What causes atrial fibrillation. Atrial fibrillation

Atrial fibrillation is not so much a diagnosis as a pathological condition in which a rhythm disturbance predominates, caused by erratic contraction of certain groups of atrial muscle fibers. If we talk about the pathogenesis of this disease, then the basis of atrial fibrillation is considered to be numerous small circles of impulse movement in the atrial myocardium.

In modern medical practice, paroxysmal and persistent flicker are distinguished, where in the latter case the pathological process is preceded by paroxysms that prevail with variable regularity. Each form of the disease has its own specifics and symptoms. So, in the case of paroxysmal fibrillation, the heart rate is 350-600 beats per minute, and if this condition prevails for more than 48 hours, then cardiac ischemia develops and pathogenic blood clots form.

On average, paroxysms can progress several times a day, preceded by increased physical activity, elevated ambient temperatures, emotional stress, alcohol, fluid accumulation in the body and digestive disorders.

But persistent atrial fibrillation is a manifestation of such chronic diseases heart disease, such as atherosclerotic cardiosclerosis, mitral heart defects, alcohol poisoning, myocarditis, myocardial infarction, branch thromboembolism pulmonary artery, arterial hypertension, constrictive pericarditis and other cardiac pathologies vascular system. In these clinical pictures, paroxysms are represented by a rare ventricular rhythm.

This disease, in the absence of timely therapeutic measures, contributes to the prevalence of heart failure, deterioration of general blood flow, thromboembolic complications and the pathogenic formation of thrombosis. Therefore, it is important to know not only the symptoms, but also the causes of atrial fibrillation.

Thus, the etiology of the pathological process is represented by hypertension, heart failure, ischemic heart disease, myocardial infarction, infectious lesion heart, as well as myocardial defects, both acquired and congenital. So it is quite obvious that atrial fibrillation predominates against the background of an underlying disease of the cardiovascular system, which occurs in a chronic form.

However, quite often this pathology develops against the background of surgical interventions, severe emotional shock, stroke, or taking certain medications. The so-called “risk group” also includes patients suffering from diabetes, especially if this disease is accompanied by obesity at one of the existing stages.

Statistics show that men are susceptible to this heart disease much more often than women, and in this clinical picture the risk of unexpected death is especially dangerous.

Symptoms

It is very difficult to determine the symptoms of this disease, since in each clinical picture it is preceded by a different pathogenic factor. So in modern cardiology, symptoms depend on the form of atrial fibrillation, the state of the heart muscle, the characteristics of mental and physical condition specific patient.

Typically, atrial fibrillation early stage is represented by paroxysmal progression of paroxysms, where after two relapses the disease tends to become chronic. However, in most cases, the typical patient clearly observes increased sweating, trembling in the limbs, general weakness, panic, dizziness, and less often, fainting.

As a rule, the above symptoms disappear immediately after normalization of the sinus heart rate. If the body is dominated by permanent form atrial fibrillation, then over time patients stop responding to all its alarming symptoms. But compression of the sternum and shortness of breath remind themselves more and more often, so if such discomfort occurs, it is important to urgently seek help from a doctor.

Diagnostics

It is not possible to determine this disease without a clinical examination, therefore, to identify atrial fibrillation, it is extremely important to perform an ECG, ultrasound of the heart muscle, x-ray of the sternum, Holter monitoring, and also pass the required blood tests.

The main diagnosis is an ECG, which reliably determines an abnormal heart rhythm and all existing cardiac anomalies. Daily monitoring monitors heart rate in different times days to determine the interval of paroxysms. Ultrasound determines the size of the heart chambers, the condition of its valves and contractility. If these examination methods are not enough, then it would also not hurt to take a chest x-ray.

As for laboratory tests, a blood test determines electrolyte deficiency, signs of myocarditis and problems in the functioning of the endocrine system, if any, of course, exist.

Prevention

There is no need to talk about reliable prevention measures in this clinical picture, since all diseases that cause atrial fibrillation occur in the body in a chronic form. That is why it is very difficult to protect yourself from such a diagnosis.

However, the task of each patient is to strictly monitor the underlying heart disease, avoiding its relapses and exacerbations, and in the remission stage the patient’s condition does not cause any special concern on the part of a qualified cardiologist.

Treatment

In most clinical pictures of atrial fibrillation, doctors choose conservative treatment, since heart surgery, even with favorable clinical outcome cause health complications. The goal of drug therapy is to restore and maintain sinus rhythm at an acceptable level, as well as to avoid repeated relapses of atrial fibrillation. In addition, special control of the rhythm frequency and prevention of thrombosis formation prevail.

So, first of all, the patient must know how to quickly eliminate chest pain. For this, doctors recommend oral or intravenous administration of cordarone or novocainomide, quinidine or propanorm. However, these are quite strong medications that are not necessary to take at the early stage of atrial fibrillation. That is why it is advisable to replace them with gentler medications such as digoxin, anaprilin and verapamil.

To avoid the formation of thrombosis, Warfarin is indicated two days after persistent pain, and Cordarone Sotalex or Propanorm is recommended as restorative therapy.

If the disease predominates in an acute form, then electrical cardioversion, that is, the direct effect of an electrical discharge on the myocardial area to immediately restore the heart rhythm, can improve the patient’s well-being.

If the disease predominates in a chronic form, then in this clinical picture the patient has to take drugs from pharmacological group adrenergic blockers, that is, atenolol, egilok, concor. Also appropriate indoor application digoxin, calcium antagonists and warfarin. Of course, there is no particular opportunity to completely cure the disease, but to alleviate net worth every patient can.

The human heart creates and conducts electrical impulses through a special system. Normally, the organ contracts 60-80 times per minute with approximately the same frequency. Some diseases of the heart and other body systems lead to conduction and rhythm disturbances, resulting in asynchronous contractions of the myocardium. A disease that leads to such pathological changes, is called arrhythmia. There are many types of arrhythmias, some of which are quite life-threatening. Atrial fibrillation heart disease, or atrial fibrillation, is a serious cardiac disorder that requires urgent diagnostics and treatment.

What is atrial fibrillation

Atrial fibrillation is translated from Latin as “madness of the heart.” The term “atrial fibrillation” is a synonym, and the definition of the disease is as follows: atrial fibrillation is a type of supraventricular tachycardia, characterized by chaotic activity of the atria with their contraction at a frequency of 350-700 per minute. This heart rhythm disorder is quite common and can be observed at any age - in children, the elderly, middle-aged men and women. young. Up to 30% of cases need for emergency care and hospitalization for rhythm disturbances is associated precisely with the consequences of atrial fibrillation. With age, the frequency of the disease increases: if up to 60 years of age it is observed in 1% of patients, then later the disease is registered in 6-10% of people.

With atrial fibrillation, contraction of the atria occurs in the form of their twitching, the atria seem to flutter, flickering ripples run through them, while individual groups of fibers work uncoordinated in relation to each other. The disease leads to a natural disruption of the activity of the right and left ventricles, which cannot throw a sufficient amount of blood into the aorta. Therefore, with atrial fibrillation, the patient often exhibits a pulse deficiency in large vessels and irregular heart rate. The final diagnosis can be made by ECG, which reflects the pathological electrical activity of the atria, and also reveals the random, inadequate nature of cardiac cycles.

The pathogenesis of the disease, that is, the mechanism of its development is as follows. The pathology is based on the re-entry of excitation into the heart muscle, with the primary and re-entry occurring through different pathways. Atrial fibrillation is caused by the circulation of excitation in the region of Purkinje fibers, and atrial flutter is caused by the circulation of impulses along the conduction pathways. For a repeated impulse to take place, there must be a zone with impaired conduction in the myocardium. The initiation of fibrillation occurs after the occurrence of atrial extrasystole, when it appears after normal atrial contraction, but not in all fibers. Due to the peculiarities of the functioning of the atrioventricular node, irregular functioning of the ventricles is also observed in atrial fibrillation. Weak impulses in the AV node fade as they move along it, and therefore only the strongest impulses coming from the atria enter the ventricles. As a result, ventricular contraction does not occur fully, and various complications of atrial fibrillation arise.

What is the danger of the disease

Because patients with atrial fibrillation have insufficient cardiac output, this can cause heart failure over time. As the arrhythmia continues, chronic circulatory failure progresses and can become acute. Heart failure occurs especially often in individuals with hypertrophic cardiomyopathy and heart defects, in particular mitral stenosis. It is very severe and can be accompanied by pulmonary edema, cardiac asthma, sudden cardiac arrest and death. Death It can also occur against the background of an arrhythmogenic form of cardiogenic shock due to a serious drop in cardiac output.

Against the background of asynchronous contraction of the atria, blood can stagnate, which creates serious preconditions for thrombus formation. Typically, blood clots form in the left atrium, from where they easily enter the cerebral vessels and provoke an ischemic stroke. If atrial fibrillation cannot be stopped early, the risk of stroke is up to 6% per year. Such strokes are a very serious disease and cause serious consequences in future. Acute thrombosis cerebral vessels can develop during prolonged paroxysm of arrhythmia (over 2 days), if it is not possible to relieve the attack in time.

Risk factors for development severe complications atrial fibrillation - the patient has diabetes mellitus, age over 70 years, previous pulmonary embolism or thromboembolism of other localizations, severe arterial hypertension, congestive heart failure.

Types of atrial fibrillation

There are several classifications of atrial fibrillation that are used in modern cardiology. According to the nature of the course, arrhythmia can be:

chronic (constant or permanent form) - continues until surgical treatment and is determined by the ineffectiveness of electrical cardioversion;
persistent - lasts more than 7 days;
transient (form with attacks of paroxysm) - the development of the disease occurs within 1-6 days, while the attack of paroxysmal atrial fibrillation can be primary and recurrent.

Based on the type of atrial rhythm disturbance, the disease is divided into two forms:

Atrial fibrillation, or atrial fibrillation. This pathology is caused by contraction of individual groups of myocardial fibers so that there is no overall coordinated contraction of the entire atrium. Some of the impulses are delayed in the atrioventricular junction, the other part passes into the cardiac muscle of the ventricles, forcing them to also contract with an irregular rhythm. Paroxysm of atrial fibrillation leads to ineffective contraction of the atria, the ventricles fill with blood in diastole, so normal discharge of blood into the aorta does not occur. Frequent atrial fibrillation causes high risk development of ventricular fibrillation - essentially cardiac arrest.
Atrial flutter. It is an increase in heart rate up to 400 beats per minute, at which the atria contract correctly, maintaining a correct, coordinated rhythm. There is no diastolic rest during flutter, the atria contract almost continuously. The flow of blood into the ventricles is sharply reduced, and the release of blood into the aorta is disrupted.

Forms of atrial fibrillation, which are differentiated by the frequency of ventricular contraction following malfunction the atria are:

tachysystolic form, or tachyform (ventricular contractions from 90 per minute);
normosystolic form (ventricular contractions 60-90 per minute);
bradysystolic form, or bradyform (ventricular contractions occur as a bradyarrhythmia - less than 60 per minute).

Atrial fibrillation can be assigned one of four classes according to the severity of its course:

first class - no symptoms;
second class - minor signs of the disease, no complications, vital functions are not impaired;
third class - lifestyle has been changed, pronounced symptoms of pathology are observed;
fourth class - severe arrhythmia causing disability, ordinary life becomes impossible.

Causes of arrhythmia

Not all causes of the disease are due to heart pathologies and other serious disorders. Up to 10% of all cases of atrial fibrillation in the form of paroxysmal attacks are caused by immediate causes, and the leading one concerns those people who prefer to drink alcohol in large quantities. Wine, strong alcohol, and coffee are drinks that disrupt the balance of electrolytes and metabolism, which entails a type of pathology - the so-called “holiday arrhythmia.”

In addition, atrial fibrillation often occurs after severe overexertion and against the background of chronic stress, after operations, a stroke, with too fatty, heavy meals and overeating at night, with prolonged constipation, insect bites, wearing too tight clothes, heavy and regular physical activity . Those who like to go on a diet, take diuretic drugs in excess quantity are also at risk of developing atrial fibrillation. In children and adolescents, the disease is often hidden, blurred and provoked by mitral valve prolapse or other birth defects hearts.

And yet, in most cases, atrial fibrillation is caused by cardiogenic causes and diseases of the vascular system. These include:

cardiosclerosis of various etiologies;
acute myocarditis;
myocardial dystrophy;
rheumatic heart disease;
valvular insufficiency (valvular defects);
cardiomyopathy;
sometimes - myocardial infarction;
arterial hypertension;
damage to the coronary arteries by atherosclerosis;
pericarditis;
lesions of the sinus node - the pacemaker;
heart failure;
heart tumors - angiosarcomas, myxomas.

Non-cardiac causes of atrial fibrillation and flutter can be:

thyrotoxicosis (hyperthyroidism);
pheochromocytoma;
other hormonal disorders;
poisoning, toxic substances, carbon monoxide and other poisonous gases;
overdose of drugs - antiarrhythmics, cardiac glycosides;
VSD (rare);
severe neuropsychic stress;
obstructive pulmonary diseases;
serious viral, bacterial infections;
electric shock.

Risk factors for the development of atrial fibrillation are obesity, diabetes, high blood pressure, chronic illness kidneys, especially when they are combined with each other. Often, under the guise of atrial fibrillation, another pathology appears - SSSU - sick sinus node syndrome, when it ceases to fully carry out its work. Up to 30% of people with atrial fibrillation and flutter have a family history of the disease, meaning it could theoretically be inherited. In some cases, the cause of the disease cannot be determined, so the arrhythmia is considered idiopathic.

Symptoms of manifestation

The initial stages of the disease often do not give any clinical picture. Sometimes some manifestations are observed after exercise, for example, when exercising physical exercise. Objective signs of atrial fibrillation, even at this stage, can only be detected during an examination. As the pathology progresses, characteristic symptoms appear, which will largely depend on the form of atrial fibrillation and whether the disease is constant or manifests itself in attacks.

The tachysystolic form of the disease is much worse tolerated by humans. Chronic course leads to the fact that a person adapts to living with arrhythmia and little notices its symptoms. Typically, the patient initially has paroxysmal forms of atrial fibrillation, and then its permanent form is established. Occasionally throughout life, as provoking factors influence, rare attacks of the disease may occur, and permanent illness it never installs.

Sensations during the development of arrhythmia may be as follows (the specific list of signs depends on individual characteristics organism and type of disease that caused flickering or fluttering):

feeling of lack of air;
heaviness, tingling in the heart;
sharp, chaotic twitching of the heart;
shiver;
weakness;
heavy sweating;
coldness of hands and feet;
strong fear, panic;
increased amount of urine;
disordered pulse, heart rate.

Paroxysm of atrial fibrillation can lead to dizziness, nausea, fainting and the occurrence of a Morgagni-Adams-Stokes attack, which is quickly relieved by taking antiarrhythmic drugs. When atrial fibrillation is complicated by heart failure, the patient develops swelling of the extremities, angina pain in the heart, decreased performance, shortness of breath, difficulty breathing, and enlarged liver. Due to the wear and tear of the myocardium, this development of events is natural, so it is important to start urgent treatment diseases as early as possible.

Carrying out diagnostics

Usually, an experienced cardiologist can make a presumptive diagnosis already during an external examination, counting the pulse, and auscultation of the heart. A differential diagnosis should be made at an early stage of the examination with frequent extrasystole. Characteristic signs atrial fibrillation are:

irregular pulse, which is much rarer than heart rate;
significant fluctuations in the volume of heart sounds;
moist rales in the lungs (with edema, congestive heart failure);
The tonometer reflects normal or decreased blood pressure during an attack.

Differential diagnosis with other types of arrhythmias is possible after an ECG examination. The interpretation of the cardiogram for atrial fibrillation is as follows: absence of the P wave, different distances between the complexes of ventricular contractions, small waves of fibrillation instead of normal contractions. With flutter, on the contrary, there are large waves of flutter and the same periodicity of ventricular complexes. Sometimes the ECG shows signs of myocardial ischemia, since the heart vessels cannot cope with its need for oxygen.

In addition to the standard 12-lead ECG, Holter monitoring is performed to more accurately formulate the diagnosis and to search for the paroxysmal form. It allows you to detect short atrial fibrillations or flutters that are not recorded on a simple ECG.

Other methods for diagnosing atrial fibrillation and its causes are:

Ultrasound of the heart with Doppler sonography. Necessary for identifying organic heart lesions, valvular disorders, and blood clots. More informative method diagnosis is transesophageal ultrasound.
Hormone tests thyroid gland. They are definitely recommended for use in cases of newly diagnosed atrial fibrillation, as well as in case of relapse of the disease after cardioversion.
Chest X-ray, MRI, CT. Necessary to exclude congestion in the lungs, search for blood clots, and assess the configuration of the heart.

First aid

Treatment methods for permanent and paroxysmal forms of the disease differ significantly. If an attack develops, emergency relief of paroxysms should be performed to restore heart rhythms. It is necessary to restore the heart rhythm as soon as possible from its onset, because any attack is potentially dangerous for the development of severe complications and death.

First aid at home should include calling an ambulance, until which the person arrives should be placed in a horizontal position. If necessary, it is necessary to perform indirect cardiac massage. It is allowed to take those prescribed by a doctor antiarrhythmic drugs in the usual dosage. Standards of treatment for all patients with an attack of atrial fibrillation require hospitalization to find the cause of the pathology and differentiate it from a chronic form of arrhythmia.

You can stop an attack with the following drugs:

Quinidine (there are many contraindications to the drug, so it is not used in every case and only under ECG control);
Disopyramide (cannot be given for prostate adenoma, glaucoma);
Novocainamide;
Bancor;
Alapinin;
Ethacizin.

To prevent acute heart failure, the patient is usually prescribed cardiac glycosides (Corglicon). The treatment protocol for an attack of atrial flutter involves intravenous administration of Finoptin, Isoptin, but this will not be the case with atrial fibrillation effective treatment. Other antiarrhythmic drugs will not be able to normalize the heart rhythm, so they are not used.

A painful, but much more effective procedure for restoring sinus rhythm is electrical cardioversion. It is usually used if the arrhythmia does not go away after taking medications, as well as to relieve paroxysm of arrhythmia with acute left ventricular failure. Before such treatment is administered sedatives or do general anesthesia on a short time. The shocks start at 100 J, each increasing by 50 J. Cardioversion helps restart the heart and eliminate an attack of atrial fibrillation.

Treatment methods

Etiotropic therapy for hyperthyroidism and some other diseases helps stop the development of atrial fibrillation, but under other conditions it requires symptomatic treatment. Clinical recommendations for the asymptomatic form of the pathology suggest observational tactics, but only in the absence of pulse deficiency and the presence of a heart rate not higher than 100 beats per minute.

Drug treatment

With the development of heart failure, organic pathologies of the heart, or a pronounced degree of atrial fibrillation, the pathologies need to be treated more actively, so the following tablets and injections may be prescribed:

cardiac glycosides for the prevention and treatment of heart failure;
beta-blockers to reduce stagnation in the pulmonary and systemic circulation;
anticoagulants to thin the blood and prevent thrombosis, as well as before planned treatment of arrhythmia;
thrombolytic enzymes for existing thrombosis;
diuretics and vasodilators for pulmonary edema and cardiac asthma.

Anti-relapse treatment for this disease is carried out for a long time - sometimes for several years. The patient must take the medications prescribed by the doctor; the only reason to stop taking the medication is intolerance and lack of effect.

Surgeries and other treatments

After restoration of sinus rhythm, many patients are recommended to perform breathing exercises, which will help improve heartbeat and normalize conductivity. It is also recommended that special physiotherapy, and you can play sports only if there is no relapse of the disease for a long time.

Surgical treatment is planned in the absence of results from conservative therapy, that is, when taking pills is ineffective. Are used the following types surgical interventions:

Radiofrequency catheter ablation. This method involves cauterization of a pathological area in the myocardium, which is the source of arrhythmia. During treatment, the doctor places a conductor through the femoral artery directly to the heart and delivers an electrical impulse, which eliminates all disorders.
Ablation with installation of a pacemaker. Required for serious types of arrhythmia in which sinus rhythm is disturbed. Before inserting a pacemaker, the His bundle or atrioventricular node is destroyed, causing complete blockade, and only then an artificial pacemaker is implanted.
Installation of a cardioverter-defibrillator. This device is sewn into top part breast subcutaneously and is used to immediately stop an attack of arrhythmia.
Operation "labyrinth". This intervention is performed on open heart. Labyrinth-shaped incisions are made in the atria, which will redirect electrical impulses, and the organ will continue to function normally.

Nutrition and folk remedies

After your doctor’s approval, you don’t have to limit yourself conservative medicine and apply traditional treatment for atrial fibrillation. Below are the most effective folk recipes for this disease:

Collect and dry viburnum berries. Every day, brew a glass of berries with 2 cups of boiling water, put on fire, cook for 3 minutes. Then leave the decoction for an hour, take 150 ml three times a day for at least a month.
Grind the yarrow herb, fill half the bottle with it, and fill it to the top with vodka. Leave the product for 10 days in a dark place. Take a teaspoon of tincture against atrial fibrillation twice a day before meals for a month.
Brew 1/3 cup of dill seeds with 250 ml of boiling water, leave in a thermos for an hour. Strain the infusion, drink, dividing into 3 parts, three times a day before meals. The course of therapy is 14 days.
Grind 100 g walnuts, add half a liter of honey. Consume a tablespoon on an empty stomach every morning for at least a month.
Grind a small onion and 1 apple in a blender, take a tablespoon of the mixture three times a day after meals for 14 days.

Dietary nutrition is very important for atrial fibrillation, consuming only the right products. Changing your diet often helps reduce the clinical manifestations of the disease. You should avoid fatty meats, smoked meats, and an abundance of butter, since this food only contributes to the development of atherosclerosis and the progression of arrhythmia. Negatively affects the heart spicy food, vinegar, excess salt, sweet dishes. The diet should include lean meat, fish, vegetables, fruits, and fermented milk foods. The number of meals per day is 4-6, in small portions.

What not to do

Patients with atrial fibrillation should never stop taking medications prescribed by their doctor on their own. It is also not recommended to do the following:

ignore the daily routine;
forget about sufficient sleep and rest;
drink alcohol;
smoke;
practice sports and other physical activities;
allow stress and moral strain;
plan pregnancy without prior health monitoring by a cardiologist or obstetrician;
try to remove acute attack arrhythmias using folk remedies.

Prognosis and prevention

If there are no organic pathologies of the heart, the functional state of the myocardium is normal, then the prognosis is favorable.

To prevent atrial fibrillation and flutter, the following measures are important:

timely treatment of all cardiac and non-cardiac diseases that can cause arrhythmia;
quitting smoking, alcohol, junk food;
reduction of physical and moral stress, regular rest;
consumption of large quantities plant food, taking vitamins, minerals;
moderate physical activity;
avoiding stress, mastering auto-training techniques;
if necessary, take sedative medications;
control cholesterol and blood glucose.

Atrial fibrillation, which is also defined as atrial fibrillation, is one of the types of complications that arise due to coronary disease heart disease in parallel with other types of heart rhythm disturbances. Atrial fibrillation, the symptoms of which can also appear as a result of the relevance of thyroid diseases and a number of associated factors, manifests itself in the form of heart contractions reaching a limit of 600 beats per minute.

general description

Atrial fibrillation, in its characteristic cardiac arrhythmia, is accompanied by chaoticity and frequency of excitation and contraction experienced by the atria, or fibrillation and twitching occurring with individual groups of atrial muscle fibers. As we have already noted, the actual heart rate in this state can reach about 600 beats per minute. In the case of a long paroxysm with atrial fibrillation, lasting about two days, there is a risk of blood clot formation, as well. Against the background of the persistence of atrial fibrillation, rapid progression of the state of circulatory failure in its chronic form can also be noted.

Notably, atrial fibrillation is the most common type of heart rhythm disorder, accounting for 30% of its related hospitalization rates. As for the prevalence of this type of pathology, its increase occurs in accordance with increasing age. Thus, among patients under the age of 60, the incidence rate is 1%, among patients after this age limit - 6%.

To risk factors for development this state include the following:

Age . Age-related structural and electrical changes occurring in the atria become relevant; this, in turn, provokes the development of fibrillation in them.
Availability organic diseases hearts. This also includes open-heart surgery performed by patients.
The presence of another type of chronic disease. These are thyroid diseases, hypertension and other pathologies.
Alcohol consumption.

Atrial fibrillation: classification

Atrial fibrillation in determining one or another form of its classification involves focusing on the features clinical manifestations this condition, the mechanisms of electrophysiology, as well as on etiological factors.

Atrial fibrillation can be constant in its manifestation, that is chronic , persistent , and paroxysmal . Paroxysmal atrial fibrillation lasts for seven days, mostly ending within a period of 24 hours. Chronic atrial fibrillation and persistent atrial fibrillation, on the contrary, lasts more than 7 days. The paroxysmal atrial form of the disease, as well as the persistent form, can be recurrent.

An attack of this disease may be first appeared or recurrent , which in the latter case implies the occurrence of the second and subsequent episodes of fibrillation.

In addition, atrial fibrillation can manifest itself in accordance with two types of rhythm disturbances, that is, it can be atrial flutter or their flicker . Atrial fibrillation (fibrillation) occurs with the contraction of individual groups of muscle fibers, due to which there is no coordinated contraction of the atrium. There is a volumetric concentration of electrical impulses in the atrioventricular connection, as a result of which one part of them is delayed, and the other is switched to the myocardium, causing the ventricles to contract in one rhythm or another.

According to the frequency of contractions, atrial fibrillation, in turn, may be tachysystolic , which implies reductions within the indicator of 90 and above, as well as normosystolic , in which ventricular contractions can correspond to an interval of 60-90 per minute and Bradysystolic , where ventricular contractions reach a maximum of 60 per minute.

During paroxysm, blood is not pumped into the ventricles, atrial contractions are ineffective, and therefore the filling of ventricular diastole occurs freely and not in in full. Ultimately, there is a systematic lack of release of blood into the aortic system.

As for a condition such as atrial flutter, it consists of an increase in contractions within the range of 200-400 per minute while maintaining this process coordinated and clear atrial rhythm. In this case, myocardial contractions follow each other, which occurs almost continuously, there is no diastolic pause, and at the same time, the atria do not relax, because for most of the time they are in a systolic state. Due to the difficulty of filling the atria with blood, less blood enters the ventricles.

The arrival of impulses to the ventricles along the atrioventricular connections occurs in every second, third and fourth case of them, which ensures the correct ventricular rhythm, that is, determines the correct flutter. If a disturbance in conduction occurs, the contraction of the ventricles is characterized by chaotic behavior, as a result of which atrial flutter, accordingly, occurs in an irregular form.

Atrial fibrillation: causes

The pathology in question appears as a result of the relevance of the disease to the patient. various systems and organs in the body, as well as diseases directly related to the heart. Let us highlight the main conditions and diseases, the course of which may be accompanied by a complication in the form of atrial fibrillation:

heart defects (this mainly concerns mitral valve);
syndromes: Wolf-Parkinson-White, weak sinus node;
acute poisoning alcohol or chronic poisoning (alcoholic myocardial dystrophy);
electrolyte-type disorders (mainly reduced to a lack of magnesium and potassium in the body).

Atrial fibrillation extremely rarely appears “for no reason”, being idiopathic; moreover, it is possible to assert that this is precisely this form only if the patient is thoroughly examined in the absence of any diseases that provoke the arrhythmia.

It is noteworthy that in some cases, just the slightest impact is enough for an attack to occur. Sometimes a clear set of reasons can be identified that determined the patient’s subsequent occurrence of an attack of atrial fibrillation. We can also highlight certain part similar reasons: physical or emotional overload, drinking alcohol or coffee, eating too much food, etc.

Recent observations indicate significant role nervous system in the appearance of arrhythmia. Thus, due to the increased activity of its individual links, an attack is often provoked. In the case of influence of the parasympathetic link, which also belongs to the nervous system, we are talking about the vagal type of arrhythmia, but if the influence is the sympathetic link, then the arrhythmia corresponds to the hyperadrenergic type.

Vagal type of atrial fibrillation characterized by the following features:

manifests itself predominantly among men;
the onset of attacks occurs at night or during meals;
The following factors were identified as provoking the attack: horizontal position occupied by the patient, rich food, rest, bloating, bending of the body, tight tie or collar, tight belt;
This condition does not occur during periods of emotional stress and physical activity.

Hyperadrenergic type of atrial fibrillation

This condition manifests itself much more often among women;
Seizures predominantly occur in morning time, it is possible that it will appear during the day or in the evening;
stress, emotional stress and physical activity provokes the occurrence of this condition;
This type of arrhythmia disappears when taking a horizontal position, when calming down and during rest.

Atrial fibrillation: symptoms

The manifestations characteristic of the pathological condition under consideration are determined based on the form that is relevant for it, that is, we're talking about about the state of tachysystolic, bradysystolic, constant or paroxysmal atrial fibrillation. Besides important role plays and general state valve apparatus, myocardium, mental state.

The most serious condition is a condition provoked by tachysystolic atrial fibrillation. In this case, there is an increase in heart rate and shortness of breath, and the intensification of these symptoms occurs as a result of physical stress, interruptions in the functioning of the heart and pain in it.

As a rule, the course of atrial fibrillation occurs in paroxysms, with the progression of paroxysms. The frequency, as well as their duration in this case, is determined exclusively individually. Some of the patients, after just a few attacks of flickering, are faced with the establishment of a chronic or persistent form, while others experience short-term and rare paroxysms throughout their lives; in this case, there may be no tendency for subsequent progression.

Paroxysm during atrial fibrillation can be felt in a variety of ways. Thus, some patients may not notice their arrhythmia at all, learning about it by chance, at the time of a medical examination.

If we consider the typical course of atrial fibrillation, it can manifest itself in the form of chaotic heartbeat, polyuria, fear, trembling and weakness. Excessive heart rate can cause dizziness and fainting in the patient. In addition, Morgagni-Adams-Stokes attacks may also occur (convulsions, loss of consciousness, pallor, breathing problems, inability to determine blood pressure, heart sounds).

Symptoms of atrial fibrillation disappear almost immediately when cardiac sinus rhythm is restored.

With constant atrial fibrillation, patients often simply do not notice it.

Auscultation (listening to the heart for sound phenomena relevant to it) of the heart determines the presence of tones in it that appear with varying degrees volume. The pulse is arrhythmic, the amplitude of the pulse waves is different. Atrial fibrillation is characterized by a pulse deficiency, which is caused by the peculiarities of the condition, as a result of which blood is not released to the aorta with every contraction of the heart.

If patients experience atrial flutter, this condition is usually accompanied by a characteristic increase in palpitations, shortness of breath, pulsation of the veins of the neck and, in some cases, a certain discomfort in the heart area.

Atrial fibrillation: complications

Most often, complications of this condition manifest themselves in the form and.

Mitral stenosis, when complicated by atrial fibrillation, can be accompanied by blockage of the atrioventricular (left) opening by an intra-atrial thrombus, which, in turn, can cause sudden cardiac arrest and, accordingly, death due to these processes.

When intracardiac blood clots enter the arterial system concentrated in the systemic circulation, thromboembolism occurs in the most various organs, and 2/3 of the blood clots are due to blood flow in the cerebral vessels. Thus, almost every sixth case of ischemic stroke occurs precisely in those patients who have been previously diagnosed with atrial fibrillation.

The group of patients most susceptible to peripheral and cerebral thromboembolism are those over 65 years of age. In cases of thromboembolism previously suffered by patients, regardless of the characteristics of its concentration, in diabetes mellitus, congestive heart failure and in cases of arterial hypertension the chances of developing the listed variants of thromboembolism also significantly increase.

The development of heart failure against the background of atrial fibrillation occurs in those patients who have heart defects, as well as disturbances in the contractility of the ventricles.

One of the most severe manifestations relevant to heart failure in the presence of atrial fibrillation is arrhythmogenic shock, which occurs due to low and inadequately produced cardiac output.

In certain situations, a transition from atrial fibrillation to ventricular fibrillation with subsequent cardiac arrest may also occur. Most often, atrial fibrillation accompanies the development of chronic heart failure, as a result of which its progression is possible up to the state of dilated arrhythmic cardiomyopathy.

Diagnosis of atrial fibrillation

The following main methods are used:

Electrocardiogram (ECG);
Holter monitoring (24-hour recording ECG indicators during the patient’s usual rhythm of life and its conditions);
Real-time recording of paroxysms (one of the variants of the previous diagnostic method, in which a portable device provides signals via telephone in the event of an attack).

Treatment of atrial fibrillation

The determination of appropriate treatment tactics occurs in accordance with the specific form of the disease, and in each case it is focused on restoring normal sinus rhythm and its subsequent maintenance, as well as preventing reoccurrence attacks of fibrillation. It also ensures adequate control of heart rate while simultaneously preventing thromboembolic complications.

Relief of paroxysms is carried out intravenously and internal reception drugs novocainamide, cordarone, quinidine and propanorm, which is determined by the appropriate dosage in combination with control over the level blood pressure and ECG.

The absence of a positive trend in changes in the condition of patients when using drug therapy suggests the use of electrical cardioversion, with whose help paroxysms are relieved in more than 90% of cases.

Atrial fibrillation in mandatory requires treatment of the underlying disease as a result of which the rhythm disorder developed.

As a radical method to eliminate atrial fibrillation, a method of radiofrequency provision of isolation is used, aimed at pulmonary veins. In particular, in this case, the focus of ectopic excitation, concentrated in the area of the mouths of the pulmonary veins, is isolated from the atria. The technique is invasive in nature, and the effectiveness of its implementation is about 60%.

Atrial fibrillation (AF) is a disease caused by wear and tear of the heart muscle, the development of various pathological conditions other organs and systems. Like most other diseases, atrial fibrillation is associated with age: its prevalence increases after 40 years.

An important age milestone is the seventh decade of life. If about 2% of the population under the age of 65 suffers from MA, then in the group after 65 years the figure gradually increases to 10%.

Closer to the age of 80, signs of atrial fibrillation are present in every fifth elderly person, that is, in 25% of this age group.

The causes, symptoms and treatment of atrial fibrillation are well known and discussed in detail in articles on our website. IN general outline All this will be discussed below.

Atrial fibrillation: what is it?

The term “atrial fibrillation” is traditionally used not only by patients, but also by cardiologists. Although in latest version There is no international classification of diseases (ICD 10) under this name. Instead, the term “atrial fibrillation” is used, which more accurately reflects the essence of the disease.

What is atrial fibrillation?

The impulse that controls the contraction of the heart is called sinus and originates in the sinus node, which is also called the main pacemaker. Further along the conduction system of the heart, the impulse passes through the atria to the ventricles, leading to their sequential contraction.

With arrhythmia, some impulses are blocked, some are looped, which leads to their repeated entry into the same area (“reentry”). As a result, the heart stops contracting normally: instead of a full 60-70 contractions, it begins to “flicker” at a frequency of up to 600 times per minute.

It is wrong to think that in patients with MA the heart contracts at a frequency of several hundred times per minute. This would cause it to stop instantly. The conduction system of the heart is designed in such a way that it cannot transmit such frequent impulses. The so-called atrioventricular node, which transmits impulses from the atria to the ventricles of the heart, reduces their number.

Thus, only the atria are affected by atrial fibrillation; ventricular fibrillation does not occur. It is for this reason that the term is gradually falling out of use. The modern code for atrial fibrillation according to ICD 10 is I48 - Atrial fibrillation and flutter. This state of affairs will continue in ICD 11, which will be released in 2017, and in subsequent classifications.

In this article, we will use the terms atrial fibrillation (AF) and atrial fibrillation (AF) interchangeably.

A heart with atrial fibrillation is unstable. There are many reasons for impaired electrical conductivity of the heart muscle. These are, first of all, diseases caused by the condition of blood vessels and the heart:

atherosclerosis and hypertension;
cardiac ischemia;
heart attack;
sclerotic changes in the heart muscle;
heart defects;
heart failure.

Other body systems also influence the functioning of the heart. Such causes are usually classified as non-cardiac (extracardiac). Among them:

endocrine disorders;
metabolic disorders;
chronic lung diseases;
neurogenic causes.

Attacks (paroxysms) of MA can be provoked by the following factors:

stress;
excessive alcohol consumption.

Can atrial fibrillation be caused by allergies? The role of autoimmune diseases in the development of atrial fibrillation is unknown.

Classification of atrial fibrillation is carried out on two grounds:

the ability to restore correct sinus rhythm;
change in heart rate.

Based on the first, paroxysmal, persistent, long-persistent and permanent atrial fibrillation are distinguished.

Forms of atrial fibrillation, in accordance with the second basis of classification, are divided into:

accompanied by rapid heartbeat (tachysystolic form of atrial fibrillation);
accompanied by a slow heartbeat (bradycardia);
occurring against the background of a normal heart rhythm (normosystolic type).

In most cases, paroxysms are accompanied by atrial fibrillation with a heart rate of more than 90 beats/min.

The mildest form of atrial fibrillation is the paroxysmal form. The leading feature of the clinical picture of atrial fibrillation of this type is the spontaneous restoration of sinus rhythm without taking medications.

Why does the rhythm spontaneously restore during MA? As a rule, this is due to the cessation of exposure to the factor that provoked the attack of atrial fibrillation: for example, a decrease in stress, emotional or physical stress.

Atrial fibrillation is an abnormal heart condition. If possible, it will try to return to normal impulse conduction.

People suffering from atrial fibrillation are advised to take anti-anxiety medications. plant based: hawthorn, motherwort, valerian.

Radish, as well as its juice and infusion, have a positive effect on the heart. peppermint. Rose hips and viburnum have a general strengthening effect on the heart muscle.

However, folk remedies cannot replace visiting a doctor and receiving adequate drug therapy.

Since in most cases people suffering from atrial fibrillation have other cardiovascular pathologies(in particular, hypertension), the diet should be based on the exclusion of foods that negatively affect the condition of blood vessels. This primarily concerns:

sugar and everything that contains it in high concentrations, including sweet fruits;
salt and prepared products with high content salts (vegetable pickles, sausages and other processed meat products, overly salted cheeses);
any fatty meat and fatty broths (including chicken);
butter, margarine, bread and culinary products containing them.

Atrial fibrillation suggests an increase in the consumption of raw and cooked vegetables. Vegetables contain virtually no sugar (unlike fruits), usually contain little acid (unlike berries), and at the same time are a reliable source of vitamins and antioxidants. Vegetables should be present in the diet all year round.

Lifestyle with atrial fibrillation

All heart diseases require leading a lifestyle that is traditionally characterized as healthy. Atrial fibrillation is no exception.

Standard recommendations include light physical activity for atrial fibrillation: morning exercises, daily walks fresh air. A person should maintain natural mobility and should not lie down all the time (except during periods of an arrhythmic attack).

A separate issue is the combination of the diagnosis of atrial fibrillation and alcohol.

People with heart disease should not abuse alcohol.

At the same time, it is known that in small quantities alcohol can have a positive effect, in particular: on nervous system(calming effect), on the digestive system (stimulates digestion), on blood vessels (dilates blood vessels). In exceptional cases, a person suffering from atrial fibrillation can drink no more than 50 g of a drink with 40% alcohol and no more than 150 g of a drink with 12% alcohol per day.

When choosing a tonometer for atrial fibrillation, it should be taken into account that not all devices are capable of correctly measuring blood pressure in patients with abnormal heart rhythm.

The main danger of atrial fibrillation is that each attack carries a risk of death.

The form of the disease does not have a significant impact on the prognosis and complications of MA. Thus, the prognosis for a permanent form of a person who follows the doctor’s instructions and leads a correct lifestyle may be more favorable than that of a patient with rare paroxysms who does not pay attention to his health.

Why is cardiac MA dangerous?

development of ventricular fibrillation;
development of heart failure.

Many patients are interested in whether atrial fibrillation gives disability. As a rule, they don't. The exception is cases of cardiac ablation followed by implantation of an artificial pacemaker (pacemaker).

Useful video

For more information about atrial fibrillation, watch the following video:

Conclusion

Atrial fibrillation is a dangerous pathology. People who encounter it should follow the doctor’s instructions and also follow the basic recommendations:

adhere to moderation in everything;
do not overexert yourself physically and emotionally;
lifestyle with atrial fibrillation should not change dramatically.

Remember that all changes, even healthy ones, should happen slowly. This is especially true for older people, whose adaptive capabilities of the body are reduced.

General information

(atrial fibrillation) is a disturbance of the heart rhythm, accompanied by frequent, chaotic excitation and contraction of the atria or twitching, fibrillation of individual groups of atrial muscle fibers. The heart rate during atrial fibrillation reaches 350-600 per minute. With prolonged paroxysm of atrial fibrillation (exceeding 48 hours), the risk of thrombosis and ischemic stroke increases. With a permanent form of atrial fibrillation, sharp progression can be observed chronic failure blood circulation

Atrial fibrillation is one of the most common types of rhythm disturbances and accounts for up to 30% of hospitalizations for arrhythmias. The prevalence of atrial fibrillation increases with age; it occurs in 1% of patients under 60 years of age and in more than 6% of patients after 60 years of age.

Classification of atrial fibrillation

The basis modern approach the classification of atrial fibrillation includes the nature clinical course, etiological factors and electrophysiological mechanisms.

There are permanent (chronic), persistent and transient (paroxysmal) forms of atrial fibrillation. In the paroxysmal form, the attack lasts no more than 7 days, usually less than 24 hours. Persistent and chronic atrial fibrillation lasts more than 7 days, the chronic form is determined by the ineffectiveness of electrical cardioversion. Paroxysmal and persistent forms of atrial fibrillation can be recurrent.

A distinction is made between a newly diagnosed attack of atrial fibrillation and a recurrent one (second and subsequent episodes of atrial fibrillation). Atrial fibrillation can occur through two types of atrial rhythm disturbances: atrial fibrillation and atrial flutter.

With atrial fibrillation (atrial fibrillation), individual groups of muscle fibers contract, resulting in a lack of coordinated contraction of the atrium. A significant number of electrical impulses are concentrated in the atrioventricular junction: some of them are delayed, others spread to the ventricular myocardium, causing them to contract at different rhythms. According to the frequency of ventricular contractions, tachysystolic (ventricular contractions of 90 or more per minute), normosystolic (ventricular contractions from 60 to 90 per minute), and bradysystolic (ventricular contractions of less than 60 per minute) forms of atrial fibrillation are distinguished.

During a paroxysm of atrial fibrillation, blood is not pumped into the ventricles (atrial supplementation). The atria contract ineffectively, so in diastole the ventricles are not completely filled with blood freely flowing into them, as a result of which blood does not periodically be released into the aortic system.

Atrial flutter is rapid (up to 200-400 per minute) atrial contractions while maintaining the correct coordinated atrial rhythm. Myocardial contractions during atrial flutter follow each other almost without interruption, there is almost no diastolic pause, the atria do not relax, being in systole most of the time. Filling the atria with blood is difficult, and, consequently, the flow of blood into the ventricles is reduced.

Every 2nd, 3rd or 4th impulse can arrive through the atrioventricular connections to the ventricles, ensuring the correct ventricular rhythm - this is the correct atrial flutter. If atrioventricular conduction is disrupted, chaotic contraction of the ventricles is observed, i.e., an irregular form of atrial flutter develops.

Causes of atrial fibrillation

Both cardiac pathology and diseases of other organs can lead to the development of atrial fibrillation. Most often, atrial fibrillation accompanies the course of myocardial infarction, cardiosclerosis, rheumatic heart disease, myocarditis, cardiomyopathies, arterial hypertension, and severe heart failure. Sometimes atrial fibrillation occurs with thyrotoxicosis, intoxication with adrenomimetics, cardiac glycosides, alcohol, and can be provoked by neuropsychic overload, hypokalemia.

Idiopathic atrial fibrillation also occurs, the causes of which remain unidentified even with the most thorough examination.

Symptoms of atrial fibrillation

Manifestations of atrial fibrillation depend on its form (bradysystolic or tachysystolic, paroxysmal or constant), on the condition of the myocardium, valvular apparatus, and the individual characteristics of the patient’s psyche. The tachysystolic form of atrial fibrillation is much more difficult to tolerate. In this case, patients feel a rapid heartbeat, shortness of breath, which increases with physical stress, pain and interruptions in the heart.

Usually, at first, atrial fibrillation occurs in paroxysms; the progression of paroxysms (their duration and frequency) is individual. In some patients, after 2-3 attacks of atrial fibrillation, a persistent or chronic form is established, in others, rare, short-lived paroxysms are observed throughout life without a tendency to progress.

The occurrence of paroxysm of atrial fibrillation can be felt in different ways. Some patients may not notice it and become aware of the presence of arrhythmia only when medical examination. In typical cases, atrial fibrillation is felt by chaotic heartbeats, sweating, weakness, trembling, fear, and polyuria. When excessive high frequency heart contractions, dizziness, fainting, and Morgagni-Adams-Stokes attacks may occur. Symptoms of atrial fibrillation disappear almost immediately after restoration of sinus heart rhythm. Patients suffering from a permanent form of atrial fibrillation cease to notice it over time.

When auscultating the heart, random tones of varying volumes are heard. An arrhythmic pulse with different amplitudes of pulse waves is determined. With atrial fibrillation, a pulse deficit is determined - the number of minute contractions of the heart exceeds the number of pulse waves). Pulse deficiency is due to the fact that not every heart rate blood is released into the aorta. Patients with atrial flutter experience palpitations, shortness of breath, sometimes discomfort in the heart area, and pulsation of the veins of the neck.

Complications of atrial fibrillation

Most frequent complications atrial fibrillation are thromboembolism and heart failure. With mitral stenosis complicated by atrial fibrillation, blockage of the left atrioventricular orifice by an intraatrial thrombus can lead to cardiac arrest and sudden death.

Intracardiac thrombi can enter the arterial system of the systemic circulation, causing thromboembolism in various organs; 2/3 of them enter the cerebral vessels with the blood flow. Every 6th ischemic stroke develops in patients with atrial fibrillation. Patients over 65 years of age are most susceptible to cerebral and peripheral thromboembolism; patients who have previously suffered thromboembolism of any location; suffering from diabetes mellitus, systemic arterial hypertension, congestive heart failure.

Heart failure with atrial fibrillation develops in patients suffering from heart defects and impaired ventricular contractility. Heart failure with mitral stenosis and hypertrophic cardiomyopathy can manifest as cardiac asthma and pulmonary edema. The development of acute left ventricular failure is associated with impaired emptying of the left chambers of the heart, which causes sharp increase pressure in the pulmonary capillaries and veins.

One of the most severe manifestations of heart failure in atrial fibrillation can be the development of arrhythmogenic shock due to inadequately low cardiac output. In some cases, atrial fibrillation may transform into ventricular fibrillation and cardiac arrest. Most often, with atrial fibrillation, chronic heart failure develops, progressing to arrhythmic dilated cardiomyopathy.

Diagnosis of atrial fibrillation

Typically, atrial fibrillation is diagnosed during a physical examination. When palpating the peripheral pulse, a characteristic disordered rhythm, filling and tension are determined. During auscultation of the heart, irregular heart sounds and significant fluctuations in their volume are heard (the volume of the first sound following the diastolic pause varies depending on the magnitude of the diastolic filling of the ventricles). Patients with identified changes are referred for consultation with a cardiologist.

Confirmation or clarification of the diagnosis of atrial fibrillation is possible using data from an electrocardiographic study. With atrial fibrillation, the ECG does not show P waves, which record atrial contractions, and the ventricular QRS complexes are located chaotically. With atrial flutter, atrial waves are detected at the site of the P wave.

A transesophageal electrophysiological study (TEE) is performed to determine the mechanism of development of atrial fibrillation, which is especially important for patients who are planning to undergo catheter ablation or implantation of a pacemaker (artificial pacemaker).

Treatment of atrial fibrillation

The choice of treatment tactics for various forms atrial fibrillation is aimed at restoring and maintaining sinus rhythm, preventing repeated attacks of atrial fibrillation, controlling heart rate, and preventing thromboembolic complications. To relieve paroxysms of atrial fibrillation, the use of novocainamide (intravenously and orally), quinidine (orally), amiodarone (intravenously and orally) and propafenone (orally) under the control of blood pressure and electrocardiogram levels is effective.

A less pronounced result is obtained by the use of digoxin, propranolol and verapamil, which, however, by reducing the heart rate, help improve the well-being of patients (reducing shortness of breath, weakness, palpitations). In the absence of the expected positive effect from drug therapy, they resort to electrical cardioversion (applying a pulsed electrical discharge to the heart to restore heart rhythm), which stops paroxysms of atrial fibrillation in 90% of cases.

With atrial fibrillation lasting more than 48 hours, the risk of thrombus formation sharply increases, therefore, in order to prevent thromboembolic complications, warfarin is prescribed. To prevent recurrent attacks of atrial fibrillation after restoration of sinus rhythm, antiarrhythmic drugs are prescribed: amiodarone, propafenone, etc.

When installed chronic form atrial fibrillation, constant use of adrenergic blockers (atenolol, metoprolol, bisoprolol), digoxin, calcium antagonists (diltiazem, verapamil) and warfarin is prescribed (under the control of coagulogram parameters - prothrombin index or INR). In case of atrial fibrillation, it is necessary to treat the underlying disease that led to the development of the rhythm disorder.

A method that radically eliminates atrial fibrillation is radiofrequency isolation of the pulmonary veins, during which the focus of ectopic excitation, located at the mouths of the pulmonary veins, is isolated from the atria. Radiofrequency isolation of the pulmonary vein ostia is an invasive technique, the effectiveness of which is about 60%.

With frequently recurring attacks of atrial fibrillation or with its constant form, it is possible to perform RFA of the heart - radiofrequency ablation (“cauterization” with an electrode) of the atrioventricular node with the creation of complete transverse AV block and implantation of a permanent pacemaker.

Prognosis for atrial fibrillation

The main prognostic criteria for atrial fibrillation are the causes and complications of arrhythmia. Atrial fibrillation caused by heart defects, severe myocardial lesions (large focal myocardial infarction, extensive or diffuse cardiosclerosis, dilated cardiomyopathy) quickly leads to the development of heart failure.

Thromboembolic complications caused by atrial fibrillation are prognostically unfavorable. Atrial fibrillation increases mortality associated with heart disease by 1.7 times.

In the absence of severe cardiac pathology and satisfactory condition ventricular myocardium prognosis is more favorable, although frequent occurrence paroxysms of atrial fibrillation significantly reduces the quality of life of patients. With idiopathic atrial fibrillation, health is usually not affected; people feel practically healthy and can perform any work.

Prevention of atrial fibrillation

The goal of primary prevention is the active treatment of diseases that are potentially dangerous in terms of the development of atrial fibrillation (arterial hypertension and heart failure).

Measures secondary prevention atrial fibrillation are aimed at following recommendations for anti-relapse drug therapy, cardiac surgery, limiting physical and mental stress, and abstaining from drinking alcohol.