Treatment of reciprocal tachycardia

Author Ольга Кияница

2017-11-10

One of the few disorders of the heart rhythm, which develops without any organic pathologies of the heart. At the same time it can bring a lot of discomfort to the patient and in difficult cases become the cause of more severe disorders of the conducting system.

Reciprocating tachycardia is most commonly evolving in women and the causes of it are not yet fully understood. Pathology can lead to fainting, since after attacks, the pressure is often reduced or bradycardia develops.

The formation of reciprocal tachycardia is associated with the mechanism of re-enter. A similar definition helps to choose appropriate drugs for the treatment of arrhythmias, which can slow the passage of circulating impulses.

To date, there are various types of treatment for reciprocal tachycardia. It all depends on its course, the severity of the clinic. Also, the peculiarities of the patient play a significant role; therefore, an individual approach is important in the preference of one or another method.

Electrocardiogram video at AV node reciprocal re-entry tachycardia (AVRT, AVURT)

Medicinal treatment of reciprocal tachycardia

Frequently used drugs during cessation of reciprocal tachycardia attack:

  • Adenosine
  • Beta-adrenoblockers
  • Calcium antagonists
  • Digoxin
  • Verapamil
  • Novokainamide
  • Obsidian

The use of drugs is carried out in the oral and parenteral way. With the help of adenosine and other adrenoblockers, the slowing of the antegrade passage of the pulse along the slow path is performed. Preparations Ia and Іс classes reduce the retrograde transfer of pulses on the fast path.

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Adenosine is most commonly used because it acts quickly, but its effect is not prolonged. This drug is not suitable for frequent and long-term administration.

Anticonvulsant treatment is prescribed taking into account the course of the disease:

  • Standard therapy includes beta-blockers, calcium antagonists, digoxin.
  • In the presence of drug resistance, drugs of class Ic (propafenone, flekainid) are used. With their help trivoventricular conductivity slows down.
  • Sotalol and amiodarone are practically not used.
  • The disopyramide, quinidine, prokainamide is ineffective.

Video Therapeutic drugs for tachycardia

Recently, antiarrhythmic drugs are increasingly used for long-term treatment of reciprocal tachycardia, as a new method of choice - RFA.

Radiofrequency catheter destruction

RF, or radiofrequency ablation, is often found to be effective in 99% of cases when treating reciprocal tachycardia. The postoperative period is accompanied by a minimal number of complications. The most important thing - after the destruction of pathological paths patients do not need to take antiarrhythmic drugs for life.

Video Radio frequency ablation RFA

Complications . The percentage of occurrence is 1% of cases. Most often presented as an atrioventricular blockade, which is associated with the modification of slow paths.

Contraindications. They are basically absent, although the issue of conducting RFA in each particular case is considered separately. Most often, the patient himself expresses the desire to take drugs, in the extreme case, there may be financial difficulties in ensuring the operation.

Electric cardioversion

It is used in the extreme cases where the following indications are available:

  • The patient suffering from reciprocal tachycardia is poorly tolerated.
  • Observed unstable hemodynamics.

In the process of conducting electric cardioversion, we usually use weak discharges of the order of 10-50 J.


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