Are Disabilities Given Arrhythmia

Author Ольга Кияница

2017-07-21

The issue of disability worries many patients who suffer from severe forms of rhythm disturbance. To get an answer you need to take a look at the basic rules and regulations that are observed by the medical examination.

Arrhythmia is a violation of the cardiac rhythm (NRS), characterized by a change in the frequency of heart contractions, rhythmicity, the basic capabilities of the organ (conductivity, automatism, excitability). According to the dosichitsin classification of 1991, 10 types of arrhythmias are distinguished, among which the most severe are: flickering arrhythmia, tremor and fibrillation of the ventricles / atrium.

Arrhythmia and disability - an issue that is relevant for many and is connected with the state of health, working capacity, the prognosis of the disease.

In order to provide the correct answer to the question "Do I give an arrhythmia with a disability?" It is not enough to know the exact diagnosis of the patient, because the appointment of a disability is not only the medical sphere, but rather the medical-social category. Therefore, first of all, you need to know what are the criteria for differentiating patients sent to a disability with a disturbance in the heart rate.

What is ITU?

Medical-social examination (ITU) is a survey of the needs of the person in the social protection at the state level, for which the degree of limitation of vital organs activity, which led to persistent violations of functions of the whole organism, is estimated.

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At ITU, patients are referred to treatment and prevention institutions that are subordinate to the Ministry of Health. Medical and social expert commissions, established on the basis of the same state medical institutions, participate in the definition of disability. The commission is headed by the chief doctor, who is confirmed as head of the public health administration of the city administration.

Basic aspects of ITU definition for arrhythmia

There are a number of factors that are taken into account during the NSA health examination:

  • severity of cardiac rhythm disorders;
  • the nature of the underlying disease, which is the cause of arrhythmia;
  • Is there contraindications to working conditions;
  • used therapeutic, medical or surgical.

The severity of the violation

During the examination of a patient with arrhythmia for the assessment of the attribution of disability, the severity of heart rhythm disorders is evaluated. For this purpose it is determined:

  • duration of arrhythmia attack;
  • the frequency of paroxysms;
  • the state of the circulatory system;
  • the definition of complications or the degree of risk of their occurrence.

In terms of complications, the presence of concomitant diseases in the form of heart failure, coronary insufficiency, cerebral insufficiency, thromboembolism and its complications, syncope states has a special influence on the appropriation of disability. All of these pathologies are considered in acute and exacerbated chronic form.

The nature of the main illness

The conduct of medical and social examination does not involve the separation of various forms of NSAIDs due to the severity of the clinical picture and the predictive value. Therefore it is common to highlight the general severity of all arrhythmia manifestations:

  • Easy degree .Clinical picture of violation of rhythm and conduction function is not expressed strongly. Attacks do not occur more than once a month and last no more than four hours. In the presence of such a syndrome, as the weakness of the sinus node, the heart rate should be 50 beats / minute and above. At AB blockade corresponds to Mobitz for the first type.Inertia arrhythmia is always determined, normo- or bradysystolic type.
  • Average degree. The frequency of attacks - from 2 to 4 times a month, their duration is 4 hours or more. With SССУ heart rate - from 40 times in minutes. At AB blockade is determined Mobitz second type. Inverted arrhythmia by paroxysmal type.
  • Heavy grade. Frequency of attacks more than 4 times a month. Arrhythmia with a slowing down of the rhythm of less than 40 beats per minute. Av blockade Mobitz of the third type. Inverted arrhythmia is constant, but paroxysms are hardly stopped or not at all blocked by medication. Also, progressive heart failure, conditions like syncope, seizures of MES are determined.

Hemodynamic disorders of functional significance may be related not only to the forms of LDCs, but also to the state of the arteries (cerebral, coronary) and myocardium, which may be impaired by the development of cardiosclerosis and atherosclerosis.

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Contraindications to working conditions

In the process of disability registration with arrhythmia, the ITU commission often faces the question of working conditions. Sometimes the wrongly equipped workplace can be the cause of the development of the underlying disease, which is further complicated by a disturbance of the heart rhythm. The same applies to rheumatism, ischemic heart disease, varicose veins and the like.

Some professions have a link with risk, and with the continuous occupation in such a sphere of activity may develop ventricular arrhythmias and asystoles. The same applies to such specialties as a chauffeur, a crane operator, a pilot, a railroad manager or an aeroflot. Also, here are all the works, to varying degrees depending on extreme.

During ITU, the patient's ability to work is determined. For this, often, the condition of the underlying disease, for example, rheumatism or CHD, is assessed. The more difficult situation is in the presence of only a violation of the rhythm and conductivity. Then the categories of patients who were determined by the easy and average degree of severity of arrhythmia are considered able-bodied:

  • Lightweight - in patients with arrhythmia attacks are manifested in a mild degree, that is, the clinical picture is poorly expressed.
  • The average degree - the clinic is moderately expressed, while there are no predisposing factors for the progression of the disease from the conditions of labor.

In severe cases, the disability of the third group is issued.
Such patients, as a rule, have a "whole bunch of illnesses", among which heart failure is often expressed. Arrhythmias in the examination of the patient play a secondary role. Some forms may still increase the risk of developing fibrillation or heart failure.

Disability design for implantable EKS

There are certain indications that patients with an implanted pacemaker may be referred to ITU.

1. Reassessment of those patients who have been assigned a permanent EKS.

2. Registration of a disability group to sick people who are of working age. At the same time, at least one of the reasons listed below should be determined, according to which the disability must be formalized

  • the patient can not work in the previous job because there are absolute contraindications;
  • after implantation of a constant EKS, attacks of arrhythmia are observed, which greatly impairs hemodynamics;
  • after implantation there were complications, for elimination of which it is necessary to conduct long-term treatment;
  • the patient is absolutely dependent on the EKS;
  • the course of the underlying disease has worsened significantly.

3. After successful implantation and normal prognostic significance, the terms of temporary disability may be extended for the following reasons:

  • after surgery, complications occurred in the form of pleurisy, pericarditis, and the like;
  • cardiac rhythm disturbance is assessed as moderate, and long-term medication is required for its treatment;
  • signs of heart failure appeared in the initial stage.

What needs to be done before the ITU examinations

Patients sent for medical and social examination must undergo a series of studies, including the following types of diagnostics:

  • Electrocardiography in a calm condition.
  • Echocardiography or integral rheography.
  • Bicycle ergometry with a threshold power of about 75 watts.
  • Holter's (daily) monitoring of cardiac activity.
  • Roentgenography of the chest organs.
  • Advisory opinion of doctors of a narrow specialty (therapist).

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Criteria of patients with ECS disability

The third group. On the background of a normally performed operation and improving the quality of life in the patient, a positive test is performed by bicycle ergometry, a moderate hemodynamic disorder, and a determination of the resistance of the implanted device, expressed in the change of personality. Also, after the implantation of the EKS and the development of arrhythmia, they are given a disability in the event of a change of work place with a presumably reduced workload, a change in occupation or qualification.

The second group. The performed implantation operation of the permanent EKS turned out to be ineffective: the previously determined arrhythmias are preserved; there is an interference between the rhythms of the own and the pacemaker, there is pronounced coronary or heart failure.


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