Frederick's syndrome got its name in honor of the Belgian physiologist, who defined it as a combination of complete transverse (atrioventicular) block and atrial fibrillation, in other cases - atrial flutter. This article discusses Frederick's syndrome: clinic, diagnosis, treatment of the disease.
Syndrome mechanism
The mechanisms of Frederick's syndrome are as follows: from the atria to the ventricles, impulses are completely stopped; erratic, chaotic, often repeated arousal and contraction of certain groups of muscle fibers of the atria. The ventricles are excited through a pacemaker located in the atrioventricular junction or in the conduction system.
Causes of Frederick Syndrome
This disease can occur after severe organic lesions in the heart, which are most often accompanied by processes of inflammation, sclerotia, or degeneration in the myocardium. Such processes include, for example, coronary heart disease, mainly in a chronic form, acute myocardial infarction, myocarditis, cardiomyopathy, angina pectoris and others. With such diseases, sclerotic processes develop in the heart muscle, as a result of which the connective tissue grows excessively, which replaces normal cells familiar to the body that are able to conduct electrical impulses. Therefore, conductivity is violated, and blockade occurs.
What the cardiogram shows
To confirm the patient’s Frederick syndrome, an electrocardiogram is usually prescribed. Moreover, the study is best carried out during the day in order to assess the heart rate at different times and collect more complete information.
If there is a disease on the ECG, waves of flicker or atrial flutter are recorded, while a healthy person should have prongs. The ventricular rhythm becomes nodular or idioventricular, and in general non-sinus ectopic.
RR intervals are constant and have the correct rhythm. The number of ventricular contractions is recorded in an amount not exceeding 50-60 times per minute. Ventricular complexes are often dilated and deformed.
Clinical manifestations and symptoms
Only with the help of an electrocardiogram can Frederick's syndrome be accurately confirmed in a patient. The clinic accompanying him in ordinary life, which a person should pay attention to, is a rare but correct pulse with a heart rate of at least 30 and no more than 60 times per minute. The heart rate drops because the pumping function of the heart decreases. In turn, the above leads to oxygen starvation of the brain.
Most patients complain of weakness, dizziness, shortness of breath, poor health, even after a little physical exertion. If a person does not pay attention to Frederick's syndrome, the symptoms are aggravated, cardiac arrest may occur for 5-7 seconds. In addition, possible loss of consciousness due to tachycardia of the ventricles.
Treatment
More and more often, doctors agree that the only right solution for treating Frederick's syndrome is the implantation of an artificial pacemaker. That is, an electrode is inserted into the ventricle, which gives impulses and artificially causes myocardial contraction.
The frequency of contractions is set in advance, depending on the condition of the patient and his physical activity.
In addition to pacing, cholinoblockers are also used. These are special substances, such as atropine. However, recently their use has been abandoned due to many side effects, including a negative effect on the patient's psyche, for example, the development of atropine psychosis.
In general, treatment depends on the stability of hemodynamics and the causes of the development of atrioventricular block.
Thus, Frederick's syndrome is a rather severe lesion of the heart muscle, characterized by complete lateral blockade in combination with atrial fibrillation.
However, at present, with the correct and timely diagnosis, this phenomenon is treatable, after which the patient can return to a normal state and maintain a familiar lifestyle.