Atrial fibrillation paroxysm (ICD 10: I49) refers to a special form of atrial fibrillation, in which an attack of abnormal heart rhythm lasts for no more than 7 days. It is characterized by chaotic twitching of the atrial muscle fibers and impaired conduction of electrical impulses in the myocardium. Due to heart rhythm disturbances in this pathology, they can fluctuate between 200-300 beats over several hours or even days.
Atrial fibrillation paroxysm often occurs in the elderly and adulthood and is much less common in children and adolescents with congenital malformations of the heart muscle.
Feature of the disease
Atrial fibrillation paroxysm (ICD code 10 - I49) is a pathological condition accompanied by acute cardiac arrhythmia. Often the cause of its occurrence is ischemia, which was not cured in a timely manner.
Atrial fibrillation paroxysm is characterized by the fact that it starts suddenly and deliversdiscomfort. The duration of one such attack is approximately 5-7 minutes. Such a pathology is an acute attack of tachycardia, during which a person can experience more than 140 heartbeats per minute, which is very dangerous for his he alth.
Main classification
Depending on the number of heartbeats per minute, such types of pathology are distinguished as flutter with a frequency of up to 200 beats and flickering from 200 beats. Since, against the background of arrhythmia, the ventricles begin to contract in an enhanced mode, then, according to the classification, the following forms of the disease are distinguished:
- tachysystolic;
- bradysystolic;
- normosystolic.
Another classification of arrhythmias divides the disease into forms such as:
- ventricular, with severe cardiac arrhythmias;
- atrial, with a change in the conductivity of the His bundle;
- mixed, with a combination of these two forms.
The first attack must be distinguished from paroxysm of atrial fibrillation, in which outbreaks of the disease periodically recur and last up to 7 days. With frequent exacerbations of arrhythmia, we can talk about a recurrent type of disease.
According to the available signs, pathology is divided into several classes. At the first clinical picture is almost completely absent. In the second, the quality of life does not suffer, but there are slight signs of the course of the disease. The third degree is characterized by the fact that there are numerous complaints and a person has to significantly limit himself. At the fourth– the clinical picture is pronounced, and complications can also be observed, up to disability.
Causes of occurrence
Atrial fibrillation paroxysm (ICD 10: I49) refers to rather complex pathologies, the main causes of which are:
- chronic heart failure;
- cardiomyopathy;
- hypertension with increased heart mass;
- ischemia;
- inflammatory processes in the myocardium;
- congenital heart defects.
In addition, there are certain predisposing factors that should be attributed to such as:
- tobacco smoking and alcohol consumption;
- acute lack of magnesium and potassium;
- infectious processes in severe form;
- endocrine disorders;
- nervous strain and stress;
- postoperative condition;
- taking medications.
If the specific cause of the disease has not been established, then this form is called idiopathic. This condition is observed mainly in young patients.
Before starting treatment, it is very important to accurately determine the provoking factor. This will help the doctor choose the right method of therapy and reduce the risk of dangerous complications, including preventing recurrent attacks.
Main symptoms
Paroxysm of atrial fibrillation (ICD code 10: I49) is characterized by the complexity of the flow. The nature of the course of the pathology largely depends on the frequency of ventricularabbreviations. It is worth noting that minor deviations from the norm may not manifest themselves at all. At the same time, a reduction of 120 strokes or more is mainly accompanied by such signs as:
- lack of air;
- excessive sweating;
- panic attacks;
- heartache;
- shortness of breath;
- uneven pulse;
- weakness;
- trembling limbs
- dizziness.
When a person has a critical violation of heart contractions, a deterioration in cerebral circulation is observed. The patient may occasionally faint. In addition, sometimes there is a complete cessation of breathing. This condition requires urgent medical attention.
Emergency
Emergency care is very important for paroxysmal atrial fibrillation. The algorithm of actions in this case should be clear and coordinated. If an arrhythmia attack occurs, the main task is to seek medical help within 48 hours. After 2 days, there is a high probability of blood clots forming inside the heart and the development of a heart attack and stroke. Urgent measures for paroxysm of atrial fibrillation should go in the following sequence:
- put the patient on the bed, sofa or floor;
- open window for fresh air;
- The victim should take a deep breath.
After that, it is recommended to give the person "Warfarin" or other anticoagulants that were previously prescribed by the doctor. This will help greatlyreduce the risk of blood clots. When carrying out urgent measures for paroxysm of atrial fibrillation, in parallel with this, an emergency ambulance team should be called. Subsequent treatment should be carried out only by a doctor who selects medications depending on the severity of the attack.
To stop the paroxysm of atrial fibrillation, the doctor injects a cardiac glycoside, in particular "Strophanthin", "Korglikon" or a solution of "Novocainomide". In especially severe cases, cardiac defibrillation is performed.
Diagnostics
After providing emergency care for a paroxysm of atrial fibrillation, a diagnosis is mandatory. To confirm the presence of a problem, the heart rhythm is heard. An accurate diagnosis is possible with flutter during the second or fourth contraction.
Additionally, the doctor prescribes electrocardiography. This procedure helps to determine the presence of pathological changes in the heart. Diagnosis is based on the degree of atrial size and valve wear. The results obtained largely influence the tactics of therapy.
Features of treatment
Treatment of paroxysmal atrial fibrillation is selected separately for each patient. In addition to prescribing medications, it is important to stick to a diet, exclude heavy physical exertion, and also lead a he althy lifestyle. It is very important to establish the root cause of the pathology and act on it.
When leakingmild illness can be treated on an outpatient basis. The main indications for hospitalization are as follows:
- first time attack;
- heart rate over 200 beats per minute;
- a sharp drop in pressure;
- signs of heart failure;
- clot formation.
The main goal of conservative therapy is to restore the heart rhythm. It is important to eliminate the existing symptoms as soon as possible, reduce the risk of thrombosis and prevent the occurrence of complications.
Initially, the doctor prescribes antiplatelet agents and anticoagulants. If a person is younger than 60 years of age and there is no organic myocardial damage, drug therapy should include the constant intake of acetylsalicylic acid. In the presence of ischemia and other diseases, "Warfarin" is indicated with regular testing. In especially acute cases, low molecular weight heparins are prescribed, but it is worth remembering that they can only be taken in a short course.
To restore the normal rhythm of the heart, cardioversion is prescribed, which can be medical or instrumental. There are a number of antiarrhythmic drugs that prevent the occurrence of attacks of paroxysmal fibrillation. These include such as "Propafenone", "Sotaleks", "Kordaron", "Amiodarone".
If heart rate control is carried out without eliminating arrhythmia, then beta-blockers are prescribed, as well as calcium channel blockers.
Additionally can be assignedelectrical cardioversion, which involves bringing the heart rhythm back to normal by applying an electric current. Due to the high degree of pain, the procedure is performed under anesthesia. A defibrillator with electrodes is installed in the right collarbone, which sends impulses to the heart and "reboots" the work of the organ.
Cardioversion is done on an emergency or elective basis. If the procedure is planned, then within a month before and after it, a person must take Warfarin. Before emergency cardioversion, the patient is urgently injected with Heparin.
When a recurrent form of the disease occurs and other methods fail, an operation is indicated, namely radiofrequency catheter ablation. It is a minimally invasive intervention. The electrode is inserted through the femoral vein into the heart, and then pathological foci of excitation are destroyed with the help of an electric shock.
If it is necessary to destroy the bundle of His, then during the operation a pacemaker is required. In a particularly severe form of leakage, the installation of a defibrillator is indicated to eliminate the resulting attack.
Atrial fibrillation paroxysm is very dangerous for the patient's life, so treatment must be carried out only under the supervision of a doctor. Folk remedies are used only as preventive measures to strengthen the heart muscle. For this, it is recommended to take rosehip and hawthorn infusions, consume lemon with honey, and add vegetable oils to food.
Possible Complications
Atrial fibrillation paroxysmarrhythmias (ICD code 10: I49) refers to serious and dangerous diseases that, if not properly and untimely treated, can lead to dangerous complications. If assistance has not been provided, then a change in the intensity of blood flow is possible. This increases the likelihood of atrial embolism. As complications, there may be such as:
- pulmonary edema due to acute failure;
- hypoxic shock, accompanied by a decrease in pressure;
- fainting;
- cardiac arrest;
- pathological change in blood flow.
The most severe complication is thromboembolism. The likelihood of its occurrence increases significantly if more than two days have passed since the attack without appropriate treatment. This period is enough for the formation of large blood clots in the atria.
Complications are mainly provoked by circulatory disorders or due to the formation of blood clots. One of the most dangerous consequences of paroxysm is shock, in which pressure drops sharply and the process of providing tissues and organs with oxygen is disrupted. This disorder may occur due to a high or low ventricular rate.
With heart failure, pulmonary edema often occurs. During an attack, there may be a loss of consciousness, which is provoked by impaired blood supply to the brain. Possible negative consequences can be a heart attack, stroke or gangrene.
Forecast
Prognosis for paroxysmal atrial fibrillation is individual for each patient. He is inlargely depends on the history of the disease, the cause of its occurrence, the form of the course and the timely treatment. In addition, the weight of the patient, his age, as well as the presence of concomitant pathologies play a very important role.
In general, the prognosis for such a disease is quite favorable. Timely treatment allows you to maintain normal he alth, preventing the frequent occurrence of seizures. It is worth noting that with full compliance with all medical prescriptions, a person can lead a completely normal life, with the exception of only a few restrictions on diet and physical activity.
The most important thing is to consult a doctor in a timely manner and not self-medicate. In addition, the normalization of the heart rhythm is important, which must be restored during the first day, until dangerous complications arise.
Prophylaxis
Atrial fibrillation paroxysm (ICD 10: I49) is a dangerous condition, which is why it is best to prevent the onset of an attack than to treat it for a long time. To reduce the risk of atrial fibrillation, it is important to adhere to the following recommendations:
- giving up bad habits;
- obesity prevention;
- he althy eating;
- timely treatment of all myocardial diseases.
In addition, you need to enrich your menu with foods high in calcium, undergo a scheduled examination by a cardiologist every 6 months. It is important to avoid allstress, depression and nervous tension. Be sure to allocate time for good sleep and rest.
Constantly need to monitor the pulse and pressure with a home blood pressure monitor. An electrocardiogram is recommended at least once a year. With proper treatment and compliance with all the rules of prevention, very good results can be achieved.
With this diagnosis, quite a few people live to a ripe old age, but it is imperative to follow all medical prescriptions.
