According to medical statistics, in the first place among all diseases are pathologies of the heart and vascular system. What caused this? The state of the cardiovascular system is affected by many negative factors. One of them is constant stress and lack of time for a good rest. Air pollution also plays a negative role in the growth of such pathologies. But a person suffers not only from ever worsening environmental conditions. Magnetic storms negatively affect the health of the inhabitants of our planet. From these bursts on the sun, it is the cores that feel especially bad. The initial stage of more serious pathologies, often threatening a fatal outcome, is arrhythmia.
The essence of the disease
Often the term "arrhythmia" is not perceived by us as a diagnosis. But do not treat this health disorder so irresponsibly. Normally, the number of heart beats should be no more than 90 per minute. Moreover , this value should not be less than 70. But many people do not know such information. And, as a rule, we do not control our pulse, do not visit a cardiologist and do not go on our own initiative ECG. However, such actions are the most minimal measure that contributes to maintaining their own health.
Many failures in the work of such an important organ as the heart can not only be prevented, but also stopped. And the first bell for taking the most urgent measures is the slightest deviation from those rhythm indicators that are considered the norm.
Some reasons for a change in heart rate are:
- fatigue;
- severe stress;
- an overdose of alcohol;
- Congenital heart defect.
The essence of arrhythmia is that it represents a violation in the functioning of the cardiac system.
Cardiologists distinguish various degrees of severity of such a deviation. For example, a simpler treatment is presented with conditions in which only a few strokes are not enough to the required frequency. However, quite often, patients suffer from a significant increase in myocardial contractions. It is very dangerous for humans and can lead to death.
Types of diseases
There is currently no unified classification of arrhythmias. This is due to all the ongoing discussions about the grounds that should be taken as its basis. Indeed, despite the centuries-old scientific studies of this pathology, the specialists did not get the desired result in its treatment.
For example, in 2014, the idea was expressed that the classification of arrhythmias should include three basic types of pathologies. Among them:
1. Arrhythmias, which are a normal reaction of the body, manifesting themselves in conditions of adaptation, but at the same time leading to certain disorders that are dangerous to the body.
2. Arrhythmias arising for the regulation of cardiac activity.
3. Arrhythmias caused by the disorganization of the anti-wave functioning of the heart muscle.
The classification of cardiac arrhythmias (WHO) identifies three large groups of these pathologies. They include the following diseases:
- caused by a violation of the formation of an electrical impulse in the cardiovascular system;
- associated with conduction disturbances;
- combined type, due to both the first and second reason.
Arrhythmia is also classified due to its origin. So, they distinguish congenital, acquired and idiopathic pathology. The first of these three species is found from the moment a person is born. Idiopathic arrhythmia is of unclear origin. As for the acquired illness, it occurs throughout the patient’s life and becomes the result of some dangerous diseases, including coronary heart disease, diabetes mellitus and hypertension.
When arrhythmias occur, the heart muscle continues to pump blood as before. However, this pathology can cause the development of pathologies such as thromboembolism and heart failure. And this indicates the danger of arrhythmia.
Impaired heart rate
This is one of the reasons for the development of pathology. In this regard, there is a classification of arrhythmias in terms of heart rate. It includes:
1. Sinus tachycardia. This pathology is associated with a malfunction of the sinus node, which is the main mechanism for the formation of electrical impulses of the heart.
With tachycardia of this type, heart rate exceeds the upper threshold equal to ninety beats per minute. A similar condition is felt by the patient as a heartbeat.
2 . Sinus arrhythmia. This pathology is an incorrect alternation of heart contractions. Most often, sinus arrhythmia is observed in children, as well as in adolescents. Often it is functional and has a direct relationship with breathing. During inspiration, heart contractions become more frequent, and when you exhale, on the contrary, they become more rare.
3. Sinus bradycardia. Its main symptom is a reduction in heart rate to 55 beats per minute. This phenomenon can be observed even in healthy and physically strong people during sleep or at rest.
4. Paroxysmal atrial fibrillation. In this case, there is a very rapid heartbeat that has the correct rhythm. A person’s heart rate sometimes reaches 240 beats per minute. However, it causes weakness and pallor, increased sweating and fainting. The reason for this phenomenon are additional impulses that occur in the atria. As a result of their occurrence, a very strong reduction in the periods of rest of the myocardial muscle occurs.
5 . Paroxysmal tachycardia. This pathology is the correct, but at the same time very frequent rhythm of the heart muscle. Heart rate in this case is in the range from 140 to 240 beats per minute. Paroxysmal therapy, as a rule, arises and disappears suddenly.
6 . Extrasystole. This type of arrhythmia is an extraordinary (premature) contraction of the myocardial muscle. At the same time, a person can feel increased tremors in the region of the heart, and his fading.
To help a cardiologist
The most convenient from a practical point of view is the classification of arrhythmias according to Kushakovsky. It includes three groups of pathology. Moreover, they have a detailed description of all pathologies included in them. Let us consider in more detail the typology that this classification of arrhythmias includes.
Violations in the rhythm
This group consists of three subsections. The first of them, which this classification of arrhythmias highlights under the letter “A,” includes nomotopic pathologies. They represent a malfunction in the sinus node. At the same time, they distinguish:
1. Sinus tachycardia.
2. Sinus baricardia.
3. Sinus arrhythmia.
4. SSSU, or sick sinus syndrome .
The next subsection includes the ectopic causes of cardiac arrhythmias.
The classification distinguishes this list of pathologies under the letter "B". This subsection includes violations caused by heterotopic rhythms that arose due to the predominance of automatism in the work of ectopic centers. This list contains:
1. Replacing (slow) slipping rhythms and complexes, including atrial and ventricular, as well as from AV connections
2. Migrations observed in the supraventricular pacemaker.
3. Non-paroxysmal types of tachycardia or accelerated rhythms of the ectopic type.
The next subsection indicates non-impaired cardiac arrhythmias. The classification highlights the pathology data under the letter “B”. This includes:
1. Extrasystole (ventricular, atrial and from AV connections).
2. The paraxism of tachycardia.
3. Atrial flutter.
4. Atrial fibrillation (flickering).
5. Ventricular fibrillation.
Conductivity Disorders
This group includes several other ventricular arrhythmias.
Classification according to Kushakovsky distinguishes in this case:
1. Sinoatrial blockade.
2. Atrial block.
3. AV blockade.
4. Intraventricular blockade of the branches of the bundle of His, including mono-, bio- and triophaoscopic pathologies that affect one, two or three branches of the atrioventricular bundle, respectively.
5. Asystole of the ventricles.
6. Syndromes of premature ventricular arousal.
Combined rhythm pathology
This group includes such violations:
1. Paraxystopia.
2. Ectopic rhythms characterized by exit blockade.
3. AV dissociation.
International scheme
It is worth saying that when determining an ailment such as arrhythmia, the WHO classification considers such groups in almost the same order. In this case, the pathology is divided into ailments caused by various causes of impaired functioning of the heart muscle. Thus, WHO distinguishes the following groups of arrhythmias:
1. Caused by violations of automatism, including:
a) pacemakers in the sinus node (sinus tachycardia, baricardia and arrhythmia, as well as CVS and non-respiratory sinus arrhythmia);
b) pacemakers outside the sinus node (atrial, atrioventicular and idioventric rhythms).
2. Caused by disorders of excitability, including:
a) according to the sources of pathology (ventricular, atrial and atrioventicular);
b) by the number of sources (mono- and polytropic);
c) by the time of occurrence: early (during atrial contraction), late (at the moment of relaxation of the heart muscle) and interpolated (with a localization point between atrial contractions and cardiac relaxation);
d) in frequency: group (with several in a row), paired (two at the same time), single (five or less) and multiple (more than five);
e) by ordering (quadrigeminia, trigeminia, bigeminia);
e) paroxysmal tachycardia.
3. Caused by impaired conduction, that is, its increase (WPW syndrome) or decrease (various types of blockade).
4. Mixed (flickering / fluttering of the ventricles / atria).
All types of diseases are accompanied not only by violations in the anatomical structure of the heart. They lead to an imbalance of all metabolic processes occurring in the muscle of the myocardium. This causes various types of arrhythmias of a different nature and duration. Only a cardiologist can make a true diagnosis. He will establish the cause of cardiac arrhythmias, classification, etiology, pathogenesis, clinic based on the received electrocardiographic data.
Atrial type of pathology
The classification of this type of ailment includes the nature of its clinical course, electrophysiological mechanisms, as well as etiological factors.
What is atrial fibrillation? Classification distinguishes its following types:
- chronic (permanent);
- persistent;
- transient (paroxysmal), lasting from 24 hours to seven days.
In this case, chronic and persistent forms of pathology can become recurrent.
Atrial fibrillation is also distinguished by the type of heartbeat disturbance. At the same time, flutter and atrial fibrillation are distinguished.
At the frequency with which the ventricles contract, atrial fibrillation is distinguished:
- tachystolic (90 or more times per minute);
- normosystolic (60-90 times per minute);
- bradisystolic (less than 60 times per minute).
Extrasystole
This variant of the pathology is characterized by extraordinary contractions of the heart muscle or its individual parts (extrasystoles). At the same time, a person feels anxiety, lack of air, a strong shock of the heart or his sinking. Such a pathology sometimes leads to angina pectoris and disorders in the cerebral circulation.
Any extrasystole is characterized by a mass of parameters. That is why with its full classification, more than ten sections are distinguished. However, for practical use, only those are distinguished that can most closely reflect the course of the disease.
The classification of arrhythmias according to Laun was an important step in the history of cardiology. Using the proposed grouping, the practitioner is able to adequately assess the patient’s pathology and the severity of its course. The fact is that gastric extrasystole of the heart (ZhES) is very widespread. This pathology is observed in almost fifty percent of patients who seek the advice of a cardiologist. In some of them, the disease is benign and carries no threat to life in itself. However, there are patients in whom a malignant form of ZhES is detected, which requires a certain course of therapy.
The main function performed by the classification by Laun is to separate the malignant pathology from the benign one. In this case, five classes of the disease are distinguished:
1. Monomorphic ventricular extrasystole, the frequency of which is less than 30 per hour.
2. Monomorphic ZhES with a frequency of more than 30 per hour.
3. Politopny.
4. In the fourth grade, two subsections are distinguished (paired VES and ventricular tachycardia with three or more VES in a row).
5. Extrasystole when finding the R wave in the first 4/5 of T.
Such a classification finds its application in cardiology and cardiac surgery. For many years, doctors of other specialties have been using it. Appeared in 1971, it has become a reliable support for specialists in the installation of arrhythmia, classification and treatment of this pathology.