In those cases where disturbed heart rhythm (heart beats too frequent or, conversely, too infrequently) resorted to the effects on the heart electrical pulses generated by special devices - pacemakers. The most common pacemaker sewn into the patient's body.

What is pacing and why it is needed

Pacing - a method of treatment and diagnosis of heart rate with the use of special devices pacemakers (ECS), generating electrical pulses of a certain frequency, and the forces acting on the heart muscle and cause contraction of the heart.

Pacing may be male or extracorporeal (it usually is temporary) and internal or intracorporeal (pacemaker is implanted into the patient's body). In some cases (for example, for the detection of coronary artery disease) for diagnostic electrical stimulation during which the heart is given fast rhythm (as during exercise), and then the analysis of the results of the heart.

Kardiostimulyatsiya, quickens the heart rate is used in disorders of conduction of the heart (for example, atrioventricular heart block, when the impulse from the atria does not reach to the ventricles, and they cut in a different rhythm), rhythm disturbances that arose against the backdrop of an overdose of some heart means (for example, cardiac glycosides that make heart beat stronger and more rare).

Pacing, heart rate slows, used in paroxysmal tachycardia (frequent attacks palpitations).

Types of pacemakers

Pacemaker or a pacemaker - a device that supports a specific (predetermined) heart rhythm. They can be single-chamber, two-and three-compartment.

Single-chamber pacemakers - this is the first kind of stimulants they can stimulate only one atrium and one ventricle. They can work with a certain preset fixed frequency or automatically accelerate the rhythm during exercise. Today, pacemakers are used mainly in atrial fibrillation Arrhythmia - when we hear your heart .

Dual-chamber pacemakers can stimulate both atrium and ventricle. In addition to the functions typical of the single-chamber pacemakers, they have additional functions that allow you to customize the operation of the apparatus in accordance with the individual characteristics of the patient

Three-chamber pacemakers - the most modern machines of this kind, to monitor and enforce the heart rate under such severe disorders as ventricular tachycardia Tachycardia - the body to the limit?   and ventricular fibrillation (sudden appearance of a lack of coordination of individual fibers contractions of the heart muscle quickly leads to heart failure).

Electrodes for pacemakers have a special coating on the tip, warning inflammation at the site of implantation.

The electrodes, which electrical pulses are delivered to the heart, can be implanted (sewn) directly to the heart muscle (myocardium) or in the region of the endocardium (the inner lining of the heart). The latter method is more common, as it is less traumatic. In the left half of the chest (sometimes to the right - it is solved individually) in the subclavian area under the pectoralis major muscle implanted pacemaker and the electrodes under the control of the X-ray is injected through a vein to the heart.

Once the pacemaker is implanted, he set the required parameters. These parameters can be changed with the help of a special device that sends impulses to the pacemaker.

Conducting system of the heart

The human heart has the ability to shrink under the influence of pulses that occur within itself (automatic). Automata provides special muscles that form a series of nodes and beams in the heart - vascular system, which includes:

• sinoatrial node - in the right atrium, is the leading event of nerve impulses from him depart to the atrioventricular node branches;
• atrioventricular (atrioventricular) node - located in the atrial septum right away by branch impulses are conducted to the ventricles; It can generate nerve impulses when not working sinoatrial node.

In the heart there are additional paths that connect the atria and ventricles to bypass the atrioventricular node, which are important during the pulses to the ventricles in the case of destruction of the atrioventricular node.

What is atrial fibrillation

Atrial fibrillation - a heart rhythm disturbance, in which due to conduction abnormalities occur chaotic contraction of muscle fibers of the atria, but the atria as a whole is not reduced, the duration of cardiac cycles varies considerably, and is random in nature, the excitement is not passed in a timely manner ventricles, ventricles unevenly, with frequency of 250-300 beats. 1 minute, disturbed coordination between contractions of the atria and ventricles.

Atrial fibrillation can have a more or less permanent nature or take the form of attacks.

Causes of atrial fibrillation and its prevalence

Atrial fibrillation can occur under such severe heart damage as malformations of the mitral valve (the valve between the left atrium and ventricle), ischemic heart disease, increased thyroid function The thyroid gland - is responsible for your hormones   (hyperthyroidism), alcoholism and so on. The attacks of atrial fibrillation can occur in the background of myocardial infarction, acute poisoning by certain drugs (cardiac glycosides, caffeine) or alcohol. Sometimes an attack occurs against a background of tension and chronic stress How to beat stress? Create an oasis .

The frequency of the prevalence of atrial fibrillation is less than 1% of people under the age of 60 years and more than 6% in patients older than 60 years.

How is an attack of atrial fibrillation

The attacks of atrial fibrillation can occur in different ways, it all depends on the condition of the heart. Patients may not even notice that they changed heart rhythm or feel vague discomfort in the heart. But often there is an attack in a sudden chaotic heartbeat. If the ventricular rate is very high, there is a general weakness, dizziness, Dizziness - if the ground is slipping from under his feet , Semiconscious state, and sometimes fainting.

Complications of atrial fibrillation

Atrial fibrillation can cause acute heart failure - the heart can not cope with their work, which can be the result of pulmonary edema. The disease can also be complicated by thromboembolism Thromboembolism: severe complications   (thrombus occludes the blood vessel).

No less common complication of atrial fibrillation is an ischemic stroke - the result of insufficient blood supply to the brain Tacna.

What examinations are required for atrial fibrillation

In order to establish the correct diagnosis, it is necessary to identify itself atrial fibrillation, the conditions of its origin and termination, as well as to identify the disease that led to it.

To detect atrial fibrillation need to do an electrocardiogram (ECG), but on a normal ECG revealed atrial fibrillation do not always (attack can pass). Therefore the ECG recorded during the day (this is called Holter monitoring).

Most arrhythmias occur during exercise, so to measure the level of permissible physical activity and evaluation of preventive action of antiarrhythmic drugs sometimes do an ECG with exercise and the intake of drugs.

For accurate diagnosis of arrhythmias performed electrophysiological study of the heart with the introduction of a catheter into the cavity of the heart.

Treatment of atrial fibrillation

Treatment of atrial fibrillation includes treatment of the underlying disease (eg, myocardial infarction), and to restore normal heart rhythm.

As a rule, the treatment of arrhythmia begins with the appointment of antiarrhythmic drugs, which should only appoint a doctor, because they all have their own indications and contraindications, to understand this the patient can not.

In some cases, to eliminate atrial fibrillation radiofrequency ablation surgery is performed when a normal heart rhythm is restored by cauterization of very small, carefully calibrated portion of the heart using a special catheter.

Another type of operation - is to restore a normal heart rhythm using a pacemaker (pacemaker). A pacemaker is usually implanted in the left subclavian region, the electrodes are held by him through a puncture in the subclavian vein to the heart.