Treatment of flickering tachycardia
Author Ольга Кияница
A flickering tachycardia is characterized by irregular heartbeat, when the heart rate is greatly increased, and the person starts to feel like a "trembling heart". It is necessary to restore such a rhythm as quickly as possible, since the main complication of the pathology is thromboembolism of the vessels of various organs. If it occurs, a critical state may arise.
According to statistics, flickering tachycardia is more common in men, especially in individuals at the age of 50 years and older. Therefore, it is important to determine the ratio of the patient to the risk group for treatment.
The diagnosis of flickering tachycardia should be confirmed by instrumental research methods. Electrocardiography is used for this, supplemented, if necessary, by Holter monitoring and loading tests. After a complete patient examination, therapy is usually carried out as a complex one, since in some cases the use of one drug is not sufficient.
Video Doctor Myasnikov recommends false arrhythmias
In cardiology, it is imperative to follow the general recommendations given to all patients with cardiovascular disease.The heavier the clinical picture, the greater the medication intervention, but from the implementation of the submitted advice should not be refused.
- It is necessary to try to avoid stressful situations and various disturbances that can provoke a flicker attack.
- Habits in the form of smoking, drinking alcohol or strong coffee negatively affect the state of the cardiovascular system.
- Overweight is worth adjusting, for which it is important to adhere to the rules of healthy eating.
- It is necessary to periodically determine the amount of cholesterol and glucose in the blood, to prevent heart disease.
- In the absence of symptoms, examination with a cardiologist should be carried out not less than once a year, in other cases - as necessary.
Medicinal treatment of flickering tachycardia
Depending on the clinical manifestations, there are two forms of flickering tachycardia: paroxysmal and constant. For each variety, their therapies are used.
Treatment of paroxysmal flickering tachycardia
Paroxysmal flickering tachycardia is similar to the usual paroxysmal tachycardia, and therefore similar drugs are used to resuscitate it - novocainamide and quinidine. Also used beta-blockers and aimalin, but also in their effectiveness, they lose the above.
Quinidine is an antiarrhythmic drug that has a pronounced antiarrhythmic effect. The mechanism of its action is based on a decrease in the excitability of atrial fibrillation cardiomyocytes. The refractory period is also lengthened, and, in addition, the transmission of the excitation wave along the bundle of Guillaume slows down.
An approximate scheme of administering quinidine during the cessation of an attack of a flickering tachycardia:
- on the first day - up to 3 times in 0.2 g;
- the following days - the amount of the drug is increased to 1.4 g, for this every four hours increase by 0.3 g.
After restoration of normal rhythm for several weeks, successive doses up to 0.5 g are used. It is important to remember that there should be constant medical control.
There may be an allergic reaction to quinidine (increase in body temperature, rash on the skin, decrease in the number of platelets), therefore a trial dose should be introduced before use. The drug can not be used in all conditions. For example, a direct contraindication is myocardial infarction and other serious myocardial lesions.
Exemplary schemes for the use of other drugs for the treatment of paroxysmal flickering tachycardia:
- Novoquanamide - three times a day for 0.5 g, if the dose is insufficient, then the multiplicity of receptions is increased to 5-6 times. The drug is often combined with a mezatone, as the background of its administration often lowers arterial pressure.
- Beta-blockers - Of this pharmacological group is often used obidzidan, isoptin, panangin. In some cases, aimalin is used.
Sometimes, after all the medical regimens used, the paroxysmal flickering tachycardia continues to be disturbing. Then Electropulse Therapy is performed.
Treatment of permanent flickering tachycardia
With this pathology, therapy is conducted in two main ways:
- Restoration of normal cardiac activity.
- The translation of the rapid heart beat into the truncated, while in the case of heart failure or pulse deficiency, their elimination is carried out.
The first way is realized by means of electrodefibrillation. In some cases, quinidine is additionally used, which, with constant flickering tachycardia, is effective in 40-80% of cases. Further, antiarrhythmics in the form of beta-blockers, potassium salts and others are used to maintain the rhythm restoration.
Treatment of some concomitant conditions of constant flickering tachycardia:
- Cardiac insufficiency is corrected with the help of digitalis preparations.
- The risk of thromboembolism is reduced by the use of anticoagulants.
- Electrolyte exchange in the heart muscle is normalized with potassium and quinidine salts. For this, cocarboxylase is also used.
Diagram of treatment with quinidine constant flickering tachycardia A. L. Myasnikova:
- Find out the sensitivity of the patient, for which the drug is injected at a dose of 0.2 g.
- The first two days are taken up to five times in a dose of 0.2 g.
- The next three days take 0.3 g.
- The next four days - 0.4 g.
- Subsequently, with normal tolerability, the medication is taken at 0.5 g until the rhythm is restored to normal.
The criterion for assessing the treatment of quinidine - the rhythm should be restored to the end of the second week since the beginning of the course. With this it is important to adhere to a strict bed regime. If, however, under such conditions, cardiac activity is not restored, then the use of quinidine is discontinued.
Quinidine has a large number of side effects, so it is used when absolutely necessary and only under continuous medical and electrocardiographic control.
Electro pulse therapy is a frequently used method of treating permanent flickering tachycardia, which is considered to be quite effective. Before it is carried out medical preparation in the form of correction of heart failure. For this purpose, diuretics and cardiac glycosides are prescribed. When observing disturbances of metabolic processes in the myocardium, cocarboxylase, potassium and magnesium salts, and vitamin complexes are used. Additionally, anticoagulant treatment is necessary for the prevention of thromboembolism.
Contraindications to defibrillation with flickering tachycardia:
- Presence of a patient with active myocarditis.
- The heart cavities, in particular atria, are strongly stretched.
- There are extremely severe disorders of the conducting heart system.
- Dermal preparations were administered at elevated doses, resulting in an overdose.
- There is a tendency to complications in the form of thromboembolism.
- If the permanent form formed on the background of frequent paroxysmal attacks.
Non-traditional treatment for flickering tachycardia
Some patients try to use non-traditional therapy of the disease. Often with flickering tachycardia it turns out to be fruitless. Acceptance of some herbs can have a beneficial effect on the heart muscle, but often the opposite effect is achieved - the patient becomes worse.
Flickering tachycardia is a serious disease requiring many different medical and research approaches. Pathology is not only treatable, therefore self-healing is dangerous to health. At least for the reason that it is not known how the organism that is weakened by the disease will respond to the introduction of untrained in such therapy of non-traditional drugs.