Treatment of paroxysmal tachycardia

Author Ольга Кияница


Paroxysmal tachycardia is diagnosed in the elderly against the background of organic heart disease and in young, when neurogenic and hormonal disorders are observed. Modern treatment of paroxysmal tachycardia helps to get rid of ailment and improve quality of life.

The name of the paroxysmal tachycardia is associated with a characteristic manifestation of the disease, paroxysms, which are paroxysmal heart rhythm disorders. The disease is dangerously sharp deterioration of the circulatory system, cardiac muscle disorder.

Among all the pathologies associated with excessive myocardial arousal, paroxysmal tachycardia is in third place in frequency of occurrence.

The beginning and end of arrhythmia attacks are sudden, the duration can range from a few seconds to several minutes or more. During paroxysm, the work of the sinus node is tumbling and the "rhythm" imposed by the ectopic foci is observed. The more such focal points in the heart muscle, the more severe the disease takes place, and the more difficult it is to treat paroxysmal tachycardia.

Video What you need to know about paroxysmal tachycardia 

General recommendations

When paroxysmal tachycardia, one should adhere to a certain lifestyle, which will prevent the development of paroxysms.

  1. Avoid harmful habits, especially smoking, alcohol and energy use.
  2. Adjust the mode of the day in which you will be assigned to sleep (day and night) for at least 8 hours.
  3. To monitor your weight, this will help to refuse food while watching TV, work near the computer, reading books.
  4. It is useful in the morning and in the evening to take outdoor walks, exercise, physical activity, swimming or light gymnastics.
  5. It is important not to overeat, for what it is necessary to eat in small portions.
  6. Do not go to bed with a full stomach.
  7. Monitor the amount of sugar and cholesterol in the blood.

Some products are unwanted to use paroxysmal tachycardia. This is a solid coffee and tea, high-calorie foods, as well as sugar and starch in its composition, fatty varieties of fish and meat.

Medicinal treatment of paroxysmal tachycardia

There is a definite algorithm of action preceding the treatment of paroxysmal tachycardia.

  • The peculiarity of the course of the disease is estimated.
  • The form of paroxysmal tachycardia is determined.
  • The duration of the disease is set.
  • The character of the present complications is studied.

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Hospitalization of a patient with paroxysmal tachycardia is only performed when there is progress in a heart failure clinic.Often this occurs during complicated course of nodal and supraventricular form of paroxysmal tachycardia. If ventricular paroxysmal tachycardia is detected, then admission to hospital is obligatory. There is also planned hospitalization, which is applied in the case of frequent attacks, that is, more than twice a month. Planned patients are treated for treatment in an interrupted period.

Surgery of paroxysmal tachycardia

It is carried out at the stage of medical care. The following methods are used to provide emergency care:

  • The patient is seated and opens the oven or door to access fresh air.
  • In the presence of heart pain, nitroglycerin is taken.
  • Vagal tests are carried out, which include strain, the challenge of the vomiting reflex, the application to the face of a cold towel, the execution of samples of Achner, Valsalva, Chermak-Goering.

Vagus tests help stimulate the vagus nerve, which in turn slow down the heart rate. Performed until normal rhythm. They always help, but are accessible both by the sick and their relatives .

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The ambulance team in difficult cases carries out an electrical cardioversion with use of low discharges at 50 and 75 J. For sedation, seduxene can be used for pain relief. The presence of reciprocal paroxysmal tachycardia is an indication of conduction of cerebrovascular stimulation of the heart.

Medicinal compression of paroxysm is performed taking into account the form of arrhythmia. In case of violations of rhythm with narrow-gastrointestinal complexes, prokainamide, adenosine phosphate is injected intravenously. Also can be used in tablets verapamil, atenolol. Ventricular and supraventricular paroxysms are effectively eliminated by amiodarone, prokainamide.

Long-term treatment of paroxysmal tachycardia

It is concluded in the appointment of antirecurring therapy, which consists of cardiac glycosides and antiarrhythmic drugs.

  • Cardiac glycosides are tselanid, digoxin. Must be used only by the appointment of a doctor, as they can cause a heart stop.
  • Antiarrhythmic drugs - ethaczine, cordarone, verapamil. Causes various side effects, therefore, they are used in the presence of hemodynamic disturbances against the background of paroxysms.

With supraventricular (supraventricular) PA, various antiarrhythmic drugs are prescribed, but the most effective are verapamil and ATP-restoring sinus rhythm in most patients. Also, in the treatment of this form of paroxysmal tachycardia, novocainamide (positively affects 50% of patients) and Cordaron (effective in 80% of cases) are used.

The predisposition of the patient to the development of atrial fibrillation is an indication of the use of beta-blockers. Their use can help reduce the dosage of antiarrhythmics.

Ventricular FV is first treated with lidocaine and after the appointment of novocainamide with a cordaron. In some cases, it is not possible to accurately determine the location of the ectopic focus, then after lidocain, ATP is assigned, followed by novocainamide with the cordaron.

Surgical treatment of paroxysmal tachycardia

Operative intervention is used in the case of ineffectiveness of medical treatment. The patient is first thoroughly examined, and then one of the methods of surgical treatment of paroxysmal tachycardia is proposed:

  • Destruction of conducting paths and foci that are associated with heterotropic automatism. Various means are used for such manipulations: cryogenic, laser, chemical, electrical, mechanical. Access to the heart is represented through therapeutic and diagnostic catheters. The first is determined by the pathological focus, and the second one is conducting its destruction.

The most widespread destructive method today is radio frequency ablation. With its help, burning of pathological foci is carried out, which maximizes the probability of complete cure from PT.

  • Implantation of the pacemaker. The so-called artificial heart can be of two kinds - cardioverter defibrillator and pacemaker. With the help of these instruments, the ability to develop an attack is minimized.
    Classical surgery is performed on open heart, if for some reason it is impossible to conduct a minimally invasive surgical procedure. The main purpose of such treatment is to remove the problem areas of the conducting system.

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Indications for surgical intervention:

  • Using these devices minimizes the possibility of an attack.
  • Development of ventricular fibrillation, even single.
  • Sustained attacks of paroxysms that can not be medically treated.
  • Definition of organic heart defects in the form of valve defects and anomalies in the structure of the organ.
  • Expressed non-perception of antiarrhythmic drugs or contraindications to their use.
  • Development of paroxysms in children and adolescents, significantly disrupting the full body growth.

Treatment of paroxysmal tachycardia by folk remedies

Phytotherapy is often used in anti-rheumatic therapy of paroxysmal tachycardia. Apply infusions, broths and tinctures from those plants that help calm down cardiac activity.

  • Different charges are used to relieve nervous tension. One is prepared on the basis of wild boar, valerian, hawthorn, anise. Another of chamomile, cumin, fennel, valerian and mint. It is better to take such infusions before going to bed at night.
  • Melissa found application in the form of fees and as an independent national remedy for paroxysms. Herbal tea from Melissa is recommended to take a little during the day.
  • Paroxysmal tachycardia often develops in the face of hypertension. In such cases, the components that lower blood pressure are added to the sedative plants. Collections are received from melissa, calendula, peppermint, rosette, scallop, and blackberry.
  • Good effect on the cardiovascular system of decoctions of hawthorn. Useful berries, along with chicory, calendula, livestock, are part of the reinforcement fees.

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Treatment of paroxysmal tachycardia in children

In children, 95% of cases of rhythm disorders are diagnosed with PA. In adolescence, this disease often leads to arrhythmogenic collapse, so it is very important in the event of a paroxysmal tachycardia in a timely manner to help.

Treatment of paroxysmal tachycardia in children is based on the following algorithms:

  • Conducting vaginal samples.
  • Effects on the central nervous system using appropriate drugs.
  • The use of antiarrhythmics in the age-appropriate dose.

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For normalization of cortical and subcortical relationship, carbamazepine, phenybut, tincture of plants such as peony, hawthorn, valerians are prescribed. Also shown is the use of magnesium and potassium.

Antiarrhythmics are used in the ineffectiveness of vaginal samples and psychotropic drugs. In the age-old dose, triphosadenin is used. Verapamil is used in the narrow ventricular complex defined on the ECG. This drug can not be used in blocking the atrioventricular node. If supraventricular tachycardia is detected after verapamil, digoxin is administered.

Beta-adrenoblockers for the treatment of paroxysmal tachycardia in children are rarely prescribed. Instead, it is often used for acupuncture, curative physical training, psychotherapy, and vegetotropic medications.

Treatment of paroxysmal tachycardia during pregnancy

The occurrence of reflex or compensatory PA is not an indication for the purpose of antiarrhythmic drugs. These funds are used in the event of a clear threat to the health of women. Instead, it's best to take general advice and then arrhythmia will stop worrying.

In the presence of a woman's organic heart disease, groups of drugs that help strengthen the cardiovascular system are used.

  • Soothing agents are magnesium B6, etazicin, new-pasit.
  • Drugs that reduce heart rate - propranolol, flecanil, verapamil.
  • Drugs used in ventricular tachycardia - Validol is taken at home, in the hospital Novocaminamide, quinidine.

The treatment is performed under the control of an electrocardiogram and a cardiologist. It is categorically unacceptable to use these drugs on their own, because the mother and child's life is at stake.

Video What is heart tachycardia and how to treat it? 

In most cases, the prognosis for paroxysmal tachycardia is favorable. Timely treatment provides an opportunity to quickly stop an attack, while the use of suitable drugs prevents the relapse of the disease. It is also important to observe general guidelines that, in mild cases, allow you to do without the use of antiarrhythmic drugs.

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