are observed:

    1. A rare pulse of less than 45 – 50 per minute or a frequent pulse of more than 120 per minute,
    2. Loss of consciousness, fainting state,
    3. Heartache,
    4. Cold sweat, weakness
    5. Severe shortness of breath.

    The occurrence of pathology is always associated with organic myocardial damage, therefore, during a clinical examination of a patient, the symptoms of the underlying disease come to the fore:

    • zamedlenie vnutripredserdnoj provodimosti chto ehto takoe 3 - ECG retardation of atrial conduction treatment
      vegetovascular dysfunction – sweating, redness of the face;
    • arrhythmic pulse with satisfactory filling and amplitude characteristics;
    • blood pressure lability;
    • ultrasound – areas of hypokinesia, a significant expansion of the cavity of the left atrium.

    Depending on the cardiogram data, the degree of (1, 2, 3) pathology is distinguished. The first degree is most often accompanied by other rhythm disturbances – atrioventricular or intraventricular blockade, ectrasystole.

    • The duration of the P wave is more than 0,11 sec;
    • The tooth P in its amplitude can be expanded, split, jagged, two-humped;
    • The amplitude of the P wave can be reduced.

    2nd degree is characterized by the following features:

    • Gradual increase in the duration and splitting of the P wave,
    • Periodic disappearance of the left atrial phase of the tooth in lead V1.

    Atrioventricular block 3 degrees

    The 3rd degree is characterized by atrial dissociation and is quite rare. Diagnostic signs:

    • The presence of a short P wave on the ECG, reflecting the excitation of the right atrium;
    • The presence of small left atrial P waves (flicker waves).

    After an ECG diagnosis of atrial conduction disturbance, a number of additional laboratory and instrumental studies are performed aimed at identifying the underlying disease. An isolated treatment for atrial conduction disturbance does not exist, since it is caused by a specific disease or pathological condition. Treatment is directed to the underlying disease.

    The third stage of the disease requires surgical intervention. A tangible slowdown in conduction, accompanied by bradycardia, raises the question of installing a pacemaker.

    It sends the desired signal to the node at a certain point.

    Blocking any part of the heart requires symptomatic treatment. It is impossible to fix the problem, since there is a connection with brain activity and the nervous system.

    Aggravation of the problem leads to death in 70% of cases. This is due to a lack of nutrients that must arrive on time.

    In addition, the picture is exacerbated by oxygen deprivation in some parts of the brain. With complete blockade, the following symptoms are observed:

    • prolonged dizziness;
    • murmur in the region of the heart;
    • violation of the cardiogram.

    The question often asked by people about the slowdown of atrial conduction, what it is and how dangerous the disease is, gets a very clear answer: the transmission of an electrical impulse to the heart can be diagnosed only at the last stage.

    In this regard, to prevent irreparable consequences, you need to undergo a regular examination by a cardiologist twice a year. This primarily refers to patients at risk.

    There are no specific manifestations of atrial conduction disturbance in the patient. All clinical signs and symptoms are due to the underlying disease.

    After an ECG diagnosis of atrial conduction disturbance, a number of additional laboratory and instrumental studies are performed aimed at identifying the underlying disease. An isolated treatment for atrial conduction disturbance does not exist, since it is caused by a specific disease or pathological condition.

    Treatment is directed to the underlying disease.

    After the patient finds several of the above symptoms of this ailment, he should immediately consult a specialist. He will conduct a thorough diagnosis before prescribing treatment. A cardiologist deals with such ailments.

    The first stage of the diagnosis of the disease is an initial examination. The specialist must be aware of the patient’s complaints. They can already diagnose a disease at an early stage.

    Symptoms of the disease

    The histological structure and structure of the cells providing the conductivity allows us to distinguish them into a special type, indicating an affinity for myocardial elements and the nervous system. Transport fibers consist of intensely innervated cardiomyocytes with a reduced number of myofibrils.

    The transfer of excitation from one cell to another is provided by an electrophysiological mechanism

    The whole system is divided into 2 parts:

    • sinus-atrial (sinoatrial);
    • atrioventricular (atrioventricular).

    The sinoatrial section includes:

    • sinus node (Kisa-Flak node) – located in the right atrium near the mouth of the vena cava, therefore it is also called a sinoatrial or pacemaker, since it is in it that a normal impulse is generated to ensure the correct rhythmic contraction of all the chambers of the heart;
    • three internodal bundles for quick connection of the sinus node with the atrioventricular;
    • the interatrial tract connecting the main node with the left atrium.

    Information transport between nodes passes through beams:

    • Bahman – to the left atrium;
    • Wenkebaha – to the atrioventricular node along a branch of medium length;
    • Torella – in the same direction, but in a longer way along the back surface.

    To date, there are disputes between cardiologists about the role of these pathways in the conduction system. The presence of additional paths is shown. Some scientists believe that they, together with the Torell beam, are spare and are connected only in emergency cases.

    Both the sympathetic and parasympathetic nervous systems are in contact with the node.

    The parasympathetic nervous system exerts its maximum influence through the vagus nerve on the sinus and atrioventricular nodes

    The following elements belong to the atrioventricular part.

    Atrioventricular node (Asofa-Tavara) – lies in the lower part of the atrial septum. In structure differs from sinus:

    • a lower content of pacemaker cells providing excitability, and a larger content of transport cells;
    • It is divided by collagen layers into longitudinal structures (α slow and β fast channels), they are the anatomical basis of dissociation of conduction, create conditions for conducting a pulse in both directions, they are called anterograde and retrograde;
    • the structure creates the possibility for paroxysms of nodal tachycardia;
    • It has mainly the endings of parasympathetic nerve fibers through which it participates in the process of slowing the heart rhythm.

    The bundle of His, consisting of a common trunk and three branches (the left is further divided into the posterior and anterior), receive innervation from parasympathetic nodes.

    Purkinje fibers – directly come into contact with cardiomyocytes and transmit excitement with the requirement to contract, do not have a connection with nerve endings.

    The pulse velocity in the trunk of the bundle of His is about 1,5 m/s, in the interventricular zone of branching of the legs of the bundle of His is increased to 4 m/s, in the final fibers of Purkinje it is significantly reduced and reaches 1 m/s.

    Passing in the myocardium of the atria and ventricles, the excitation reduces the speed to 0,8 and 0,4 m/s. Such a small indicator of distribution in the atrioventricular node provides physiological protection against the ingress of a large number of pulses and reduces the conditions for ventricular arrhythmias.

    Before you find out how to properly treat the disease, you need to find out what the violation of atrial conduction means and what is the reason for its development. If even insignificant changes in the sequence of heart contractions have occurred in the body, this can negatively affect the functioning of each of the organs. This condition indicates that the process of blood flow into the aorta is difficult. Medics determine several stages of the disease. Depending on the nature of the disorder, these blockades can be distinguished:

    • Incomplete. It can be detected at the initial stage of the development of the disease. Its main sign is a slow transmission of an impulse transmitted through the fibers of the heart.
    • Complete. It is observed in patients who do not follow the recommendations of the doctor, or the therapy was chosen incorrectly. This species is most often incompatible with life and all because the passage of impulses is completely stopped.

    The main reason for the violation of atrial conduction may be hidden in damage to the heart muscles, the presence of defects and coronary artery disease. Smoking and alcohol abuse play an important role in the development of this pathology. An incorrect lifestyle, stressful situations, and taking medications that stimulate the cardiovascular system negatively affect the work of the heart.

    The following types of blockades exist, depending on the localization of the pathology:

    • interatrial;
    • sinoarterial;
    • artioventricular;
    • intraventricular.

    Failures in the work of other organs and electrolyte disturbances provoked by a long intake of diuretics can also lead to a slowdown of intraatrial conduction.

    If the patient has only partial dysfunctions of sinoarterial conduction, then there will be no symptoms, and with full, he may feel discomfort in the chest and dizzy, these symptoms are provoked by poor blood circulation in the brain.

    6e25dd271abaefccb519dea92e787f80 - ECG retardation of atrial conduction treatment

    Atrioventricular atrial conduction disorder is only symptomatic in some patients, but if bradycardia is additionally observed, then no one is safe from an attack of MAS. At this point, the patient has weakness throughout the body. Dizziness with loss of consciousness, convulsions that are associated with impaired blood flow in the brain may be observed.

    This condition requires urgent hospitalization and skilled care. If no measures are taken, the patient is at risk of cardiac arrest. The intraventricular form is manifested due to the impaired passage of blood through the legs of the bundle of His. Partial blockage is not always manifested by symptoms, but a rare pulse, loss of consciousness, and chest discomfort can tell about complete blockade.

    At the first degree of atrial block, there are no clinical manifestations. Its identification is an accidental finding during the examination of the patient. If loss of contractions of the left atrium in the second degree of the disease is rare, then an uncomfortable sensation in the heart area, brief episodes of dizziness, general weakness may appear. The absence of 2 or more consecutive contractions or atrial dissociation is accompanied by:

    • feeling of sinking heart;
    • dizziness;
    • pallor of the skin;
    • fainting conditions;
    • darkening in the eyes;
    • tinnitus.

    Causes of slowing atrial conduction

    The intra-atrial blockade does not pose a direct threat to life, however, its presence in the patient may indicate that he has a high risk of atrial fibrillation, which can lead to dangerous complications.

    atrial fibrillation – a dangerous complication of atrial conduction

    1. As a rule, the slowing of the atrial conduction has no specific symptoms and is manifested only on the ECG,
    2. Symptoms of a causative disease are characteristic – shortness of breath when walking or at rest, swelling of the lower extremities, cyanotic staining of the skin, pain in the chest, etc.

    From the article you will learn about the slowdown of atrial conduction: what it is, what types of disorders are, why they occur. Is slowing always symptomatic? In what cases and how to treat such a pathology.

    The author of the article: Yachnaya Alina, oncologist surgeon, higher medical education with a degree in General Medicine.

    Slowing of atrial conduction is the initial stage of a decrease in the function of the sinus node (CS), which normally is the source of the electrical impulse necessary to contract the heart muscle. Therefore, deceleration is attributed to violations in the conduction nerve fibers of the myocardium from the “sinus node dysfunction” group.

    In pathology, under the influence of causal factors, a decrease in the frequency of occurrence of an electric pulse from SU is observed, which manifests itself in a decrease in the number of myocardial contractions (bradyarrhythmia or bradycardia). Depending on the degree of violation, a slowdown of conductivity appears, up to its complete absence or blockade against the background of a stop of the node function.

    Such changes in the contractile activity of the heart muscle lead to a decrease in the amount of blood ejected and inadequate blood flow in all internal organs, which is manifested by clinical symptoms of pathology.

    Deterioration of well-being is not in all cases: moderate deceleration does not affect the function of the heart, is a physiological feature in people who are professionally involved in sports and some children until they reach puberty. Such forms of heart rate change do not require any medical intervention.

    The danger is represented by extreme forms of disruption of the SU, especially its complete shutdown. With this variant of the disease, patients have symptoms of pathology that limit them in all areas of life and can cause cardiac function to stop. In this case, the pathology requires appropriate treatment.

    Disorders in the conduction nerve fibers of the myocardium caused by reversible causes can be completely cured if they are fully corrected. Cardiogenic causes are usually irreversible, it is impossible to recover from them. But conducting therapy or surgery can save the patient from the manifestations of the disease and maintain the quality of life.

    Cardiologists, therapists, arrhythmologists and vascular surgeons are involved in the problem of conduction disturbances in the heart tissue.

    Violation of the occurrence of an electrical excitation pulse appears only when less than 10% of functioning cells remain in the SU.

    The article discusses a decrease in its function of a secondary nature, under the influence of reversible and external influences. The primary decrease is called “sinus node weakness syndrome,” and is described separately.

    (predominance of the action of the parasympathetic part of the autonomic nervous system)

    Increased intracranial cerebrospinal fluid pressure against the background of infectious and inflammatory diseases of the brain, thrombosis of the cranial sinuses, tumors, etc.

    Bleeding into the subarachnoid space (subarachnoid) due to stroke, traumatic injury

    Diseases (inflammatory, tumor) in the upper third of the esophagus, larynx

    Carotid sinus syndrome – increased activity of the nerve node, manifested by sudden fainting

    Myocardial infarction in the area adjacent to the diaphragm (lower)

    Nocturnal apnea – complete respiratory arrest during a night’s sleep due to hyperactivity of the parasympathetic system

    Vasovagal syncope – loss of consciousness on the background of a pronounced expansion of blood vessels and slow heartbeat

    The Bezold-Yarish reflex is a sharp expansion of the lumen of small arterioles against the background of receptor irritation in the left ventricle with a large volume of blood (surgery, pregnancy, tumors with compression of the inferior vena cava, etc.). A characteristic triad of symptoms occurs: a pronounced decrease in pressure, respiratory arrest, slowdown of the heart

    Atherosclerotic lesion with decreased blood flow

    Endocarditis (inner heart disease)

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    Definition

    Changing the order of heart contractions negatively affects the work of the heart, endangering a person’s life.

    Deviations in the functioning of organs and electrolyte disturbances, which are usually associated with prolonged use of diuretics, can also provoke a slowdown in the transmission of cardiac impulses.

    Due to such a malfunction, a large volume of blood flows directly into the aorta.

    Further, the blood circulation changes, which can lead to a pre-infarction state, rupture of the myocardium, a violation of the heart rhythm and an increase in blood pressure with a decrease in vascular.

    076984c54d4773d7bb84ff71b8f28971 - ECG retardation of atrial conduction treatment

    Violation of myocardial conduction has similar symptoms, because of which they can be confused. Often confused slowdown and violation.

    Violation of the conduction of the heart occurs when the sinus node sends a signal to the muscles to contract at the wrong moment. As a result, the desired rhythm is lost and contractions do not occur on schedule. The reason why the conduction of the heart gets disturbed is because of impaired brain and neural plexus functions.

    The basis of the problem is the missing signal, which should come from the nervous system to the sinus node. If there is no signal at the right time, the node does not turn on at the right time, which leads to a failure of the natural rhythm of heart contractions.

    Such a violation of atrial conduction can lead to a myocardial rupture or preinfarction condition. You can track it by a violation in the rhythm of the heart, decreased vascular and increased blood pressure.

    In contrast to the calm state of a person, changes occurring under a similar load cause blood to be pumped 3 times faster. This shows that not all of these symptoms are an indicator of valve and heart problems.

    If a person is in a calm state and slowdown is manifested, it is necessary to go to the hospital. The examination will show the cause and how it affected the functioning of the heart. On the ECG, changes in the work of the atria will appear, which will allow to assess the patient’s condition.

    Depending on the cause, appropriate treatment is prescribed.

    Factors

    Neurocirculatory dysfunction is a common cause of slowdown. Its danger and the degree of exposure to the patient depends on the stage of deceleration of conduction. Stage 3:

    • an insignificant stage, a partial violation of the rhythm of contractions and the absence of an effect on the functioning of blood vessels and the heart are observed;
    • severe stage, increased pressure on the heart muscle;
    • high stage, blood circulation in the vessels changes and there is a threat of cardiac arrest or heart attack.

    The first two stages are often accompanied by atrial fibrillation. It is expressed in random impulses that cause chaotic muscle contractions. The work of the heart is difficult.

    Causes of atrial fibrillation:

    • glycoside that exceeded the normal degree of concentration;
    • the presence of rheumatic fever;
    • heart muscle inflamed;
    • high stage hypertension;
    • heart defects;
    • intoxication;
    • physical deterioration.

    The largest number of patients with a problem of slowing atrial conduction are children and senior citizens. Children suffer from congenital illness. Pensioners – due to wear of neural fibers.

    Slowing down is dangerous for lovers of alcohol and cigarettes. In those who abuse, it can occur periodically and cause intoxication.

    Symptoms: persistent headache and short-term loss of mind, even in the absence of stress. After blocking irritating nodes, intraventricular conduction is disrupted – the main reason for the increase in pressure, since part of the muscle does not contract.

    Evidence

    If the disorder is small, then it is difficult to diagnose due to the lack of visual symptoms. The patient can feel good, indicators are normal.

    The danger can be noticed when blocking on one of the muscle areas: the pulse slows down to 50 beats per minute. A person experiences:

    • sensation similar to boiling in the chest;
    • mild pain
    • sweating;
    • sleep is disturbed;
    • dizziness.

    With such symptoms, it is clear that the organs lack oxygen. With an increase in the disorder, the patient’s vision rapidly deteriorates.

    Particular attention should be paid to atrioventricular block (AV or AV block). This is a disease dangerous to humans, as it occurs when the impulse from the atria to the ventricles is delayed. It accounts for 17% of all sudden deaths caused by heart problems.

    If AV block is ignored, it will develop to the third degree: the ventricles contract regardless of the atria. The reason is a complete signal blocking between them.

    AV block may occur due to:

    • pathologies of the heart congenital and acquired;
    • ischemia;
    • myocardial inflammation;
    • hormonal, toxic effects on the heart.

    The condition is dangerous to humans. Without proper treatment, it develops rapidly. Having developed, AVA-blockade can cause death.

    The problem is that in the early stages it is difficult to identify the av-blockade. Especially if the pulse is kept within 55 beats per minute. Only in the last stage do bradycardia, fainting, cramps and weakness appear.

    In this case, the patient is immediately sent to the hospital – the only way to save him from death.

    3 Classification

    Etiology of heart block

    The heart is a muscular organ consisting of four chambers:

    • the right atrium collecting venous blood from the body;
    • the right ventricle, injecting venous blood into the pulmonary circulation – into the lungs, where gas exchange with atmospheric air occurs;
    • the left atrium, collecting oxygen-enriched blood from the pulmonary veins;
    • the left ventricle, which provides the advancement of blood to all organs of the body.

    Violation of the conduction of the heart occurs when the sinus node sends a signal to the muscles to contract at the wrong moment. As a result, the desired rhythm is lost and contractions do not occur on schedule. The reason why the conduction of the heart gets disturbed is because of impaired brain and neural plexus functions.

    In contrast to the calm state of a person, changes occurring under a similar load cause blood to be pumped 3 times faster. This shows that not all of these symptoms are an indicator of valve and heart problems.

    Particular attention should be paid to atrioventricular block (AV or AV block). This is a disease dangerous to humans, as it occurs when the impulse from the atria to the ventricles is delayed.

    It accounts for 17% of all sudden deaths caused by heart problems.

    1be466d6b6f1a2a4150a1ef6909ac863 - ECG retardation of atrial conduction treatment

    If AV block is ignored, it will develop to the third degree: the ventricles contract regardless of the atria. The reason is a complete signal blocking between them.

    In this case, the patient is immediately sent to the hospital – the only way to save him from death.

    1. Organic heart lesions: cardiosclerosis, myocardial infarction, all myocarditis, especially of rheumatic origin, syphilis, congenital heart defects, heart injuries, especially surgical.

    a) an overdose of cardiac glycosides,

    b) an overdose of antiarrhythmic drugs (beta-blockers).

    3. Electrolyte disturbances, especially hyperkalemia: medication, some pathological conditions associated with an increase in potassium in the body.

    With the isolated or combined action of the above factors, various types of blockages can occur.

    1 degree – slowing down the momentum;

    2 degree – loss of part of the pulses, incomplete conduct;

    3 degree – a complete blockade of the conduct. Currently, only 2 degrees are diagnosed, since the rest are not diagnosed. In this case, the pulse does not extend to the atria, the entire complex falls out.

    Slowing or stopping the conduction of a cardiac impulse along the myocardium of the atria occurs with coronary disease, hypertension, rheumatism, heart defects. In terms of severity, three options were distinguished – from low-symptom to severe, characterized by complete dissociation of atrial contractions. The main detection method is ECG. Cholinolytics and sympathomimetics are used for treatment.

    The heart has a complex structure, consists of many departments whose work is interconnected. For example, an electronic pulse arises in the sinus node. He goes on to cardiomyocytes. Their conductive ability is determined by the ability of muscle cells to respond to an incoming impulse. The signal generated in the sinus node passes through a number of structural units, causing excitation in the atria and ventricles. The essence of this complex process is to push blood flow from the heart muscle into the aorta and further through the body.

    The impulse can linger at any point on its path, thereby causing a violation of the intraventricular conduction of the heart – this is what it is. We tried to briefly and in an accessible form to state the essence of the problem. If we succeeded, then we can move on.

    In order for the heartbeat to be sufficient for blood circulation, excitation waves must be transmitted through the cardiac sections in a certain sequence and at a constant speed.

    Normally, impulses pass from the sinus node, the atrial part to the atrioventricular – atrioventricular. Thus, first the upper sections are excited, and then the lower ones.

    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 atrioventricular node and enters the bundle of His, which is divided into the left and right legs.

    The right one is a branch 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.

    zamedlenie vnutrigeludochkovoi provodimosti provodjaschaja sistema - ECG retardation of atrial conduction treatment

    With conduction disorders of this type, the impulse is blocked on the bundles of His, violating the correct contractions of the ventricles.

    In rare cases, the disease is congenital, and, usually without compromising the quality of life, is accidentally detected during a medical examination.

    However, much more often its cause is the disease:

    • 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.

    Classification

    The classification of intraventricular conduction disorders is based on the internal structure of the His bundle.

    TypesLesion localization
    Single beam
    • 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).
    Double beam
    • 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;
    Three-beamConductivity is broken at the level of the right and left legs (on both branches).

    symptomatology

    Symptoms of intraventricular conduction disturbance are less pronounced than in other types of blockade (for example, atrial atrial).

    Single-beam and double-beam conductivity 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 bradycardia – decreased);
    • 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.

    Signs on an ECG

    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.

    Indicators of incomplete blockades of the anterior or posterior branches of the left ventricle are similar to those with complete blockade, but their expression is minimal and is determined by the values ​​of the S and R.

    When, with a visible pathology of the left heart, the S indicator increases, this indicates impaired patency of the anterior branch.

    If, in the pathology of the right part, the R wave is larger, then the blockade of the posterior branch is diagnosed.

    Also pay attention to the time spent by the pulse 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.

    Treatment rarely consists in eliminating only the manifestations and consequences of the pathology.

    Therapy is aimed at eliminating the causes that provoked a violation of conduction.

    Disorders of a physiological type, characterized only by a slowdown of the pulse and due to congenital features or, for example, sports, do not need treatment (but people with this 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.

    Determination of intra-atrial conduction retardation, factors, signs and treatment of pathology

    What is a violation of atrial conduction, it is already known what forms of pathology are, too, but it is important to know how the disease manifests itself in order to seek help in time.

    More often, patients note such manifestations:

    • cardiopalmus;
    • disorders of the heart;
    • periodic stopping of contractions;
    • dizziness;
    • fainting;
    • angina pectoris in the heart;
    • dyspnea.

    If the patient has a slowdown, and not a violation of atrial conduction, then the symptoms are not always manifested. The clinical picture is most pronounced only in the presence of pathology, which provoked such violations. Some patients complain of rapid fatigue, weakness throughout the body, memory problems, they often worry about a sense of fear, their mood changes dramatically.

    With complete blockade, the patient has a heart defect, which only the surgeon can correct after surgery. Such problems often occur in newborns. They diagnose an ailment in infants born to a mother who suffers from autoimmune diseases or has problems with the heart and blood vessels.

    Factors

    The largest number of patients with a problem of slowing atrial conduction are children and senior citizens. Children suffer from congenital illness. Pensioners – due to wear of neural fibers.

    Symptoms: persistent headache and short-term loss of mind, even in the absence of stress. After blocking irritating nodes, intraventricular conduction is disrupted – the main reason for the increase in pressure, since part of the muscle does not contract.

    Intracardiac blockade during pregnancy

    If the patient has at least one of the symptoms listed above, then he just needs to consult a doctor, and maybe even undergo a full examination to identify the disease and immediately begin its treatment. To make the correct diagnosis, you will have to undergo the following types of examinations:

    • cardiogram;
    • Holter monitoring;
    • ECG tests with loads;
    • Ultrasound of the heart;

    Any malfunction that occurs in the body of a woman during the bearing of a baby can lead to serious and irreversible consequences. Disorders of the heart are a serious problem for physicians when the fetus and its further proper development are at risk. This ailment develops in pregnant women most often against the background of hormonal changes and functional changes.

    • antiarrhythmic: Proponorm, Cordaron, Etatsizin, Bisoprolol.
    • cardiac glycosides: digoxin;
    • diuretics: Eplerenone, Spironalokton, Torasemide;
    • cardioprotective: ATP-long, Tivortin.

    High-degree intra-atrial blockades, which cause symptoms of heart failure, require the installation of a pacemaker (artificial pacemaker). The installation of electrodes in both atria allows you to synchronize the myocardial function. Violation of the electrical impulse from the right atrium to the left is caused by various diffuse pathologies of the myocardium of rheumatic, coronary or unknown genesis.

    Isolated intraatrial blockade does not cause hemodynamic disorders and clinical signs of heart failure, however, it can be the cause of the further occurrence of high-grade arrhythmias. Treatment of pathology is carried out depending on the underlying disease and the symptoms present, and involves the use of pharmaceuticals or the installation of an artificial pacemaker. The following sources of information were used to prepare the material.

    First and second degree AV do not affect a woman’s condition, when every second and third reduction falls out of the rhythm, the underlying disease is treated. For disorders that cause severe symptoms, the pregnant woman takes glucocorticoids, not more than 40 mg, under the supervision of a doctor. The occurrence of a complete blockade requires measures to urgent hospitalization of women for resuscitation. A temporary effect (before the installation of a pacemaker) in such cases is given by drugs: alupent, atropine, ephedrine, isadrine.

    • Atropine or Platifillin, Norepinephrine in a dropper on a 5% glucose solution;
    • Eufillin or Alupent intramuscularly;
    • Hydrocortisone and Lasix to reduce potassium in the blood;
    • Riboxin and ATP in the course of tablets to maintain metabolic processes in the myocardium.
    1. Drug treatment involves the intake of vitamins, fortifying drugs, drugs aimed at reducing or completely eliminating unpleasant symptoms.
    2. Some types of cardiac conduction disorders can be treated with a diet. Its essence lies in the adjustment of nutrition, the rejection of junk food, the introduction of fresh plant products into the diet.
    3. Surgical intervention is prescribed for serious disorders that are not subject to medical treatment and are a threat to later life. Also, such treatment is prescribed after taking a course of medications, which was unsuccessful. The essence of this treatment is to install a pacemaker. This miniature device will constantly set the heart to a normal rhythm.

    As you can see, there are many ways to treat a violation of intraventricular conduction of the heart. Without an accurate and comprehensive diagnosis, it is impossible to determine the desired treatment option.

    If a violation of cardiac conduction is detected during pregnancy, special treatment is not prescribed. If the violations are severe and interfere with the normal life of the future mother, then the cardiologist together with the gynecologist prescribes drugs with minimal impact on the fetus. The advantage is given to vitamin complex preparations and herbal medicines. With such a disease, a cesarean section is always performed.

    This is rather 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.

    It is very important to take timely preventive measures to strengthen the vascular system, even if you have not found a violation of intraventricular conduction. What does it give? First of all, it reduces the risk of illness.

    zamedlenie vnutrigeludochkovoi provodimosti dissociacija - ECG retardation of atrial conduction treatment

    Walking in the fresh air is the key to good blood supply to all vital organs, including the heart. Fresh air saturates tissue and cells with oxygen. A balanced diet enriched with potassium and vitamins. In general, eating healthy foods adds strength, energy and health. Compliance with the daily routine – if you get enough sleep, eat at the same time, your well-being improves significantly, and the risk of illness becomes much lower

    Non-intense physical activity, which is very important – daily. Easy jogging, gymnastics, exercise, yoga

    It is undesirable to engage in power sports, especially bodybuilding, it has a rather negative effect on the blood vessels of the heart. No matter how commonplace, less stress and anxiety. Constant emotional stress is detrimental to the heart muscle. Annual vacation at sea. If there is such an opportunity, then it is definitely worth using it.

    A two-week trip to clean, salty, mineral-enriched water restores a person’s physical and psychological state. If you can’t go to the sea, you just need to take a rest in nature. A trip to the forest will be a worthy alternative to the sea breeze. Timely examination in a medical institution. It’s better not to ignore even the slightest discomfort when it comes to heart muscle health.

    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.

    Recovery prospects and forecasts are variable, which is due to an impressive number of likely changes.

    In order to fully understand the nature of deviations within the framework of this form of the process, you need to turn to the anatomical and physiological information.

    The generation of an electrical impulse in cardiac structures occurs in a natural pacemaker, the so-called sinus node. This is an accumulation of special cells of cardiomyocytes capable of spontaneous excitation.

    Through the fibers known as His bundles, the signal passes to the ventricles and other structures, providing normal contractility of the entire organ. The indicated “conductors” of the pulse are formed by two legs. Right and left. Further, they branch already within the framework of cardiac structures.

    Some part of the heart is excluded from work, because the contraction of muscle fibers does not occur. In some cases, this does not endanger life and health; in some situations, a fatal outcome is likely.

    It all depends on the localization of the process, and on the other hand, on the volume of the lesion and the prescription of the course of the condition.

    Within the ventricles, three types of pathological process are observed.

    • Blockade of the legs of His. A particularly common form of the disease. It is accompanied by a minimal clinical picture with damage to the right branch. The left-hand version is much more dangerous, since the operation of the camera of the same name is disrupted. In the absence of an adequate signal, a large circle of blood circulation suffers, generalized hypoxia, from all organs and tissues simultaneously. This in the long run leads to atrophy, multiple organ failure, cardiac arrest, stroke, vascular dementia. Clinically non-hazardous options can last a lifetime without visible manifestations.
    • Insufficient speed of the electric pulse along the fibers. The severity of the clinical picture and the threat to life again depends on the nature of the pathological phenomenon. However, this is a less dangerous variety compared to the classic complete blockade of the legs of His. Slowing down intraventricular conduction is the result of chest injuries, operations, or congenital heart defects.
    • Atrioventricular (AB) block. More rare type. It is characterized by selective stopping of the movement of electrical signals along cardiac structures.

    You can also classify the process on such a basis as the nature and degree of deviations in conductivity.

    • Complete blockade. The signal does not pass at all. This is the most dangerous clinical option. Outside the course of symptoms, in many cases, cardiac arrest is noted.
    • Partial ventricular conduction. The likelihood of fatal complications is present, the clinical picture is expressed, but to a lesser extent compared with the first process.
    • Conductivity slowdown. Almost not noticeable until a certain point.

    Finally, classification based on the extent of change is possible.

    • Generalized conductivity. Not only the ventricles, but also the atria suffer.
    • Focal (local) conduction disturbances. One or two ventricles are involved. It proceeds relatively easily, without pronounced symptoms, life risks are determined by the localization of the process. If the left side is affected, the probability of a fatal result is almost three times higher.

    A more accurate version would look like this:

    • Single beam conduction. With the blockade of a single branch.
    • Bifascicular form.
    • Full variety. When three fibers are blocked.

    Clinical types are important for developing treatment tactics.

    Causes of violation

    • Blood and urine test.
    • Electrocardiography
    • Electrophysiological study.
    • Echocardiography.
    • Stress tests.
    • Tilt test.
    • Different types of samples, etc.

    Prognosis for the patient

    The first degree of blockade is considered the most favorable variant of atrial conduction disturbance. With it, deviations in the well-being of patients for many years may not be observed. With the addition of concomitant organic heart pathologies (ischemia, inflammation, cardiosclerosis), complex rhythm disturbances are possible.

    In this case, often a periodic blockade becomes permanent. The second degree is characterized by atrial arrhythmias – tachycardia, extrasystole, flicker. Its course is more severe, and the prognosis is completely determined by the background disease. Violation of the conduction of the cardiac impulse in the atria occurs when the walls are dilated (dilatation) or the myocardium is damaged in the area where the Bachmann beam passes.

    And here is more about ECG in myocarditis. Atrial block is manifested by a slowdown in signal movement, loss of regular contractions of the left atrium, or complete atrial dissociation. At the same time, it is possible (with degrees 1 and 2) a low-symptom course or nonspecific complaints, and complete blockade is characterized by fainting conditions, vascular insufficiency due to an ineffective blood flow. Drug treatment is used to treat the underlying disease and drugs that accelerate conduction.

    zamedlenie vnutrigeludochkovoi provodimosti 3 stepeni - ECG retardation of atrial conduction treatment

    Blockade of LDL in lesions of both branches can be a sign of extensive destruction of the heart muscle during a heart attack, therefore its accession is regarded as one of the risk factors for cardiovascular death.

    When blocking PNPH and asymptomatic forms of another localization, such arrhythmia proceeds benignly. Deterioration of ECG indices, occurrence of atrioventricular block, hypertension, myocardial hypertrophy, circulatory failure increase the possibility of cardiac decompensation.

    A decrease in intraventricular conduction of impulses occurs with myocardial pathology, pulmonary hypertension, and malformations. It manifests itself in the form of blockade of the His bundle (one-, two- and three-beam lesions). Symptoms are absent or determined by a background disease.

    Asymptomatic cases are not subject to therapy, and with the acute development of the blockade, conduction improvement is achieved by the introduction of medications. With a rare rhythm of contractions, the installation of a pacemaker is required.

    Violation of sinoatrial conduction

    In another way, this is called sinoatrial blockade. An electrical impulse originating in the sinus node cannot fully reach the atria, and their excitation occurs with a delay. Often found in healthy people and does not require active treatment, but can also occur with organic diseases of the heart tissue.

    izmerenie pulsa u cheloveka - ECG retardation of atrial conduction treatment

    • Neurocirculatory dystonia with a predominant effect on the sinus node of the vagus nerve, which can slow the heartbeat,
    • Enlarged (hypertrophied) heart in athletes,
    • An overdose of cardiac glycosides (strophanthin, korglikon, digoxin) used in the treatment of other types of arrhythmias,
    • Various heart diseases
    • Myocardial ischemia.
    1. With partial conduction disturbance, symptoms rarely occur,
    2. With a complete violation of conduction, there is a feeling of interruptions in the heart, discomfort in the chest, dizziness due to a deterioration in the blood supply to the brain due to rare heart contractions,
    3. Pulse becomes rare – less than 50 per minute.

    ECG for sinoatrial blockade – prolapse of the atria and ventricles (PQRS complex)

    Disorders in childhood

    Heart block in children is manifested by the same symptoms as in an adult, but the treatment and prognosis have their own characteristics. Violation of the conduction of the heart pulse in children is diagnosed at any age, in the fetus even in the womb. To provoke the development of the disease in young patients can: inhibition of the sinus node and the inclusion of additional pathways that help to conduct the signal. But the problems of the sinus node can cause such conditions:

    • myocardial sclerosis;
    • myocardial inflammation;
    • failures in the electrolyte balance;
    • changes in cell metabolism.

    But in newborns, the cause of atrial conduction disorders can be such negative circumstances:

    • infection in the womb in the mother;
    • difficult pregnancy;
    • prematurity;
    • low birth weight.

    All these factors lead to the fact that even during the laying in the baby’s body, failures occur, including in the cardiovascular system.

    Injuries during labor can also trigger the development of the disease, and this is due to neurovegetative ways. In such babies, additional pathologies are additionally detected:

    • psycho-vegetative;
    • motor development disorders;
    • neurological.

    If the child has prolonged blockades, but in a mild form, then treatment is not prescribed. But if there is pain and discomfort, they recommend:

    • treatment of the underlying ailment with antibiotics and hormonal drugs;
    • resuscitation methods are used for acute myocardial infarction and infectious endocarditis;
    • acute myocarditis is treated with antibiotics and glucocorticosteroids;
    • in the chronic form of heart failure, digitalis and diuretics are recommended.

    Some drugs that are prescribed for children to treat intra-atrial conduction disorders can block the conduction of impulses through the leg of His, so they are either completely canceled or the dosage reduced significantly.

    Correction methods and treatment: what and when to do

    nizkij uroven rabotosposobnosti - ECG retardation of atrial conduction treatment

    Adequate passage of the pulse while maintaining intervals and pauses corresponds to the systolic and diastolic phases of the cardiac cycle.

    Sometimes in one of the departments of the conductive system, the conductivity of an electrical signal (block) is slowed down. This process is called conduction disturbance. Pathophysiologically, blockade develops for two reasons: insufficient activity of nerve fibers and their low sensitivity to mediators.

    Two pathology options are distinguished:

    • Incomplete – the impulse passes from the right atrium to the left at a longer period of time.
    • Full – both cameras work independently of each other. Most often, the rhythm of the ventricles provides the sinus node, and the left atrium – ectopic foci.

    Violations are most often associated with an overdose of cardiac glycosides and other antiarrhythmic drugs. They also occur against the background of chronic coronary heart disease, cardiomyopathy, and rheumatic endocardial damage.

    High-degree intra-atrial blockades that cause symptoms of heart failure require the installation of a pacemaker (artificial pacemaker). The installation of electrodes in both atria allows you to synchronize the work of the myocardium.

    zabor krovi na analiz - ECG retardation of atrial conduction treatment

    Violation of the electrical impulse from the right atrium to the left is caused by various diffuse pathologies of the myocardium of rheumatic, coronary or unknown origin. Isolated intraatrial blockade does not cause hemodynamic disorders and clinical signs of heart failure, however, it can be the cause of the further occurrence of high-grade arrhythmias.

    The following sources of information were used to prepare the material.

    And the second approach to the treatment of this disease is surgical. It is a necessary measure in cases where the drug approach is already ineffective. This usually happens in the later stages of the disease.

    Frequent dizziness and fainting, conditions that threaten the patient’s life, are the basis for surgical intervention.

    The most popular and common operation to date is the installation of a small apparatus that can restore normal heart rhythm and accelerate cardiac conduction to optimal levels.

    – This is a violation of the electrical impulse from the atria to the ventricles through the atrioventricular node. AV blockade occurs in patients with coronary heart disease, acute myocardial infarction, rheumatic heart disease, with an overdose of cardiac glycosides, B-blockers, some antiarrhythmic drugs (quinidine, verapamil).

    There are 3 degrees of AV blockade: I and II degree – incomplete blockade, III degree – complete blockade.

    beremennaya zhenshchina na konsultacii u kardiologa - ECG retardation of atrial conduction treatment

    – It is characterized only by a slowdown in atrioventricular conduction.

    – extension of the PQ interval more than 0.20 s (due to the lengthening of the PQ segment).

    Auscultatory and on FKG – a presystolic gallop rhythm.

    Type I (Mobitz I).

    On the ECG, a gradual lengthening of the PQ interval followed by prolapse of the ventricular complex QRST (P wave preserved). QRST fall periods are called Samoilov-Wenckebach periods.

    Type II (Mobitz II)

    On the ECG, regular precipitation of individual ventricular complexes is not accompanied by a gradual lengthening of PQ (it often remains normal, less often somewhat elongated). The loss of ventricular complexes occurs with a certain frequency – 2: 1, 3: 2, 4: 3, etc. For example, an AV block of 3: 2 means that every 3 atrial P waves corresponds to 2 ventricular QRST complexes, i.e. every third ventricular complex falls out.

    III type of AV blockade of the II degree received the name of AV blockade of a high degree. At the same time, either every second or two or more consecutive ventricular complexes fall on the ECG (2: 1, 3: 1, 4: 1, etc.)

    – This is a complete AV block, characterized by a complete cessation of the impulse from the atria to the ventricles, as a result of which the atria and ventricles contract each in its own rhythm independently of each other. Atria contract under the influence of impulses from the sinus node, and ectopic centers of automatism of I or III order serve as a source of ventricular excitation. In this case, the ventricles contract regularly, but with a lower frequency than the atria (from 60 to 30 per min.).

    – complete dissociation of the atria and ventricles;

    – RR are the same, RR are the same, but larger than RR.

    sometimes the contraction of the atria and ventricles coincides, then on the ECG the P wave is superimposed on the QRS ventricular complex or on the T wave, deforming them. Auscultation is heard loud I tone – “cannon tone” Strazhesko.

    AV blockade of the II and III degree is often accompanied by severe hemodynamic disturbances due to a decrease in the minute volume of blood and hypoxia of the brain. Particularly dangerous are long periods of ventricular asystole, resulting from the transition of degree II AV blockade to complete blockade, when a new ectopic ventricular pacemaker, which is located below the level of the blockade, has not yet begun to function.

    Intraventricular blockade is caused by a slowdown or complete cessation of excitation along the branches or legs of the bundle of His.

    The signal initially occurs in the sinoatrial node, goes through the structures one at a time, leads to excitation of the atria, then the ventricles. The whole process is aimed at pushing blood from the heart into the aorta.

    Impulse delay can occur on any segment and cause a violation of the conduction of the heart.

    Causes

    The causes of impaired cardiac impulse are either very simple, or indicate a serious heart disease. It is necessary to clearly define what the process of deceleration means and what is the deceleration of conductivity.

    If periods of atrioventricular blockade of the first degree are visible on the ECG of the heart, then they speak of a slowdown in conduction.

    If the ECG shows a blockade of the second or third degree, then determine the violation of conduction of the heart, which, in turn, is partial or complete. The second option is much more dangerous and requires urgent medical intervention.

    Violation of the sinoatrial conduction of the heart is a condition when the impulses that appear in the sinus node do not completely reach the atria, which delays excitation. This situation is sometimes characteristic of a healthy person and does not require urgent treatment. But most often, heart block occurs on the background of organic heart diseases.

    The reasons for the violation may be:

    • NDC with a prevailing effect on the sinus node, which causes a slowdown in heart rhythm;
    • an increase in heart size in people who are actively involved in sports;
    • uncontrolled intake of glycosides used to treat arrhythmias;
    • congenital and acquired heart defects;

    With a partial violation, the signs are practically absent.

    Slowing of atrial conduction is not dangerous for human life, but can cause irregular heart function, which leads to very dangerous consequences.

    The causes of atrial conduction of the heart are:

    • glycoside intoxication;
    • rheumatism;
    • heart development disorders;
    • consistently high pressure.

    Signs of an acute manifestation of conduction slowdown do not appear until the electrocardiogram.

    In the chronic course of the disease, patients complain of shortness of breath and during movement and at rest, swelling of the legs, acrocyanosis of the skin, pain in the sternum and others.

    Violation of the conduction of the heart along the atrioventricular node of the first and second degree appears when the transmission of impulses from the atria to the ventricles is delayed.

    With blockade of the third degree, the ventricles contract regardless of the atria, since the impulses do not reach them at all. Thus, a condition dangerous to the body arises, and a sudden fatal outcome is possible.

    Causes of atrioventricular blockade:

    • pathologies of the heart congenital and acquired;
    • anemia;
    • myocardial inflammation;
    • toxic hormonal effects.

    The danger of the condition is that in the absence of treatment, an active development of the blockade is noted.

    Symptoms during the blockade of the first two degrees are not pronounced, especially if the pulse is within fifty-five beats per minute.

    The third degree is characterized by bradycardia of the heart (pulse rate within forty beats), weakness, short-term fainting. In this state, convulsions join.

    The patient needs urgent medical care, the absence of which entails a fatal outcome.

    Violation of the intraventricular conduction of the heart is a complete or partial blockade of the legs of the bundle of His. Distinguish violations of the contractility of the right or left ventricle.

    The causes of intraventricular conduction of the heart are as follows:

    • a hole between the atria;
    • myocardial proliferation;
    • ischemia;
    • myocardial infarction;
    • pulmonary diseases;
    • cardiosclerosis.

    An ordinary person may experience a partial blockade of the right leg of His, which is asymptomatic.

    A complete blockade is manifested by bradycardia, pain in the sternum, short-term loss of consciousness. With pressing pains in the chest, nausea, weakness, a cardiogram will show a complete blockade on the left, then you can diagnose a heart attack. Only a multiple cardiogram shows this for sure. With such indications, urgent inpatient treatment of the patient is required.

    Definition

    1. The non-cardiac group consists of the following subgroups:
    • neurogenic causes are characterized by impaired functioning of the nervous system;
    • hypoxic subgroup is associated with insufficient oxygen supply;
    • endocrine diseases can also cause the development of the disease.
    1. Organic, cardiac or cardiac causes are a change in the conduction system of the heart muscle. In most cases, such changes are reversible. Organic causes are manifested in myocarditis, coronary disease, cardiomyopathy, congenital malformations, after surgery.
    2. Medicinal causes result from an overdose of certain drugs and taking medications without a doctor’s prescription. The individual characteristics of the body, in which the intake of certain drugs is unacceptable, may also be unaccounted for. Disorders with medicinal causes can take a dangerous and serious form.
    3. Electrolyte disturbances.
    4. Toxic effects.
    • angina pectoris;
    • pulmonary artery thrombosis;
    • MES attack;
    • brain ischemia;
    • stroke;
    • sudden death.

    3 Classification

    Therapeutic measures

    If you follow simple preventive measures, you can protect your heart and reduce the likelihood of developing violations of its conduction. Prevention measures are as follows:

    • the regime of work and rest is strictly observed and violated only in exceptional cases;
    • a balanced and rich diet;
    • junk food is completely excluded from the diet;
    • lack of stress;
    • giving up tobacco and alcohol;
    • taking medications only on the advice of a doctor and under his supervision;
    • passing the diagnosis in a timely manner, without delay;
    • passing the full course of treatment prescribed by the doctor;
    • contact your cardiologist immediately if you notice unpleasant symptoms.

    Medicine is constantly evolving, and now there are methods for diagnosing and treating even such complex diseases as cardiac conduction disorders.

    An individual treatment is selected for each patient. All concomitant ailments, body characteristics, age, health status of the patient are taken into account. There are several stages of treatment, but the most popular medication. It helps to slow down the development of the disease if it was detected at an early stage.

    To adjust the patient’s condition, he is recommended a vitamin-mineral complex. Often in these cases, experts recommend “Preductal”. In order to prevent the transition of the disease into a more severe form, calcium antagonists, thrombolytics and anticoagulants are necessarily used. There are other, equally effective drugs that have helped more than one patient to stop the development of the disease:

    • magnesium and potassium preparations;
    • anti-ischemic agents;
    • adrenomimetics;
    • beta blockers.

    You will also need drugs that help improve blood flow in the brain. In addition, the patient needs to change his usual lifestyle, it is important to strictly follow a diet that will help lower blood cholesterol. Violation of atrial and intraventricular conduction is treated with glycosides.

    What is a violation of atrial conduction: electrophysiology

    An electrical impulse in the heart is produced by special pacemaker (P-cells) in the sinoatrial node, located at the site of the confluence of the vena cava into the right atrium. The signal is transmitted through T cells in the fibers of the Bachmann, Torel and Wenckebach bundles inside the atrial myocardium (first left, then right) to the atrioventricular node.

    The excitation spreads to the ventricular myocardium through the bundle of His and Purkinje fibers. Adequate passage of the pulse while maintaining intervals and pauses corresponds to the systolic and diastolic phases of the cardiac cycle. Conductivity disorders are processes that are characterized by a slowdown in the electrical signal (block) in one of the sections of the cardiac conduction system. Excitation of atrial cells is provided mainly by the functioning of the Bachmann bundle.

    Pathophysiologically, blockade develops due to insufficient activity of nerve fibers and their sensitivity to mediators. Two pathology options are distinguished:

    incomplete, in which each impulse passes from the right atrium to the left for a longer period of time;

  • full, which is characterized by the independent activity of both cameras. Most often, the ventricles contract with a rhythm drawn from the sinus node. The left atrium is excited with its automatism from ectopic foci.
  • The arising disorders are most often associated with an overdose of cardiac glycosides, other antiarrhythmic drugs, as well as against the background of chronic ischemic heart disease, cardiomyopathy, rheumatic endocardial damage. Pregnancy due to the level of estrogen and chorionic gonadopropin, increased sensitivity of adrenergic receptors, and fluid accumulation in the body is proaritis factor.

    How to heal

    In the first stage, treatment is not carried out. Starting from the second stage, patients are prescribed observation by a cardiologist. To cure serious stages, it is necessary to go to the hospital of the cardiology department.

    Those who have stage 3 are given surgery and stimulation of the natural signal transmission to the sinus node. During the operation, the surgeon will install a pacemaker, which is responsible for the timely supply of a signal.

    In certain situations, they resort to radiofrequency ablation. The device is inserted through a special fiber, as a result of which pathological nodes are destroyed. A spike of the pulse delay source occurs.

    70% of cases of exacerbation lead to the death of the patient due to lack of nutrients, supplemented by oxygen starvation of several areas of the brain.

    Such a blockade has a number of symptoms:

    • heart murmur;
    • dizziness that lasts a long time;
    • cardiogram is broken.

    To cure the first two stages, vitamins are used, for example: Product. Helps improve muscle nutrition. To combat the early stages, calcium channel blockers, anticoagulants and thrombolytics are used.

    It is possible to detect deceleration of conductivity only at the final stage. And to avoid risk, you need to visit a cardiologist twice a year, which is important for people at risk.

    Functionality of the heart

    Like any heart problem, slowing of atrial conduction requires attention

    To avoid serious health problems and sudden death, you should pay due attention to your body. To do this, just listen to yourself and seek the advice of a specialist if necessary

    For prevention, do not forget to visit a cardiologist 2 times a year. Such visits will help to identify the problem at an early stage and save a life.

    Wolf-Parkinson-White Syndrome WPW

    caused by the presence of additional abnormal ways of conducting an electrical impulse from the atria to the ventricles – the so-called Kent bundles, which can be located anywhere around the left or right atrioventricular ring. In this case, the impulse from the atria to the ventricles is carried out along the AV node and along the Kent bundle, which conducts the impulse much faster. The impulse travels through the ventricles in an unusual way, which causes deformation of the ventricular complex QRS and a violation of depolarization.

    – broadening and slight deformation of the QRS complex;

    -discordant complex of the QRS ST segment shift and polarity change T.

    Conducting arousal in the heart can be not only slowed down, but also accelerated. This is due to the functioning of additional pathways for conducting an impulse, for a given pathology of Kent bundles through an atrioventricular junction. As a result, excitation is transmitted to the ventricles much faster than normal, causing them to contract more often, and moreover, the impulses move in the opposite direction to the atria, provoking supraventricular tachycardia.

    On the ECG, the arrow indicates a characteristic symptom of ERW syndrome – the “delta” wave at the beginning of the ventricular complex

    ERW – a syndrome is a congenital disease, as normal additional pathways in the fetus are closed after 20 weeks of pregnancy. In the case of ERW syndrome, they remain functioning. The occurrence of this pathology can be affected by a genetic predisposition, negative factors acting on the fetus (radiation, drug use, alcohol, toxic drugs, pregnant women).

    The syndrome can manifest itself both in childhood and in adulthood, or it may not appear at all, and then it is diagnosed only by ECG. Signs of sinus tachycardia or atrial fibrillation are characteristic – increased heart rate of more than 200 per minute, chest pain, shortness of breath, feeling of lack of air. In very rare cases, it is possible to develop life-threatening arrhythmias – ventricular fibrillation.

    It is a peculiar form of ERW syndrome, only James’s bundles between the atria and the lower part of the atrioventricular node act as abnormal paths. Also an innate feature. If it is diagnosed only by ECG, not accompanied by symptoms, then they talk about the phenomenon of shortened PQ, and if accompanied by signs of tachycardia, then about the syndrome of shortened PQ. Differences between ERW and PQ syndromes in ECG signs.

    Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

    Detonic