The causes of idioventricular heart rhythm, diagnosis, treatment

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2017.06.11
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Arrhythmia

Ectopic rhythm, produced in the ventricles of the heart, is called idioventricular. The peculiarity is that the ventricles contract slowly (about 40 bpm). As a rule, there is an idioventricular rhythm due to impaired automatism or disorders of the autonomic nervous system.

Patients are diagnosed with idioventricular rhythm due to a violation of the heart's automaticity and myocardial excitability

Content

  • What is an idioventricular rhythm?
  • Causes
  • Diagnostics
  • Treatment and prognosis
    • Forecast

What is an idioventricular rhythm?

A healthy person has only one way of transmitting nerve impulses to a consistent reduction. The beginning of the path is in the right atrial appendage - where the sinus node is located, and continues to the AV node. Passing through the bundle of His and the fibers of Purkinje, the nerve impulse reaches the fibers of the ventricles.

For some reason, the sinus node loses its ability to generate excitations for contraction. In such cases, the excitatory process in the heart changes. To support the activity of the heart, compensatory ectopic rhythms develop. In the translation, the word "ectopia" means that something arose not in the place where it should have been.

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Important!The source of ectopic rhythms can be located in the atria, in the AV-connection or in the ventricles.

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Causes

Ectopic rhythms are formed due to the incapacity of the sinus node, which is inhibited by various diseases:

  1. Inflammation of the myocardium, which can also capture the sinus node. This leads to the fact that the driver of the rhythm of the 1st order becomes incapable of regulating cardiac activity in the ventricles. At the same time, the atria rapidly contract, the impulses reach the AV node at an unusual frequency.
  2. Ischemia. Violation of the functions of the sinus node may be due to myocardial ischemia, leading to oxygen starvation of the heart muscle fibers.
  3. Cardiosclerosis. Transmission impulses to contraction can be blocked by replacing muscle fibers with cicatricial structures due to myocarditis or myocardial infarction.

In addition to pathological changes in the heart and coronary vessels, idioventicular rhythm can develop due to a violation of hormonal balance, adrenal and thyroid gland functions.

Diagnostics

The most effective method of diagnosing heart rhythm is an electrocardiogram. If an idioventricular rhythm appears on the ECG, the doctor will prescribe additional examinations, including echocardiography and day-to-day Holter monitoring.

According to ECG indications, ectopic arrhythmia is distinguished by the following features:

  1. Atrial arrhythmia have negative, high-amplitude teeth P. In right atrial - in additional V1-V4, with left atrial - in V5-V6 lead. They can go in front of the complex or superimpose on the QRST complex.
  2. If the ectopia is in the AV node, then the P tooth is negative, follows the QRST complex or is superimposed on it.
  3. With idioventricular rhythm, the heart rate is low, while the QRST complex is enlarged and deformed, and the P tooth is not fixed.
  4. Atrial extrasystole is characterized by unchanged QRST complex, which manifests itself prematurely.
  5. With paroxysmal tachycardia rhythm is regular, with the heart rate reaching up to 100-150 beats per minute. Determination of P teeth is difficult.
  6. Atrial fibrillation is irregular. On the ECG, this is manifested by the absence of P tooth and characteristic flickering f-waves (waves of flutter F).

Read and decode ECG readings can only be a qualified specialist.

Treatment and prognosis

Treatment of the disturbed rhythm in the patient is carried out only with the manifestation of signs of the underlying disease and apparent discomfort

Important!At an ectopic arrhythmia the patient sometimes does not feel a dyscomfort, thus there can be no pathological changes of nervous system. In such cases, treatment is not carried out.

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In cases where the patient has a moderate extrasystole, he is prescribed sedatives and adaptogens for general strengthening of the heart muscle.

In the presence of bradycardia and atrial rhythm, doctors prescribe atropine, eleutherococcus or tincture of ginseng. If the low heart rate is complicated by attacks of MES, then the pacemaker is implanted. The artificial agent of contractions of the cardiac muscle allows to restore the activity of the myocardium and to extinguish the ectopic foci of excitation.

In the presence of a rapid ectopic rhythm, for example, paroxysmal tachycardia or atrial flutter, the patient is required to provide emergency care. For this, 4% potassium chloride solution or 10% solution of novocainamide is administered intravenously. Follow-up therapy consists of taking beta-blockers or anti-arrhythmic drugs.

Both these and other groups of medicines aimed at restoring cardiac activity should be taken simultaneously with the treatment of the underlying disease.

Forecast

The final forecast is given by the attending physician, assessing the cause of the occurrence of ectopic foci and the nature of pathologies. For example, if an atrial source of contractions was detected on the ECG, and no other pathologies were detected, the overall prognosis is favorable. If paroxysmal tachycardia developed against a background of acute myocardial infarction, then the prognosis is quite unfavorable.

In any case, the situation can be improved if you seek medical help in time. If all recommendations and assignments are followed, the forecast can be improved. In some cases, to maintain quality of life at a normal level, life-long use of drugs.

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