Ventricular arrhythmia

Introduction to ventricular arrhythmia Ventricular arrhythmia refers to arrhythmia that originates in the ventricle and is a common arrhythmia, including ventricular premature beats (ventricular tachycardia), ventricular tachycardia (ventricular tachycardia), and ventricular fibrillation (ventricular fibrillation). Ventricular tachycardia, especially ventricular tachycardia combined with organic heart disease, is usually arrhythmia that can cause serious consequences such as ventricular fibrillation and sudden death. It is necessary to confirm the diagnosis in time, determine the cause of ventricular tachycardia, the cause of the ventricular tachycardia, and the impact on the prognosis. The occurrence of ventricular arrhythmias in the elderly population increases with age like organic heart disease. The early incidence of elderly patients is 70%-80%. The number of early rooms increased with age, but the complexity of the room did not increase correspondingly. The high-level room early (Lown classification) of the elderly had a higher rate of abnormal electrocardiogram detection. Often accompanied by abnormalities such as cardiac hypertrophy and infarction. Ventricular premature beats have completely different clinical significance and prognosis in different situations, and are related to the presence or absence of structural heart disease, heart disease types and cardiac function. basic knowledge The proportion of illness: 0.001% - 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: heart failure, shock, syncope

Cause of ventricular arrhythmia

Ventricular premature beats (room early) (35%):

The early incidence of elderly patients is 70%-80%. The number of early rooms increased with age, but the complexity of the room did not increase correspondingly. The high-level room early (Lown classification) of the elderly had a higher rate of abnormal electrocardiogram detection. Often accompanied by abnormalities such as cardiac hypertrophy and infarction. Ventricular premature beats have completely different clinical significance and prognosis in different situations, and are related to the presence or absence of structural heart disease, heart disease types and cardiac function.

Ventricular tachycardia (ventricular tachycardia) (30%):

The ventricular tachycardia is rare in the elderly, but it is dangerous and is a fatal arrhythmia. Common in AMI, ventricular aneurysm, heart failure, electrolyte imbalance and drug poisoning. The torsade-type ventricular tachycardia is caused by multi-loop reentry or reentry irregularities due to increased ventricular repolarization dispersion. More common in low potassium, quinidine, amiodarone, tricyclic antidepressant poisoning.

Ventricular arrhythmia prevention

1. Prevention incentives

Once diagnosed, patients are often highly nervous, anxious, depressed, seriously concerned, frequently seek medical treatment, and urgently require medication to control arrhythmia. The complete neglect of the cause and the prevention of the cause, often caused the shackles to take the lead, and put the cart before the horse. Common causes: smoking, alcoholism, overwork, nervousness, agitation, overeating, indigestion, colds and fever, excessive intake of salt, low blood potassium, low blood magnesium. The patient can combine the actual situation of the previous disease, sum up the experience, avoid the incentive, and is simpler, safer and more effective than simply taking the drug.

2, stable mood

Maintain a calm and stable mood, relax and not be overly nervous. Especially stressful emotions in mental factors are easy to induce arrhythmia. Therefore, patients should be treated with a peaceful attitude, avoiding overjoy, sorrow, and anger, regardless of minor matters. If you are in trouble, you can comfort yourself, not watching nervous TV, ball games, etc.

3. Self-monitoring

When the arrhythmia is not easily detected, the patient can find the problem himself. Some arrhythmia often have aura symptoms. If you can find timely measures to reduce or even avoid arrhythmia. Patients with atrial fibrillation often have signs of aura or prodromal symptoms, such as heart palpitations, and there is an increase in the number of veins. At this time, rest and oral administration of tablets can prevent problems before they occur.

4, rational use of drugs

The treatment of arrhythmia emphasizes the individualization of medication. Some patients are often willing to accept the advice of their patients and change their own medicines and change their dosage. This is dangerous. The patient must take the medicine as required by the doctor and pay attention to the reaction after the medication. Some antiarrhythmic drugs can sometimes cause arrhythmia, so you should use as little medicine as you can to achieve reasonable compatibility.

5. Regular medical examination

Regularly review ECG, electrolytes, liver function, thyroid function, etc., because antiarrhythmic drugs can affect electrolyte and organ function. After medication, the patient should be reviewed regularly and the medication effect and dosage adjusted.

6. The law of life

Develop a habit of working on time to ensure sleep. Because insomnia can induce arrhythmia. Exercise should be appropriate, do what you can, do not reluctantly exercise or exercise excessively, do not do vigorous and competitive activities, can do qigong, Tai Chi. Do not take too much bath water, bath time should not be too long. Develop a habit of defecation on time and keep the stool smooth. Diet should be quantified regularly. Moderate life, do not drink strong tea and do not smoke. Avoid catching cold and prevent colds. Do not engage in intense work.

Ventricular arrhythmia complications Complications, heart failure, shock, syncope

The complications of this disease are generally heart failure, shock, syncope and cerebral embolism.

Ventricular arrhythmia symptoms common symptoms flustered flustered shortness of ventricular fibrillation after ventilation ventricular premature beats

First, ventricular premature beats (room early)

Premature ventricular contractions often have no symptoms directly related to them. Whether each patient has symptoms or symptoms is not directly related to the frequency of pre-systolic contractions. The patient can feel guilty, like the weightlessness of the elevator's rapid lifting or the powerful heart beat after the compensation interval.

At the time of auscultation, there was a long pause after the ventricular contraction, and the second heart sound of the ventricular contraction was weakened, and only the first heart sound could be heard. The radial artery beats weakened or disappeared. Normal or large a waves can be seen in the jugular vein.

Second, ventricular tachycardia (ventricular tachycardia)

The clinical symptoms of ventricular tachycardia are marked by differences in ventricular rate, duration, underlying heart disease, and cardiac function. Patients with non-sustained ventricular tachycardia (seizures shorter than 30 seconds and able to terminate spontaneously) are usually asymptomatic (Figure 3-3-24). Persistent ventricular tachycardia (exceeding for more than 30 seconds, requiring drug or cardioversion to terminate) is often accompanied by significant hemodynamic disorders and myocardial ischemia. Clinical symptoms include hypotension, oliguria, syncope, shortness of breath, angina pectoris, and the like. The auscultation of the heart rhythm is mild and irregular, the first and second heart sounds split, and the systolic blood pressure can change with the heart beat. In the event of complete room separation, the first heart sound intensity often changes, and a large a wave appears intermittently in the jugular vein. When the ventricle beats back and continues to capture the atria, the atrium and the ventricle contract at almost the same time, and the jugular vein presents a regular and huge a wave.

Third, ventricular flutter and ventricular fibrillation

Clinical symptoms include loss of consciousness, convulsions, respiratory pauses and even death, auscultation of heart sounds, impaired pulse, and undetectable blood pressure.

With acute myocardial infarction without primary ventricular fibrillation with pump failure or cardiogenic shock, the prognosis is better, the survival rate is higher, and the recurrence rate is very low. In contrast, ventricular fibrillation, which is not associated with acute myocardial infarction, has a recurrence rate of 20% to 30% within one year.

For the treatment of ventricular flutter and tremor, see "cardiac arrest and sudden cardiac death."

Ventricular arrhythmia examination

Electrocardiogram examination, cardiac electrophysiological examination, exercise test.

Other examinations of ventricular late potential, ECG spectrum analysis, ventricular rate variability analysis, exercise ECG, and tilt test all contribute to the diagnosis of complex or some special arrhythmias. In addition, echocardiography, cardiac X-ray, ECT, CT, and MRI have a value that cannot be underestimated for the diagnosis of organic and non-organic arrhythmias.

Diagnosis of ventricular arrhythmia

diagnosis

Diagnosis can be made based on symptoms and ECG results.

Differential diagnosis

The disease can be diagnosed by electrocardiogram examination. The most important clinical diagnosis is the cause of arrhythmia. The influence of carotid sinus massage on tachyarrhythmia can help to distinguish the nature of arrhythmia. In order to avoid accidents such as hypotension and cardiac arrest, patients should be treated with electrocardiogram monitoring in the supine position. The elderly should be used with caution and those with cerebrovascular disease should be banned. Each time the carotid sinus is massaged on one side, the duration of one massage is less than 5 seconds, which can reduce the rate of atrial flutter, and can also turn supraventricular tachycardia into sinus rhythm.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.