Tachycardia Golden Hearts. Signs of ventricular tachycardia on ECG

The date: 04.03.2020

There are several types of rhythmic failures in the work of the heart, paroxysmal ventricular tachycardia is one of those that are caused by a violation of the excitation function. It manifests itself in the form of attacks of sharp increase in abbreviations on a short or long period of time. Contributes to this electrical impulses emanating from heterotopic centers. Pathological signals are completely replaced by a normal sinus rhythm. What is interesting, the rhythm of excitations is preserved. In the article, consider what stomatricular paroxysmal tachycardia per ECG.

Characterized by an attack of heartbeat pulses for the occurrence of which Ishodet from the ectopic focus

Forms pzht.

There are several options for the classification of ventricular tachycardius. If we talk about clinical division, then this group includes 2 types:

Special forms of indisposition, having clinical significance, belong:

Causes and mechanism for the development of tachycardia

Attention! It is necessary to solve this problem immediately after its detection, this will avoid complex consequences.

The reasons why rhythmic violations in the work of the heart muscle may occur under certain conditions, are:

serious diseases or body development pathology;
the side effect of drugs;
repeated emotional experiences;
maintaining an improper lifestyle;
the ailments that have given complications.

Customizing factors can also include operations on the body of the cardiovascular system, electrolyte disorders and genetic diseases.

In the process of developing ventricular arrhythmia, several mechanisms can take part.

Repeating excitation wave input, it is localized in the working muscular layer of ventricles or conductive system.
Additional focus of excitation of high automatic.
The source of electrical pulses of trigger activity.

Sometimes in the formation of the re-entry loop, the conductive system is also involved. This form is called a faccular. In most cases, it is diagnosed in boys and boys, refers to the category of idiopathic.

Symptoms and ECG Signs

All types of arrhythmic states manifest in principle equally. The disorder is diagnosed primarily by means of an electrocardiogram. Symptoms of paroxysmal ventricular tachycardia determine the direction of treatment. Most often in their role acts:

inexplicable weakness that appears sharply;
dyspnea;
impairment;
dizziness;
loss of consciousness.

In the conditions of this type of violation, the heartbeat can be completely different in duration, up to a decrease in systolic blood pressure. Some patients have excessive sweating, and due to the fact that the blood supply to the brain deteriorates, there can be even disorders in consciousness. But the most important and explicit sign is still chest pain.

Violation of coordination in the work of atria and ventricles leads to severe hemodynamic violations

Through physical examination, the ECG signs of paroxysmal ventricular tachycardia are detected. The tape shows that the attack of cuts in anomalous rhythm begins suddenly and suddenly stops. Often the number of blows ranges in the range of 140-180 Ud / min. The ventricular complex is deformed, and also expands more than 0.12 seconds. Graphically, it resembles a blockade of a beam legs. The RS-T segment and Tusk T predominantly disposable. In addition, the presence of av-dissociation is noted, which means a complete separation of such indicators as:

student gastric rhythm (QRS);
sinusian atrial rhythm within the norm (P).

In rare cases of paroxysmal ventricular tachycardia, ventricular complexes of sinus origin of unchanged single type are noted on ECG.

Therapeutic approaches

The treatment of paroxysmal ventricular tachycardia is primarily to eliminate the underlying disease, which provoked rhythmic violations. During the exacerbation of this state, attempts to restore normal heart activities are performed. To do this, electrical therapy, which is carried out using an electric current, or antiarrhythmic drugs are prescribed. Their action is to restore and maintain the rhythm of the reductions of the heart muscle, the medicines are introduced intravenously.

Upon repetition of tachycardia seizures, appropriate anticultimical therapy is carried out.

In order to prevent the emergence of repeated paroxysms, the doctor prescribes medication therapy, which includes drugs of various actions.

Beta blockers	make SS more weak and rare, reduce blood pressure levels
Antiarrhythmic drugs	can restore and maintain a normal reduction rhythm
Calcium channel blockers	regenerating action on heart abbreviations, making them less strong. In addition, the drugs of this group expand the vessels, due to which blood pressure is reduced
Omega 3 Polynsaturated Acids	act on the level of cholesterol in the blood, lowering it. Due to this, the likelihood of blood clots is reduced. Omega 3 preparations have also anti-inflammatory effects.

In the framework of surgical intervention, radio frequency ablation can be carried out, as well as the implantation of a piece instrument to restore rhythm.

Stomatricular tachycardia is a violation of the heart rhythm, which is determined by the defeat of the muscles of this organ. In the absence of treatment, pathology may cause human death. In this article we will give an answer to the question of what is symptoms and methods of treating ventricular tachycardia.

The rhythm of the heartbeat of the heart of a healthy person varies from 50 to 80 liters. / 60 sec. If myocardia is affected, the heart rate is 150-200 liters. / 60 sec. This condition is referred to as paroxysm of ventricular tachycardia. There are a steady and unstable type of pathology.

Table 1. Two types of ventricular tachycardia:

Note! This type of heart rate disorders occurs in 86% of patients with IHD. Paroxysmal ventricular tachycardia duration of 4 seconds is more common in male people.

How is the disease classified?

2 forms of the disease are distinguished: monomorphic and polymorphic.

The second form includes:

blockade of the right leg of a beam of Gis;
bidirectional spindle-shaped ventricular paroxysmal tachycardia;
blockade of the left leg launch of Gis;
golden Tachycardia by type Pirouette.

Also distinguish between several types of tachycardia.

Table 2. Classification Tachycardius:

Type of tachycardia	Description
Polymorphic ventricular tachycardia type Pirouette	Arises against the background of the elongated Qt interval and bradycardia. There are short-term paroxysms.
Chronic	Short attacks occur within 3-4 months.
	More often diagnosed in people up to 40 years. Signs of organic heart disease may be absent.
Unstable	The heart cut frequency is 130 ° C. / 60 seconds. Paroxysism is not captured clinically and is not registered on the ECG.
Catecholamiergic	Hereditary disease caused by the mutation of genes.

Causes of the development of pathology

The main causes contributing to the development of the disease are presented in the plate.

Table 3. Why does ventricular tachycardia develop:

Cause	Description
	This factor in 92% of cases is a provocative pathology. Infarction changes are observed in the left myocardium of ventricles.
	The reason is damage to the genes that are responsible for the work of sodium and potassium channels.
	Tachycardia arises against the background of abuse of antiarrhythmic drugs.
	A provocateur can act as myocarditis and post-infarction cardiosclerosis.

In 3% of cases, the exact cause of pathology cannot be installed. Therefore, idiopathic ventricular tachycardia is diagnosed in the patient.

If the ECG it turns out that sinus tachycardia is interrupted by ventricular extrasystoles, the reason for this may be a disruption of the functioning of the thyroid.

Clinical manifestations

The accompanying symptoms include:

loss of consciousness;
severe dizziness;
shortness of breath;
pain in chest.

Note! One of the most specific features is often repetitive fainting.

Setting diagnosis

A compulsory requirement for ventricular tachycardia is an ECG.

Research allows:

take into account the power of impulses;
register electrical activity of the heart;
take into account the frequency of pulses.

The type of pathology is determined on the basis of the curves obtained.

Diagnosis at home

If there is a need for a patient, wearing portable miniature devices. They are able to register ECG at home.

Table 4. ECG at home:

Method	Description
	The device can be worn on the shoulder or belt. It can also be attached to his pocket. Cardiac activity is recorded for 24-72 hours. This device helps a specialist to appreciate how accurately the heart works.
	The device monitors heart work. The recording duration is 3-7 minutes. The activation of the device is observed when signs of ventricular tachycardia appear.
	Cardiac rhythm monitored continuously. The device is worn patients all the time.
	Installed under the skin. The term of its wearing is 36 months.

ECG symptomatics

The main ECG signs of ventricular tachycardia are presented in the plate.

Table 5. Basic ECG signs:

How can I help?

Treatment involves the relief of paroxysm and the prevention of its emergence in the future. Regardless of the type of pathology, the patient requires an urgent room in the hospital.

Saving an attack

Emergency assistance involves the introduction:

80-120 ml of lidocaine. The medicine is introduced insert.
2.0 ml ATP. The drug is introduced into a veined insertion. It is not necessary to breed it.
10.0 Novocainamide, connected from 20.0 saline. The medication is introduced insert. At the same time, the doctor undertakes to control the level of blood pressure.
150 mg of cordaron and 20.0 ml of saline. The drug is introduced into a vein, inkjet.
With tachycardia such as a pyruet inkjet method, 10 mg of 2.4% magnesium sulfate mixed with 20.0 ml of saline is slowly injected.
In order to relieve neurological disorders, 2 ml of relaignum is intravenously introduced.
To eliminate hypotension, administration of 0.2-0.5 ml of 1% mesaton solution is prescribed.

Note! The stopping effect of lidocaine varies from 12 to 67%. It acts quickly, but not long. The toxicity of the drug is small. A large dosage of drugs can provoke the appearance of side effects.

In order to prevent the appearance of a tachycardic attack, electrocardialism is carried out. The main side effect of manipulation is the transformation of tachycardia into ventricular fibrillation.

Further treatment

The plate contains drugs intended for further therapy.

Table 6. Further treatment of paroxysmal ventricular tachycardia:

A drug	Description	Price
	It is an antiarrhythmic medicine, a repolarization inhibitor.	295 rubles.
	The medicine contributes to a significant increase in the duration of the action potential and refractory period.	187 rubles.
	refers to the antiarrhythmic products of the IB class.	192 ruble.
	Antiarrhythmic class IC.	343-497 rubles.

The dosage of the use of these medicines is determined by a specialist. Depending on these ECG permanent registration, it may vary. The effect of treatment with Cordaron is 100%.

Help with pyruette tachycardia

The instruction looks like this:

Cancellation of drugs provoked arrhythmia. It is important to abandon the use of tricyclic antidepressants and lithium salts.
Intravenous administration of magnesia and potassium chloride.
Intravenous administration of the sumsionate.

First assistance in rustling paroxysmal tachycardia

With the NZPT patient can help himself. For this, vagus samples are used. They are actions aimed at reflex irritation of the wandering nerve.

Table 7. Basic Vagus Samples:

Try	Description
	It is necessary to deeply inhale and make a sharp straightening.
	Water should be ice.
	It is necessary to put pressure on the root of the tongue or irritive the rear wall of the throat.

Note! It is impossible to squeeze the eyeballs and massage the carotid sine.

Preparations with NZPT

The plate contains basic medicines that are prescribed in the absence of the effect after the vagus samples.

Medicine	Optimal single dosage	Nuances
	1-2 millilita	The medicine is introduced into a vein, inkjet.
	10 mg 0.25% solution.	The drug is injected intravenously.
	10% solution. Dosage - 10 ml / 10 ml of saline.	The medicine is introduced into Vienna, very slowly. The medication helps reduce blood pressure. Therefore, if the tachycardic attack is accompanied by arterial hypotension, the novelocamide should be combined with 0.3 ml of 1% mesaton solution.
	1 Million 0.025% solution.	The drug is introduced insert.

Conducting electropulse therapy

The procedure is carried out with pronounced tachycardia, when the rhythm frequency is more than 150 ° C. / 60 seconds. Also, the electrical thermal therapy is carried out against the background of contraindications to treatment with antiarrhythmic agents.

The energy of charge depends on clinical manifestations of pathology and patient health:

50 J - Supported tachycardia, characterized by a sharp and paroxy increase in heartbeat;
100 J - flickering atrial;
200 J - polymorphic tachycardia, fibrillation of ventricles.

After the completion of the procedure it is necessary to check the heart rhythm. When restoring it, you need to register an ECG in 12 leads.

Treatment of tachycardius threatening life

The table contains methods of treatment, relevant in the ineffectiveness of drug therapy.

Table 9. Radical treatment methods:

Method	Indications	Description
	Unstable tachycardia, spontaneous forms of sustainable tachycardia, clinical death.	This method is considered to be more efficient than medication treatment.
	Faccicular ventricular tachycardia	Surgical treatment of rhythm disorders by means of a radio frequency pulse.
	Stagnant heart failure.	Prosthetics aortic aneurysm.
	Atherosclerotic lesion of multiple coronary arteries, cardiomyopathy.	Such an operation is the most radical method of therapy. It requires the perfect compatibility of recipient and donor tissues.

Prevent recurrence

The table contains groups of drugs appointed if the attack was revealed 2 times / 30 days and was accompanied by symptoms of heart failure.

Table 10. Medicines for recruiting recurrences:

Group of drugs	Description
	Prevent the impact of heart cuts.
	Lower blood pressure, extend vessels, reanimate the heart rate.
	Preparations have an anti-inflammatory effect. Assigns to prevent the formation of blood clots.

Forecast after treatment

According to clinical symptoms of Tachycardia, they are divided into poor-quality and benign.

In the first case, we are talking about stable tachycardians, inclined to recurrence and accompanied by hemodynamic disorders. If stable tachycardia is not accompanied by cardiac pathologies, the forecast is favorable.

Bad prognosis at ventricular tachycardia runs. They are found in 1/3 patients and are often asymptomatic. Unstable tachycardia in patients who have moved the heart stop are prognostically unfavorable.

Possible complications

The absence of timely diagnosis may result in hazardous consequences.

Table 11. Possible complications:

Complication	Description
	Pathology arising against the background of a sharp weakening of blood circulation in a certain section of the heart, or in the entire organ.
	Progresses due to ventricular tachycardia or with impassability of pulses in the heart muscle.
	A provocateur pathology can be a broken thromb.
	It is the center of the ischemic necrosis of the heart muscle. The reason for the development of a heart attack is an acute disturbance of coronary blood circulation.

Note! The heavy flow of ventricular tachycardia can contribute to the "death of the heart." For this state, the absence of a pulse is characteristic.

Preventive actions

Prevention measures can help prevent ventricular tachycardia.

Recommendation	Description
	It is necessary to abandon the use of tobacco and alcoholic beverages.
	You need to learn to relax and try not to allow the emergence of stressful situations.
	Shown Morning Charging. It should be combined with long-term everyday walks.
	It is necessary to abandon all salty, smoked, fried.
	It is necessary to pass the survey 2 times a year.

Conclusion

Persons in the risk group must be abandoned by using stimulants. Anti-inflammory medicines can provoke a rapid heartbeat, so you only need to take them under the control of the doctor.

More information about the treatment and prevention of ventricular tachycardia can be found from the video in this article.

Stomatricular tachycardia is an attack of steady heartbeats of ventricles up to 180 shots and more. The correctness of the rhythm is usually saved. With ventricular tachycardia, as well as at a sucanementaricular (supertoday), the attack usually begins sharply. Paroxism relief often occurs independently.

Paroxysmal ventricular tachycardia - The most dangerous type of rhythm disorders. This is due to the fact that, firstly, this type of arrhythmia is accompanied by a violation of the pumping function of the heart, leading to insufficiency of blood circulation. And, secondly, the likelihood of transition to fluttering or fibrillation of ventricles is high. With such complications, the coordinated work of myocardial stops, which means that the blood circulation is complete. If in this case there are no resuscitation activities, then ashistolia will follow (heart stop) and death.

Classification of ventricular tachycardium

According to the clinical classification, 2 types of tachycardia are distinguished:

Paroxysmal stable:
- duration for more than 30 seconds;
- pronounced hemodynamic violations;
- high risk of heart stop development.
Paroxysmal unstable ventricular tachycardia:
- a small duration (less than 30 seconds);
- hemodynamic disorders are absent;
- the risk of fibrillation or a heart stop is still great.

Special attention should be paid to the so-called, special forms of ventricular tachycardium. They have one common feature. If such a dramatically increases the readiness of the heart muscle to the development of ventricular fibrillation. Among them are distinguished:

Recurient ventricular tachycardia:
- the resumption of paroxysms after periods of normal heartbeat with a source of a rhythm of a sinus node.
Polymorphic tachycardia:
- such a form may occur while simultaneously presenting several pathological foci of the source of rhythm.
Bidirectional ventricular tachycardia:
- it is characterized by either different paths of the nerve pulse from one ectopic focus, or the correct alternation of two sources of the nervous pulse.
Tachycardia type "Pirouet":
- rhythm is wrong;
- in its type is bidirectional;
- very high heart rate (heart rate) up to 300 shots per minute;
- on ECG - wave-like rise, followed by a decrease in the amplitude of ventricular QRS complexes;
- propensity to relapses;
- the debut of paroxysm is determined by the elongation of the Q-T interval (on ECG) and the occurrence of early extrasystoles (premature myocardial reductions).

Etiology and prevalence of pathology

According to the global data, about 85% of cases of ventricular tachycardium are accounted for persons suffering from coronary heart disease (IBS). In two patients from a hundred suffering from this disease, the reason for finding does not succeed at all. In this case, they speak idiopathic form. Men are 2 times more subjected to such paroxysm.

There are 4 main groups of causes of paroxysmal ventricular tachycardium:

Blood circulation violation of coronary arteries:
- myocardial infarction;
- post-infarction aneurysm;
- reperfusion arrhythmias (occur during the reverse restoration of the disturbed blood flow of the coronary artery).
Genetic disorders in the body:
- left ventricular dysplasia;
- lengthening or shortening the Q-T interval;
- WPW syndrome;
- catecholaminidated trigger polymorphic ventricular tachycardia.
Diseases and conditions not related to coronary blood circulation:
- myocardits, cardiosclerosis and cardiomyopathy;
- congenital and rheumatic patterns of the heart, the consequences of operational interventions;
- amyloidosis and sarcoidosis;
- thyrotoxicosis;
- an overdose of drugs (for example, cardiac glycosides);
- "Athlete's heart" (a modified myocardial structure developing due to high loads on the heart muscle).
Other unidentified factors:
- cases of occurrence of ventricular tachycardia in the absence of all states described above.

Gold Tachycardia Development Mechanism

The science is known three mechanisms for the development of ventricular paroxysms:

Re-entry mechanism. This is the most common option to occur a rhythm violation. The basis is the re-entry of the excitation wave of the myocardial portion.
Pathological focus of increased activity (automatism). In a certain section of the heart muscle under the action of various internal and external factors, an ectopic source of rhythm caused by tachycardia is formed. In this case, we are talking about the location of such a focus in the myocardium of ventricles.
Trigger mechanism. With it, there are previously the excitation of myocardial cells, which contributes to the emergence of a new pulse "Previously the deadline".

Clinical manifestations of the disease

Symptoms of ventricular tachycardia are diverse. They directly depend on the duration of the attack and the functional state of myocardium. With short paroxysms, asymptomatic flow is possible. With longer attacks appear:

feeling of rapid heartbeat;
the feeling of "coma in the throat";
sharp dizziness and unmotivated weakness;
feeling of fear;
leather pale;
pain and burning sadness;
often the loss of consciousness is observed (there is a lack of insufficiency of the cerebral blood supply);
in disruption of the coordinated contraction of myocardium, sharp cardiovascular failure (ranging from shortness of breath or pulmonary edema and ending with a fatal outcome).

Diagnosis of pathology

In order to determine the type of paroxysmal tachycardia and make sure that there is a ventricular form, several sufficient diagnostic methods are enough. The main of them is electrocardiography (ECG).

ECG with ventricular tachycardia There are also a number of indirect symptoms, which can assume the presence of a ventricular type of paroxysmal tachycardia. These include all the above symptoms, plus some simple physical research and their results:

when listening to the work of the heart (auscultation) - a rapid heartbeat with deaf heart colors that cannot be calculated;
weak pulse on the radial artery (determined on the wrist) or its absence (if it is impossible to "try");
a sharp decrease in blood pressure (AD). Often, blood is generally not possible to determine, firstly, due to its very low level and, secondly, due to too high heart rate.

In the absence of ECG signs of ventricular tachycardia, but the presence of similar symptoms, it is advisable to conduct Halter monitoring. One of the main tasks of these both instrumental studies is the determination of the presence of ventricular tachycardia and its differential diagnostics from the supertortic form with the aberrant conduct (with an extended QRS complex).

Differential diagnosis of ventricular tachycardia

Of paramount importance in the definition of ventricular tachycardia, it has its differentiation with a sucanementaricular form with an aberrant pulse (because at both types of the QRS complex is expanded). Such a need is due to differences in the binding of the attack and possible complications. This is due to the fact that the ventricular paroxysm of tachycardia is much more dangerous.

Signs of ventricular tachycardia:

The duration of QRS complexes is more than 0.12 seconds (on the ECG in comparison with the supervalitary tachycardia complex is wider).
AV-dissociation (non-synchronous atrial abbreviations and ventricles on ECG or with electrophysiological intracardiac examination).
QRS-complexes of monophasna (type RS or QR).

Signs of religious tachycardia with an aberrant holding:

Three-phase (RSR) QRS complex in the first breast (V1) assignment.
QRS duration not more than 0.12 seconds.
Discordance (location along different sides of the isoelectric line to the ECG) Tuster T relative to QRS.
Teeth P are associated with ventricular QRS complexes.

Treatment of paroxysmal ventricular tachycardia

Unstable ventricular tachycardia usually does not require any treatment, however, its forecast is increasingly deteriorating in the presence of concomitant heart lesions. In classical stable tachycardia, an emergency relief of a paroxysmal attack.

Before conducting medical manipulations to restore normal heart rhythm under this pathology, it is important to take into account the following factors:

Lee earlier arrhythmias; Does the patient sick of thyroid gland, cardiovascular system sick.
There were previously inexplicable losses of consciousness.
Whether relatives suffer from such diseases, there were cases of sudden heartfall among them.
Whether the patient took any medicinal preparations (it is necessary to take into account that some drugs (antiarrhythmics, diuretic, etc.) can provoke a rhythm violation). It is important to remember the incompatibility of many antiarrhythmic drugs (especially within 6 hours after admission).
What medicinal substances were restored by rhythm earlier (is one of the testimony to choose exactly this drug).
There were complications of arrhythmias.

Stages of relief of the attack of paroxysmal ventricular tachycardia:
With any tachycardia with an extended QRS complex (including the supertoday with an aberrant conduction) and expressed impairment of hemodynamic indicators showing electrical cardioversion (electrical thermal therapy). For this purpose, a discharge is used 100 - 360 J. In the absence of an effect, an adrenaline solution with one of the antiarrhythmic preparations (lidocaine, amiodar) is used intravenously at the same effect.

If ventricular tachycardia is not accompanied by a circulatory impairment and a pronounced decrease in blood pressure (blood pressure), then the lidocaine is used. In the absence of the effect, electrical therapy (EIT) is shown.

In the event of an improvement in the overall condition of the patient and increase the blood pressure, but with still disturbed heart rhythm, it is advisable to use the Novocainamide. If the condition has not improved after the EIT, the amiodarone solution is administered intravenously. In case of successful relief of the attack of ventricular tachycardia, the introduction of one of the above-described antiarrhythmic drugs during the day is obligatory.

Important to remember:

with a complete atrioventricular blockade, the introduction of the lidocaine solution is unacceptable;
with the ventricular tachycardia of the type "Piroet", the relief of paroxysm must be started with intravenous administration of a solution of magnesium sulfate.

Forecast

If ventricular tachycardia is not accompanied by a violation of the function of the left ventricle (there is no decrease in blood pressure and signs of blood circulation deficit), the forecast is favorable and the risk of re-attack and sudden cardiac death is minimal. Otherwise, on the contrary.

Paroxism of tachycardia type "Pirouette" with any variant of the flow has an unfavorable forecast. In this case, the likelihood of the development of ventricular fibrillation and sudden cardiac death is high.

Prevention of ventricular tachycardia

The prevention of the disease is the constant reception of antiarrhythmic anti-inflicted drugs. Individual effective selection of drugs is possible only in half of the patients. Currently apply either Satolol or amiodar. Under the myocardial infarction, such drugs are acting as the prevention of ventricular tachycardius as:

statins - reduce blood cholesterol (atorvastatin, lovastatin);
antiagregants - prevent the formation of thromboms (aspirin, pollockard, aspirin-cardio);
aCE inhibitors - reduce blood pressure and relax the vascular wall, thereby reducing the load on the heart muscle (enalapril, lysinopril);
beta blockers (bisoprolol, metoprolol).

With repeated attacks against the background of the reception of the above-described drugs to prevent follow-up paroxysms:

implantation of a cardioverter-defibrillator, which in case of a rhythm violation in automatic mode gives a certain discharge to restore normal cardiac activity;
radio frequency ablation - physical removal of pathological paths of nerve impulses inside the heart;
heart transplant (as a last resort, with impossibility of other treatment).

Thus, ventricular tachycardia is the worst version of paroxysmal tachycardia, often accompanied by serious complications. With such a violation of the heart rhythm, the likelihood of death is high.

One of the dangerous changes in the rhythm of the heart is paroxysmal ventricular tachycardia. This is an attack of accelerated heartbeat, the source of which is myocardium ventricles.

The danger of ventricular tachycardia (Zht) is that with a high frequency of contractions of the myocardium cavity, they do not have time to fill in blood, so it is practically not thrown into the aorta and the pulmonary artery. It can be said that the bloodstream stops, so it is ineffective. All fabrics, especially the brain, are tested by the lack of oxygen. Under these conditions, the cells are quickly dying. The violation of the rhythm threatens life and requires immediate treatment.

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Causes of appearance

About paroxysmal ventricular tachycardia speak in cases where it suddenly appears, and the frequency of heart cuts (heart rate) is more than 140 per minute. It is a continuous chain of 4-5 and more ventricular extrasystoles, following continuously.

With this arrhythmia, the source of pulses that reduce the heart serves the accumulation of cells located in the myocardium of one of the ventricles. Atrialia is reduced by themselves, their rhythm is much less common than the heart rate when railway.

Gold Tachycardia Development Mechanism

It is mostly observed in older men.

The attack, or paroxysm of ventricular tachycardia, occurs in people with severe diseases:

ischemic heart disease, especially progressive angina and, as well as the aneurysm of the heart;
cardiomyopathy: restrictive, dilatation, hypertrophic, changing the structure of the conductive heart system;
some medicines (County, Digoxin, Novocainamide);
cocaine;
sarcoidosis and other systemic diseases with the defeat of many organs;
heart defects, myocardits;
increased thyroid function;
increased potassium content in blood;
chest injury.

Classification of pathology

Depending on the duration and danger, the Zht distinguish its shapes and types.

Views

unstable ventricular tachycardia - short paroxysms, independently arising and stopping; usually they are not accompanied by severe manifestations;
sustainable zht is a long episode that can go to ventricular fibrillation and lead to a heart stop.

Forms

bidirectional ventricular tachycardia, manifests itself on the ECG deformed ventricular complexes, which gradually change polarity, forming a characteristic picture of "spindle"; Another name of this very dangerous arrhythmia is "Pirouette" or spine-like ventricular tachycardia;

Ventricular tachycardia polymorphic, bidirectional

monotopic monomorphic Zht. - less dangerous, is a series of extrasystole or circular circulation of pulse in the myocardium of ventricles;

Paroxysmal monomorphic ventricular tachycardia

fascicular It is found in young people without heart disease and up to 10% of all Zht.

Signs and symptoms of rhythm disorders

Any kind of railway, especially polymorphic ventricular tachycardia, is usually poorly tolerated patients. Basic symptoms:

dizziness, faint is possible;
heart palpitations;
sense of lack of air;
sometimes nausea;
confusion of consciousness and his loss;
heart failure.

CSS ranges from 140 to 250 per minute. The duration of the attack is usually from a few seconds to several hours. Sometimes it lasts a few days.

Arrhythmia is accompanied by signs of oxygen starvation:

burning, compressive pains for sternum, not removable by nitroglycerin;
an arrhythmic shock may occur with a sharp decrease in pressure and loss of consciousness;
the separation of urine is reduced;
there is a pain in the stomach and its bloating (with long or frequent attacks).

Some people do not feel the attacks of tachycardia, although the danger to life is preserved.

Diagnosis of pathology

Recognize a railway with two methods - ECG and daily monitoring of ECG.

Decoding ECG

The ventricular tachycardia on the ECG is manifested by a sudden episode of rapid heart cuts with a frequency of 140 to 220 per minute. They are rhythmic. Ventricular complexes of the wrong shape, they are expanded.

Stomatricular Tachycardia

With a careful analysis of ECG, it is possible to notice the normal teeth of P, reflecting the calm reduction of the atria. Sometimes the sinus pulse passes into the ventricles through an atrioventricular node, and then the "ventricular grip" appears - a single normal ventricular complex, narrow and undeformed. This is a distinctive feature of it.

Stomatricular tachycardia. 9th account QRS-complex is narrow (capture)

Not every rapid heartbeat (tachycardia) with advanced complexes on ECG is ventricular tachycardia. A similar picture may be accompanied by a tachiisistolic form of atrial fibrillation, tachycardia with, religorated tachycardia with a violation of one of the feet of the Gis beam. Therefore, for final diagnostics it is necessary daily ECG monitoring.

Atrial fibrillation with the form of the QRS complex as a glocade of the left leg of the GIS (a). Stomatricular tachycardia (b). Differential diagnosis of supertoday tachycardia with the aberrant conducting and ventricular tachycardia on the electrocardiogram is complex, and sometimes it is impossible to save the right and timely first aid during tachycardia. What can and need to do at home when attack? How to provide urgent help with paroxysmal, suprazdroke tachycardia?

Supported and ventricular extrasystole is a violation of the rhythm of the heart. Options for manifestation and forms are several: frequent, rare, bigemia, political, monomorphic, polymorphic, idiopathic. What signs of illness? How is the treatment?

Outdoor tachycardia in adults and children is found. Symptoms are a sudden rapid heartbeat, dizziness and others. Not always testimony on the ECG will be praised the problem. The relief of seizures of paroxysmal NT can be carried out independently, but without treatment in the future it is not necessary.

If extrasystolia is revealed, treatment with drugs may not be required immediately. Supporting or ventricular heart extrasystole can be practically eliminated only by changing lifestyle. Is it possible to cure forever. How to get rid of tablets. What a drug selection with extrasystole is Corvalol, anaprilin. How to treat ventricular single extrasystoles.

Feeling of rapid heartbeat, "coma" in the throat.
Discomfort and the feeling of "burning" in the chest.
Sharp weakness, dizziness, up to loss of consciousness.
The feeling of "foolishness", fear.
Pallor skin.

It is also possible asymptomatic course of the disease.

Forms

In the form of ventricular tachycardia happens monomorphic and polymorphic.

Monomorphic ventricular tachycardia.
- There is one source of tachycardia (rapid heartbeat).
- More often when there is a heart lesion.
Polymorphic ventricular tachycardia.
- There are several sources of tachycardia.
- It is found in overdosing some medicines and some genetic (children transmitted from parents) diseases.

Overstream allocate paroxysmal unstable, paroxysmal stable and chronic or constantly -return tachycardia.

Paroxysmal unstable gastric tachycardia.
- The attack of ventricular tachycardia lasts less than 30 seconds.
- Such paroxysms (exacerbations) strongly on hemodynamics (blood flow through vessels) do not affect, but increase the risk of fibrillation (frequent, but erratic, chaotic excitation and reduction of individual fibers) of ventricles.
Paroxysmal stable gastric tachycardia. The attack of ventricular tachycardia lasts more than 30 seconds. In this case, a pronounced violation of hemodynamics occurs.
Chronic (constantly returnable, continuously recurrent) gastric tachycardia - Durable (weeks and months) repeating relatively short tachycardic attacks. This version of ventricular tachycardia leads to a gradual, slow increase in hemodynamic disorders.

Causes

Idiopathic ventricular tachycardia (at the same time its cause is unknown), diseases of the heart and genetic (children transmitted from parents) predisposition is not noted.
Ischemic heart disease (heart disease due to insufficient blood supply).
Myocardial infarction (heart fabric death due to insufficient blood supply).
Myocarditis (inflammation of the heart fabric, which arises most often due to the infectious disease).
Congenital heart defects (congenital heart structure).
Cardiomyopathy (a disease in which the structure of the structure and the function of the heart muscle occurs, the reason is most often unknown).
Arritmogenic dysplasia of the right ventricle is a disease that is characterized by the gressing substitution of myocardium (muscle tissue of the heart) of the right ventricle with fatty and connective tissue and is manifested by ventricular arrhythmias (violation of the normal rhythm of the heart) and a sudden death.
Surgical operations on the heart.
Overdose of some drugs:
- antiarrhythmic drugs (drugs that normalize heart rate rhythm);
- beta-adrenoblockers (drugs blocking special nerve formations (receptors) reacting to adrenaline and norepinephrine - stress hormones);
- glycosides (preparations that reinforcing the power of rejuvenating (they become rare) heart abbreviations and slowing the conductivity of the pulse in the heart).
Electrolyte disorders (decrease in electrolyte content (magnesium, potassium and other substances involved in the organism exchange processes)).
Genetic (parents transmitted from parents) diseases:
- brugada syndrome (hereditary (can be transmitted from parents to children) a disease characterized by specific changes in the electrocardiogram and an increased risk of fibrillation (frequent, but erratic, chaotic arousal and reduction of individual ventricular fibers) ventricles);
- the elongated Qt interval syndrome (a disease that may be inherited and which is characterized by changes in the electrocardiogram (the elongation of the Qt interval), as well as the increased risk of ventricular fibrillation and sudden cardiac death).

Diagnostics

Anamnesis analysis of the disease and complaints (whether the patient notes with general weakness, the feeling of heartbeat, discomfort in the chest, the pallor of the skin, dizziness, fainting, with which it binds the occurrence of these symptoms when (as long ago) they appear what accompanying diseases are available).
Analysis of the history of life (there is a myocardial infarction (a disease characterized by the death of the heart muscle tissue due to insufficient blood supply) in history, whether the patient takes any drugs, whether in close relatives of the disease of the cardiovascular system, there are cases of sudden death in family).
Physical inspection. The skin inspection is made, the pulse is measured, arterial pressure measurement and auscultation (listening) of the heart tones is measured.
General blood analysis. General urine analysis. Are carried out to identify concomitant diseases.
Biochemical blood test - determine the level of total cholesterol (zero-like substance, building material), low (contributes to the formation of cholesterol plaques - cholesterol deposits on the walls of vessels) and high density (prevents the formation of cholesterol plaques), the level of triglycerides (fats, cell energy source) , Sugar level, blood electrolytes (potassium, magnesium, calcium).
Electrocardiography (ECG) is carried out to identify changes in the heart, possible rhythm disorders, the location of the focus of ventricular tachycardia is determined.
Daily monitoring of the electrocardiogram. With the help of the study, you can not only reveal the ventricular tachycardia, but also to know the number of episodes per day, their duration, the location of the focus of ventricular tachycardia, the conditions for its occurrence.
Echocardiography (ECCG) - allows you to determine the condition of the structures of the heart, reveal the violation of its reduction, valve violations.
Electrophysiological examination of the heart. Obtaining a record of biological pulses from the inner surface of the heart, while special electrodes and registration equipment are used. Allows you to reveal the accurate mechanism for the development of ventricular tachycardia.
Load tests (cycle ergometry or Tredamil test) is the use of an increasing stepper physical activity performed by the conducted on a cyagometer (special type of cycle bar) or a treadmill (special treadmill) under the control of an electrocardiogram. In the study, the heart ischemia (insufficient blood content in the heart) is detected, as the cause of ventricular tachycardia. In addition, it is determined how ventricular tachycardia changes depending on the load.
Multispical computed tomography (MSCT). Relates the presence of diseases leading to ventricular tachycardia.
Magnetic resonance tomography (MRI). Detection of heart disease leading to ventricular tachycardia.
Radionuclide techniques (a method for determining the condition of the heart with radiation from the radiopharmaceutical preparation introduced inside). In the study it is possible to identify the area of \u200b\u200bdamage to the heart muscle, the zone of its ischemia (insufficient blood content in the heart), which can be a source of ventricular arrhythmia.
Coronoanhibition with ventriculography (study of the blood vessels and ventricular cavities) - is determined whether there is a narrowing of its own arteries of the heart, the aneurysm of the ventricles (limited protrusion of the thinned and non-reducing area of \u200b\u200bthe ventricle wall consisting of dead tissue), which are the most frequent causes of ventricular tachycardia.
Consultation is also possible.

Treatment of ventricular tachycardia

Treatment of the main disease, due to which ventricular tachycardia developed.
Restoration of the rhythm at the time of paroxysm (exacerbation) of ventricular tachycardia:
- electropulse therapy (treatment of heart rate disorders by pulse of electric current);
- antiarrhythmic drugs (preparations restoring and supporting heart rate), which are injected intravenously.
Prevention of stomach tachycardia attack.
- Medical therapy:
  - beta-adrenoblockers (weaken and replenish (they become rare) heartfrections, reduce blood pressure);
  - antiarrhythmic drugs (restore and maintain normal rhythm cardiac abbreviations);
  - calcium channel blockers (have the ability to restore normal heart rate rhythms, weaken the power of the reduction of the heart, extend the vessels, reduce blood pressure);
  - omega 3 polyunsaturated fatty acids (reduce cholesterol levels (zip-like substance, building material) in the blood, reduce the possibility of forming blood clots, and also have an anti-inflammatory property).
- Surgery:
  - radio frequency ablation - the destruction of the source of arrhythmia (source of violation of normal heart rhythm) with the help of a radio frequency pulse;
  - implantation (installation) of cardioverter-defibrillator (device restoring heart rate rhythm).

Complications and consequences

Ventricular fibrillation (frequent erratic, irregular excitation and reduction of individual muscle fibers).
Cardiac insufficiency (violations associated with a decrease in the contractile ability of the heart) - develops with a long period of the disease.
Sudden heart death.

Prevention of ventricular tachycardia

Prevention of diseases causing ventricular tachycardia.
Refusal of alcohol and smoking.
The elimination of intensive psycho-emotional loads (stress, conflict situations at work and at home).
Regular moderate physical exertion (walks, morning gymnastics).
Rational and balanced nutrition (limited consumption of fried, salt, smoked food; increase in the diet of fresh fruits and vegetables).
Body mass control.
Control of the level of sugar and cholesterol (zip-like substance, building material cells) in the blood.
When detecting genetic (transmitted children to children), the disease examination of relatives to prevent the development of the disease.