Parasistolia: treatment and diagnosis
Parasistolia is arrhythmia of the heart muscle, the myocardium which in addition to the sinus node, there is another (in some cases, there may be several) is a competing site, producing their own electrical impulses.
Parasistolia most often seen in people suffering from diseases of heart, blood, nervous and endocrine systems. Much less frequently it occurs in perfectly healthy people and even athletes.
About the mechanisms of development
The frequency of the normal operating rhythm of the heart muscle responds to the sinoatrial node - a bundle of cardiac-muscle tissue located in the wall of the right atrium.
Not being constant, your heart rate changes depending on the needs of the body: the signals governing the work of the sinus node comes from the autonomic nervous system and internal organs, secreting into the blood a specific substance.
If the body is under increased stress, the sinus node receives a command to produce a greater number of pulses during one minute; during the holidays the intensity of its work is reduced. In case of any failure to normalize the sinus node is possible by means of a number of medicines, for which he is extremely sensitive.
All of the above sign rule.
What is parasistolia? This condition is due to the presence of heart muscle secondary source of electrical impulses working at their own pace and do not obey neither the signals of the brain, nor the action of hormones in the blood and medicines.
In the result, the heart muscle begins to shrink under the influence of impulses received from the sinoatrial, node of competitive, subject to that site which had the first signal. This phenomenon, known as double remoortere, accompanied by either tachycardia (rapid heartbeat) or arrhythmia (a type of arrhythmia).
If the pulses of the competing sites come into the heart muscle, in turn, a person experiencing arrhythmia, which is manifested in "stops", "tumbling", "tremors", "interruptions", "the revolutions of the heart.
Daily ECG monitoring showed that the heart muscle of the patient during the day makes more than 30 000 "unplanned" cuts.
Parasistolia often remains unrecognized.
The patient with double ritmosonlatino can be delivered to the wrong diagnosis of premature beats on the type bigeminy (a condition in which the initiator of each of the second contraction of the cardiac muscle is part of parasistolia) or trigeminy ("unplanned"is every third reduction).
Misdiagnosis entails equally incorrect treatment that attempts to heal the patient from non-existent to him arrythmia unsuccessful, although a few facilitate portability of arrhythmia.
What exactly are the differences between parasistolia and arrythmia?
- If additional unplanned impulse comes from any one zone, the interval between the beat and the normal contraction of the heart (the so-called coupling interval) is equal to one and the same time. This type of abnormal heartbeat is characteristic of extrasystole.
- If extraordinary sources of pulses are two (or more) plot of the conduction system of the heart muscle, the duration of time the clutch will be irregular and unstable. This pattern is characteristic of parasistolia.
However, arrythmia, and parasistolia are variations of the same pathology: this explains the similarity of symptoms, causes, treatments and prevention.
The causes of
Factors that contribute to the development of parasistolia can be cardiac and noncardiac.
Cardiac causes include the presence of:
- coronary heart disease;
- cardiomyopathy (a disease resulting in the transformation of the structure and functioning of the heart muscle);
- inflammation of the heart muscle;
- heart failure;
- myocardial infarction (disease, leading to the deaths of a significant number of contractile cells of the heart muscle);
- of mitral valve prolapse (abnormal sagging flaps of this valve at the moment of contraction of the ventricle).
Parasistolia caused by extracardiac factors, can develop a fault:
- hormonal disorders;
- the increased sugar level in the blood;
- thyroid disease (hyperthyroidism and hypothyroidism, characterized by insufficient or excessive production of hormones);
- malfunction of the autonomic nervous system;
- diseases of the adrenal glands;
- changes in the electrolytic composition of the blood;
- overdose of some drugs (mostly those which stimulate heart activity).
Parasistolia, the causes of sudden onset of where to install and failed, is called idiopathic.
Depending on localization, an additional source of electrical pulsesparasistolia are divided into:
- ventricular (ventricular parasistolia is characterized by the fact that the competitive node is localized in one of the ventricles of the heart);
- atrial (pacemaker located in the atrium);
- combined (pockets additional pulses located in different parts of the heart muscle);
- multiple (multiple competitive nodes is concentrated in one chamber of the heart muscle);
- illness that originates from the atrioventricular node.
Parasistolia can manifest itself:
- sudden bouts of palpitations;
- sensations of turning, tremors and short-term paralysis of the heart muscle;
- impotence, fatigue, decreased performance, persistent vertigo;
- pain in heart accompanied by a sense of fear;
- pre-existing conditions, accompanied by bouts of palpitations and cough movements.
The main electrocardiographic signs of parasistolia characterized by:
- full magnification megascopically long intervals;
- frequency parasitol constituting from 25 to 65 beats per minute;
- a violation of the regularity of the sinus rhythm due to the lack of connection with Parasitology;
- instability intervals of coupling;
- the presence of the drain ventricular complexes (when the coincidence of sinus and parametricheskoe complexes).
A number of patients the disease has almost no clinical manifestations. To identify it is by accident, when removing ECG.
Diagnosis of parasistolia exercise methods:
- The collection and analysis of medical history. Interviewing the patient, the specialist collects information about the presence of complaints (when there was a sense of disruption of heart rhythm, dizziness, fatigue, heart pain and bouts of a rapid heartbeat); analyze family history (information about the presence of close relatives suffering from cardiovascular diseases) and the anamnesis of patient's life (is there a chronic disease, whether surgery, any medications).
- The physical examination. The doctor takes on the appearance and colour of the skin, hair and nail beds, respiratory rate, heart murmurs and the presence of rales in the lungs.
- Laboratory tests. The patient's blood taking for General and biochemical analysis, performing urine analysis.
- Establish a hormonal profile. Information about the number of thyroid hormones allows to exclude diseases of this organ,can cause of parasistolia.
- Daily monitoring of ECG by the Holter. For 1-3 days, perform ECG recording. In case of parasistolia ECG with this entry, set its character and place of localization of the additional pulses.
- Echocardiography, which allows to detect pathological changes in partitions, valves and the walls of the heart muscle.
- Treadmill test or veloergometry: test conducted by using a special treadmill or exercise bike. Applying gradually increasing physical activity, detect the presence of ischemia of the heart muscle that trigger the development of parasistolia. Along the way, find out the nature of the change of parasistolia as the load changes.
- Magnetic resonance imaging of the heart muscle. The indication for this procedure, which allows to obtain three-dimensional image of the heart muscle is ventricular parasistolia.
- Electrophysiological studies, including the introduction of a thin probe into the heart muscle (via the femoral vein). With this highly informative method it is possible to ascertain the nature of the cardiac arrhythmia and localization of paracentre.
Methods of treatment
Treatment of parasistolia can be carried out by the methods of pharmacological, non-pharmacological and surgical therapy.
Boils down to:
- The rejection of alcohol and Smoking.
- Compliance with proper sleep.
- The revision of the diet and include foods that contain huge amounts of dietary fiber (fruits, greens, vegetables, non-fatty and spicy dishes.
Is the appointment and acceptance:
- metabolicos (medicines that help improve the metabolism);
- beta-blockers (medications that reduce the strength and frequency of heart rate, depress cardiac conduction);
- drugs of omega-3 fatty acids;
- antiarrhythmic medications prevents the development of arrhythmia.
Surgical intervention in parasistolia is radiofrequency ablation of the source of additional pulses. Method of operation is as follows: to the heart muscle through the vessel on her hip down a thin tube (conductor).
After the filing of the RF pulse passing through a conductor, there is a destruction of the detected paracentre.
Possible consequences and complications
The effects of parasistolia (as a rule, they arise against diseases of the heart muscle and its blood vascular) often associated with very serious complications:
- fibrillation (irregular contractions) ventricular failure is a very dangerous heart rhythm, which in 80% of cases leads to death;
- heart failure (cause of violations is a significant decrease in the contractility of the heart muscle).
Prevention of the disease
To prevent the occurrence of parasistolia, the patient must:
- to avoid any emotional turmoil;
- a good night's sleep;
- give up bad habits;
- to eat right;
- to control body weight;
- lead an active lifestyle, with exercise at least half an hour a day.