Arrhythmia

In a healthy heart, electric signals are first emitted automatically and rhythmically from the sinoatrial node, a born pacemaker located in the upper part of the right atrium, to the atrioventricular node, and then to the left and right bundle branches via His bundles, and finally to Purkinje fibers, where the entire heart is stimulated and the systolic and diastolic movements of the cardiac muscles pump the blood to flow throughout the body. Under normal circumstances, the heart beats once after every impulse the sinoatrial node emits. The normal variation in rhythm at a rate of 60 to 100 beats per minute is known as "sinus rhythm". If there is a problem in generating and conducting electrical signals, the heart will beat too fast, too slow, or irregularly. This is known as arrhythmia, or abnormality in the cardiac frequency and rhythm.

症状表现

Mild sinus bradycardia, sinus arrhythmia, occasional premature atrial contraction, and first-degree atrioventricular block have little hemodynamic impacts and thus have no obvious clinical manifestations. However, severe arrhythmias, like sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, may cause palpitation, chest tightness, dizziness, hypotension, sweating, as well as syncope, Adame-Strokes syndrome and even sudden death in severe cases.

疾病危害

During an arrhythmia, the rhythm change of the atrial and ventricular contraction may decrease the blood pumped by the heart, resulting in ischemia and hypoxia in the brain and other body parts, causing palpitation and chest tightness, fatigue, and other symptoms in patients.

Patients with severe arrhythmia may show symptoms of syncope and convulsion, which can also be called Adame-Strokes syndrome. During the sudden onset of the syndrome, severe and fatal chronic arrhythmias (such as sinus arrest, third-degree atrioventricular block) and tachyarrhythmias (including ventricular tachycardia, ventricular flutter, and ventricular fibrillation) decrease the blood pumped by the heart within a short time. Thus, the patients may be attacked by transient cerebral ischemia and even sudden cardiac death in severe cases.

AF increases the risk of stroke by five times and the mortality rate by two times.

诱发原因

Physiological causes: psychentonia, severe emotional fluctuations, impotence, excessive strong tea or coffee intake, alcoholism, and heavy smoking.

Cardiac causes: most arrhythmias are caused by the lesion of the cardiac conduction system; arrhythmias can also be secondary to many organic cardiac diseases, including hypertension, coronary heart disease, acute myocardial infarction, cardiomyopathy, myocarditis, rheumatic heart disease, and cardiac failure.

Other causes: water, electrolyte, and acid-base disturbances and systemic diseases, such as endocrine diseases, nervous system diseases, metabolic diseases, and injuries.

应对策略

Non-drug therapies: the therapy of reflexive excitation on vagus nerves through eye massage, carotid sinus massage, forced exhalation, and breath-holding with nose pinching; electric treatment therapy by electric cardioversion, defibrillation, pacemaker implantation, and ablation; surgical procedures.

Antiarrhythmic drugs.

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