Changes in the work of the atria cause malfunctions of the heartbeat and indicate physiological pathologies of the heart. The causes, symptoms and treatment of atrial fibrillation are interrelated concepts. In order to take adequate therapeutic measures, not only an analysis of the manifestations of the disease is necessary, but also the identification and elimination of the causes of its appearance.
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Atrial fibrillation - causes
The official medical name for atrial fibrillation is atrial fibrillation. Atrial pathology is called in connection with the characteristic trembling of the atria - their contractions are scattered and random.
During an attack of atrial fibrillation, the heart rate may increase to 600 beats per minute. Such rhythm disturbances reduce the effectiveness of atrial contractions - an irregular discharge of blood into the aorta provokes circulatory failure.
The duration of the attack increases the risk of blood clots, and can trigger a stroke.
In the absence of coordinated muscle work, the heart cannot provide the proper functionality, which contributes to the development of complications, and in a chronic course it often leads to death.
The main causes of atrial fibrillation are associated with the development of other cardiac pathologies:
- arterial hypertension;
- congenital and acquired defects;
- cardiomyopathies;
- heart failure;
- pericarditis and myocarditis;
- ischemia;
- myocardial infarction;
- tumor processes.
In 20% of cases, atrial idiopathic atrial fibrillation is diagnosed - that is, that occurs for no apparent reason. The pathogenesis of its development is still unknown to physicians.
Risk Factors for Atrial Fibrillation
According to experts, the number of confirmed diagnoses of atrial fibrillation is proportional to the age category of patients. The older the patient, the greater the likelihood that he will have problems with heart muscle contraction.
The most likely risk factors for the development of the disease are:
- age. Over time, certain changes occur in the atria that affect their structure and electrical processes;
- organic cardiac pathology. Along with dysfunctions of the heart, the rhythm of the heartbeat is affected by organ operations previously carried out by the patient;
- chronic diseases - anemia, diabetes, obesity, thyroid dysfunction, chronic kidney disease;
- electric shock;
- genetic predisposition;
- HIV infection;
- overeating;
- drinking strong coffee or alcohol.
Arrhythmia is often observed against the background of nervous shocks and great physical exertion or a lack of potassium in the body. Short attacks of atrial fibrillation are possible with various types of intoxication of the body - alcohol poisoning, abuse of cardiotonic drugs or adrenostimulants.
The role of the nervous system in the appearance of fibrillation
Most manifestations of atrial fibrillation correlate with a certain type of pathology, which, in turn, is determined by the action of the parasympathetic or sympathetic part of the nervous system.
Characteristics of the vagal type of fibrillation that occurs under the influence of the parasympathetic system:
- observed only in men;
- seizures occur during meals or sleep;
- do not occur during emotional or physical exertion.
The hyperadrenergic type of arrhythmia is the result of the action of the sympathetic nervous system. It is observed only in women. Characteristic manifestations of this type occur in the morning or evening, especially after emotional or physical exertion.
Atrial fibrillation
Determining the form of atrial fibrillation depends on the nature of its course and manifestations, as well as the specifics of electrophysiological mechanisms in the body.
The main forms of pathology:
- primary manifestation. All subsequent seizures are classified as relapse;
- paroxysmal. It manifests itself in attacks of short duration - from a minute to several hours. Passes independently, without medical intervention. May occur once or periodically;
- persistent - seizures can last for days or even months. Without special treatment with antiarrhythmic drugs, the heart rhythm cannot be restored;
- chronic (constant) - seizures lasting up to three weeks. Restoring heart rate is either impossible or considered inappropriate.
Depending on the heart rate with a constant form of atrial fibrillation, the following types of the disease are distinguished - tachysystolic (pulse of 90 or more beats per minute), normosystolic (60-90 y / m), brady systolic (60 or less y / m).
Types of Atrial Contraction
Violation of the rhythm of contractions is of two types - flicker and flutter. The flickering process is characterized by the reduction of certain sections of muscle tissue, as well as the accumulation of electrical impulses in the area of the atrioventricular junction.The coordination of contractions is absent, since electrical impulses are distributed unevenly and are not carried out in full.
Atrial flutter is expressed in an increased rhythm of fibrillation up to 400 times per minute. At the same time, the coordination of contractions is preserved, since the conductivity and sequence of the arrival of electric pulses is not violated.
If the ripple is less than 40 beats per minute, fainting is possible because the brain is disturbed. In such cases, you must call a doctor as soon as possible.
Symptoms and diagnosis of atrial fibrillation
Signs of atrial fibrillation correlate with the form of the disease, the state of the departments of the heart and the mental characteristics of the patient. Analysis of the severity of symptoms plays a large role in the diagnosis.
The most common clinical signs of fibrillation are:
- heart palpitations;
- increased sweating;
- aching or tingling chest pains;
- muscle weakness;
- excessive urination;
- dizziness, fainting;
- dyspnea.
Reduced blood ejection negatively affects the work of all body systems. When sinus rhythm is restored, the listed symptoms usually disappear.
In some cases, atrial fibrillation is asymptomatic and is detected only during a planned ECG.
Methods for diagnosing fibrillation
The collection of an anamnesis for the diagnosis involves the analysis of the patient's characteristic complaints, finding out the date of the first recorded attack, possible causes and factors that provoked arrhythmia, the presence of a genetic predisposition and chronic diseases.
This necessarily takes into account the age, weight and level of mental stability of the patient, the presence of bad habits and lifestyle. During the examination, the cardiologist determines the rhythm of the pulse, its filling and tension, and also listens to the rhythm of heart tones by auscultation.
Often, thanks to the information collected and the physical examination, it is possible to diagnose the pathology already during the first appointment with the doctor.
However, the standard diagnostic procedure involves the following measures:
- ECG. The presence of arrhythmias is indicated by the absence of P waves, which reflect atrial contractions. Irregularity of the normal contraction of the ventricles is expressed in the cardiogram by the uneven distance between the R waves. The presence of waves of fibrillation confirms the diagnosis. To clarify the form of pathology, daily ECG monitoring is used;
- echocardiography allows you to establish the physiological parameters of the heart and identify organic pathologies;
- tomographic methods of MRI and MSCT are used to detail the heart and identify defects in its structure;
- transesophageal electrocardiography - a method for detecting the electrical activity of the atria and ventricles, conduction disturbances.
Additional cardiodiagnostic methods include clinical and biochemical analysis of blood, determination of the level of hormones produced by the thyroid gland, blood test for cholesterol, physical exercise tests, ultrasound of the thyroid gland.
Atrial fibrillation treatment
When choosing treatment tactics, cardiologists focus on the form of the disease, restoration and support of the natural level of sinus rhythm, as well as prevention of recurrence of arrhythmia. An additional therapeutic goal of therapy is the prevention of thromboembolism.
An important component of treatment is the elimination of the underlying cause of atrial fibrillation.
Drug treatment
The most effective drugs for atrial fibrillation:
- beta blockers that reduce the frequency of atrial contractions;
- anticoagulants - means that prevent the occurrence of blood clots and the development of a stroke;
- blood thinners;
- agents that control heart rate stability.
The choice of medications is carried out taking into account contraindications.In addition, some drugs lose their effectiveness after prolonged use. Therefore, drug treatment should be carried out under the supervision of the attending physician.
To stop the attack of atrial fibrillation at home, intravenous injections of novocainamide, and oral administration of quinidine, amiodarone and propaphenone are used.
If it was not possible to restore the sinus rhythm with the help of medications, electro-pulse therapy using a defibrillator is used.
Folk remedies and methods
Traditional medicine involves the use of plant materials that strengthen the heart muscle, cleanse blood vessels and restore normal sinus rhythm.
Among the most effective decoctions are tea from yarrow, viburnum or dill. The recommended dose is a few sips of the decoction before eating.
Atrial fibrillation surgery
If drug therapy did not bring the expected therapeutic result, doctors insist on the use of surgery.
The following surgical methods are relevant:
- catheter ablation. The therapeutic measure ensures the neutralization of cardiac cells, which provoke the development of atrial fibrillation. Separation of fused fibers in problem areas is carried out using a laser beam. Alternative methods are tissue freezing, exposure to electricity or chemicals. It is considered a minimally invasive procedure;
- implantation of a pacemaker allows you to maintain a normal level of atrial contractions. A pacemaker delivers pulses and controls the frequency of contractions. Belongs to less traumatic operations.
Surgical intervention significantly improves the quality of life of the patient, but does not guarantee complete recovery.
Rehabilitation of the patient after treatment
In the postoperative period, patients are prescribed beta-blockers, antiarrhythmic drugs and anticoagulants, as well as drugs that provide a preventive effect.
The patient's diet involves the rejection of salt, caffeinated drinks and alcohol, as well as a restriction in the use of animal fats.
The duration of the rehabilitation period is about three months.
Possible complications and prognosis
Regardless of the form of the disease, the quality of life of patients with atrial fibrillation is significantly impaired.
The lack of regular blood flow to the aorta leads to congestion in the atria and causes life-threatening conditions - blood clots in the heart, chronic heart failure, cerebral infarction, embolic stroke.
The prognosis of atrial fibrillation depends on the degree of complexity of the pathology and the age of the patient. The risk of stroke, as well as the risk of death, is highest in the elderly and patients with cardiac pathologies.
Atrial fibrillation prevention
Drug exposure is also appropriate as a prophylactic that prevents a possible recurrence of atrial fibrillation.
Regular monitoring of the heart rate and the frequency of ventricular contractions allows you to notice the signs of an impending attack in time and eliminate its cause. Patients over 65 years of age are advised to periodically take blood thinners and blood clots.
Preventive measures will be more effective if you follow the daily regimen, avoid excessive emotional and physical stress, give up alcohol and cigarettes, and take care of a healthy diet.
