Bradyarrhythmia is a disease in which the heart rhythm is disturbed and cardiac contractions become less than 60 beats per minute. The class of this pathology includes sinus bradycardia, stopping the sinus node, sinoauric blockades, as well as ciliary bradyarrhythmias, tricular blockade.
Bradyarrhythmia is divided into two forms: functional and organic. But regardless of the species, with this disease, there is always a decrease in heart rate. This is due to diastolic overload. If the heart rate is below 30 beats per minute, then cerebral ischemia develops.
Bradyarrhythmia is divided into the following forms:
- Sinus bradycardia , in which cardiac contraction is less than 60 strokes, but the sinus rhythm of the heart is preserved. This condition is normal for trained people, athletes. However, for the category of other people, the overdose of Digoxin, antiarrhythmics, beta blockers, calcium channel blockers can lead to the development of the disease. With sinus bradycardia treatment is aimed at the abolition of medicines that caused the disease;
- Nodal rhythm differs from sinus bradycardia only in that the impulse originates from the atrioventricular, and not from the sinus node. However, in the case when bradyarrhythmia does not pass after the withdrawal of drugs that caused rhythm disturbances, a permanent pacemaker is installed.
Sinus bradyarrhythmia is a disease in which there is a decrease in the heart rate. Can develop in people of any age. In the sinus node the disease originates, since it is he who is responsible for the normal heart rhythm and contraction. As a rule, the heart system does not actually affect the disease, and the patient usually seems quite healthy during the examination. However, sinus bradyarrhythmia is in the hypoxic state.
Bradyarrhythmia of the heart arises, as a rule, in the elderly and young people without visible disturbances of the cardiac system. Respiratory bradyarrhythmia in adolescents and children is very common. This is due to the fact that under the influence of the vagus nerve there is a function of the sinus node and with age it will decrease. In people over 40 years of age, respiratory bradyarrhythmia is evidence of a primary lesion of the sinus node or speaks of dysfunction (vegetative).
Bradyarrhythmia of the heart can be caused by a variety of causes that directly affect the sinus node: viral diseases, vascular thrombosis or their damage, inflammatory processes, cardiosclerosis , myocarditis , myocardial infarction . Rarely, the disease can occur with cancer of the heart.
Bradyarrhythmia in adolescents is common and it is possible that the disease develops against the background of impaired thyroid function. Overdose of medicines (Digoxin, Cordaronon) also contributes to the development of the disease. Bradyarrhythmia marked accompanied by dizziness, headache, weakness. Moderate bradyarrhythmia, as a rule, is not accompanied by complaints, because it does not lead to violations of cardio dynamics.
The causes of bradyarrhythmia
Decreased heart rate leads to a reduced cardiac output, blood supply to organs: myocardium, brain (head), skeletal muscles is disturbed.
Bradyarrhythmia can develop due to local effects on the sinus node (inflammatory or degenerative damage). Thrombosis or myocarditis of vessels is also a frequent cause of the formation of bradyarrhythmia. Due to myocardial infarction of the posterior wall, there will be a decrease in the heart rate. Many pathological processes can cause bradyarrhythmia, but the main cause is damage to the sinus node, as the tone of the parasympathetic nervous system increases. The disease always occurs because of an indirect or direct effect on the sinus node.
Bradyarrhythmia in children is formed due to the fact that in the vagus nerve increased tone, which occurs due to the pathological process of the myocardium. Hereditary predisposition, vegetative-vascular dystonia , impaired thyroid function, can also cause the development of the disease. Because of the presence of a foci of infection, the myocardium is affected and such diseases as angina , viral infection contribute to the development of bradyarrhythmia.
In elderly people, the disease can manifest as cardiosclerosis. Rarely in the presence of cancer of the heart, bradyarrhythmia may occur, as the sinus node is damaged and compression occurs. Increased intracranial pressure, viral infections, myocardial infarction, hypothyroidism may be the cause of bradyarrhythmia.
An overdose of drugs, beta blockers, cardiac glycosides, quinidine, digoxin, does not exclude the formation of bradyarrhythmia. Ischemic heart disease , cardiomyopathy , electrolyte blood disorders can also cause the development of this disease.
Symptoms of bradyarrhythmia
Moderate bradyarrhythmia can be manifested only by a single symptom: a heart rate of ~ 40 beats per minute. Expressed bradyarrhythmia is manifested by dizziness, there may be loss of consciousness. There will also be feelings of cardiac arrest or slow work, a feeling of heaviness behind the sternum.
Conditionally distinguish compensated and decompensated bradyarrhythmia of the heart. Compensated form is asymptomatic. Patients with this form of pathology are able to live a lifetime without suspecting that there is a deviation.
The clinical picture in the decompensated form of bradyarrhythmia of the heart is non-specific and is based on symptoms of impaired blood circulation of the brain, however, this is typical for many diseases. Morgagni-Adams-Stokes syndrome manifests itself with the growth of the bradycardia of the heart. In this case, blood circulation can suddenly stop, urination and defecation will be spontaneous. Often the automatism of the heart can recover spontaneously, and the patient will regain consciousness. In rare cases, resuscitation is needed, since a fatal outcome may occur. Bradyarrhythmia manifests as a neurological clinical picture and for this reason, patients are treated in neurological hospitals.
Sinus bradyarrhythmia is manifested by increased fatigue, syncope. With the increase in the clinical picture, blood pressure will rapidly fall with the subsequent development of collapse or arrhythmic shock. For a patient, such a syndrome can result in a fatal outcome. In elderly people, the disease manifests itself cardiosclerosis.
There is also a loss of appetite, shortness of breath, cold sweat, blood pressure will regularly change, absent-mindedness will appear, concentration of attention will decrease.
Respiratory bradyarrhythmia is manifested by rapid heart rate on inspiration, and on exhalation the rhythm is reduced. With a delay in breathing, this pathological manifestation disappears. In the case where this does not occur, this is evidence of the presence of non-respiratory sinus bradyarrhythmia.
Bradyarrhythmia in children, as a rule, proceeds without clinical symptoms. However, if the disease is pronounced, then headaches, dizziness and weakness are not ruled out. If the disease worsens, there will be loss of consciousness, which is caused by a violation of the blood supply to the brain.
Bradyarrhythmia in children
Bradyarrhythmia in children is diagnosed if the heart rate is less than 60 beats / min. The cause of the delayed heart rate is the sinus node. With this pathology, the whole heart system, including the work of the ventricles and atria is not broken. Occasionally, the disease manifests itself by a regular slowing of the pulse.
A fairly frequent deviation is bradyarrhythmia in children, which appears on exhalation. A similar condition can be caused by cold. The disease is divided into two forms: primary and secondary, in which the rhythm of the heart slows down due to the presence in the body of other diseases (intracranial hematoma, cerebral edema, liver disease).
At an early age, the development of sinus bradyarrhythmia is possible, which is associated with an increased tone of the vagus nerve. In some cases, the disease manifests itself by a constant slowing of the rhythm of the heart, regardless of the effect factor or condition. Also, a diagnosis can be made in the case of a slowing of the heart rhythm under a certain influencing factor (hypothermia).
As a rule, the disease is not clinically manifested. In the case of complaints of worsening state of health, a comprehensive examination should be conducted and observed regularly at the cardiologist. The childhood form of the disease is not permanent and often manifests itself in certain situations.
Children with thyroid problems, vegetative-vascular dystonia, hereditary predisposition, infectious diseases are most susceptible to bradyarrhythmia.
It is not excluded with severe form of the disease of pain in the heart, deterioration of vision, cold sweat, constant fatigue. In case of seizures, the cardiologist may prescribe electrostimulation. Due to a violation of blood flow to the brain, the child may experience loss of consciousness.
This pathological abnormality in most children is temporary and can be easily corrected. If the child feels well and has no complaints, the disease will recede independently with time. In this case, treatment is not required.
Treatment of bradyarrhythmia
Before the appointment of treatment, the patient needs a thorough examination. Using an ECG, you can detect any form of bradyarrhythmia. In patients with transient bradyarrhythmia during the day, Holter monitoring is recorded.
The most effective treatment for bradyarrhythmia is electrocardiostimulation. In rare cases, the use of the drug Atropine. For patients with this pathology electrolyte solutions, vitamins and metabolic drugs are not effective.
If the disease is asymptomatic, then treatment is not required. If symptoms are present, treatment is needed to eliminate the underlying disease that has contributed to the development of bradyarrhythmia. However, do not take drugs aimed at increasing heart rate, because such drugs can cause other forms of arrhythmia.
Treatment of bradycardia with a minimal threat to health is carried out with the help of electrocardiostimulation, that is, the patient is given a mini-operation for the implantation of an artificial pacemaker.
Previously, such surgical interventions were not performed and the treatment was performed with the help of anticholinergic drugs in order to make the pulse fast. But often these drugs led to ventricular tachycardia , which turned into ventricular fibrillation (circulation stopped). Drugs aimed at increasing the heart rate, do not allow to detect the true severity of the disease, and also do not allow the artificial pacemaker to be implanted in time.
A pacemaker is a device that generates electrical impulses. This is a system of regular cardiac rhythm monitoring and other sensors that allow you to memorize and program data. Regardless of the type and form of bradyarrhythmia that threaten the health of the patient, the pacemaker is always implanted.
Regular ECG monitoring is recommended for children, since the disease is asymptomatic. In the daily diet, foods should be saturated with magnesium, potassium, B vitamins: dairy products, meat, nuts, dried fruits, buckwheat, oatmeal, sauerkraut, spinach, parsley, tomatoes, citrus, legumes. Also recommended is breathing exercises regardless of the age of the patient.