About the disease
Ventricular flutter is a dysfunction of heart rhythm resulting in fast heart beat. The range of heart beating during the ventricular flutter may vary from 170 to 250 beats per minute. This heart beat is considered abnormal because usually people without ventricular flutter have only 90-100 heartbeats per minute. If patient has ventricular flutter he is also diagnosed with tachycardia. Ventricular flutter is more common for people who experienced hypertension and coronary artery disease. The most common ventricular flutter cause is myocardial infarction. Sometimes people who take too many antidepressants or other drugs that control mood and mental health of patients, may develop ventricular flutter. It is almost impossible to treat completely ventricular flutter, because it is considered to be one of the most dangerous forms of arrhythmia. People who have ventricular flutter may in a long run experience the drop of heart heart beat. If medical help was applied on time, patient may be saved by electrical shock, but it must be provided immediately before heart failure begins. Clinically there are two types of ventricular flutter: tonic and atonic ventricular flutter. If a person has tonic ventricular flutter, the picks of heart during ECG are very high and this means that the best treatment for patients with this type of ventricular flutter is electrical shock. People with atonic ventricular flutter do not respond to electrical shock as well as people with ventricular flutter, so they are usually treated by drugs or by inserting pacemaker. Both patients with atonic and tonic ventricular flutter may experience the heart failure if they are not treated timely. Another complication of ventricular flutter is the thromboembolism is an accumulation of blood clots. Ventricular flutter usually appears after the age of 40-45. Sometimes the ventricular flutter may result in ventricular fibrillation which is a more severe disease of the heart.
People who have ventricular flutter experience an extremely rapid heartbeat, shortness of breath and pain in heart, which is most acute when patient does some physical activity. Symptoms of ventricular flutter are similar to symptoms of atrial fibrillation. People who have ventricular flutter usually have very pale skin and feel dizziness most of the time.
Typical symptoms of atrial fibrillation are spasmodic contractions of heart, whose duration depends on the number of heartbeats. It is usually easy to diagnose ventricular flutter as normal blood pressure and pulse arrhythmic have a different amplitude and speed. When the atrial fibrillation is detected heart rate is higher than pulse frequency.
- Electrocardiogram records electrical signals, which are sent through the heart. If a patient has ventricular flutter, these signals are abnormal.
- Chest X-Ray can show if the heart enlarged in size.
- Echocardiography is probably the most precise diagnostic measure, as it produces image of the heart and can record if there is a hole between upper heart chambers. It can also show if there is a problem with the blood flow and heart valves. Most importantly, it creates live-action images, which allows doctors to see not only one image of the heart, but to track the dynamics of heart`s work.
The main objective of the ventricular flutter treatment is to slow the heart beat. There are two main methods to relieve atrial fibrillation:
- Drug treatment with antiarrhythmic drugs
- Procedure that involves electric shock
Sometimes people who have the ventricular flutter need to have the pacemaker, which would be able to accelerate their heart beat. Pacemaker is also implemented in case of brachycardia, which is a slow heart beat.
There are two main methods of surgical treatment:
- Catheter ablation. During the operation, doctor conducts neutralization of heart cells that trigger atrial fibrillation. This is done by opening the fused fibers of impulses in the problem area. Destruction of tissues is produced by laser radiation, cold, electrical or chemical reagent. Catheter ablation is considered to be a minimally invasive method, since it does not open heart.
- Implementation of a pacemaker. The pacemaker may be very useful for patients who have ventricular flutter, because it supports the heart and it can prolong the life expectancy of patients.
- The traditional ventricular flutter surgery aims to restore the sinus rhythm. It may be done by applying the precordial shock or by performing the massage of heart. In order to normalize the sinus rhythm a doctor needs to implement electrical defibrillation or mechanical ventilation, so that the heart restores the heart beat, which is not dangerous to the health of the patient.
- If the massage and precordial shock do not help. a doctor may resort to such procedure as endocardial ventricular stimulation, but it may not help if a patient already developed the cardiac arrest. Resuscitation of endocardial ventricular stimulation is terminated is the patient did not restore breathing, heart activity, consciousness after 30-40 minutes of heart stimulation. If there is no reaction of pupils to light, there is no possible cure. Nevertheless, such death happens very rarely and usually the precordial shock is the most effective endocardial ventricular stimulation, which virtually restores the heartbeat. After the precordial shock reviewed the heartbeat, a doctor usually implements the pacemaker during the same operation. The period of recovery takes about a week.