Cardiology: Atrial flutter (fibrillation) — electro convulsive therapy. Treatment
Atrial fibrillation (AF), which includes fibrilloflutter, is the most common heart rhythm disorder. It accounts for approximately 1/20 of all hospital admissions in the cardiology department. This disease prevails among people over 60 years old. The treatment choice depends on the AF type, severity of its course and patient’s general condition.
Typically, the first step in the fight against pathology becomes a drug therapy. Its goal is to eliminate the main symptoms of arrhythmia, to maintain a stable heart rate and to prevent the development of complications.
Upon a chronic AF form, the patients are recommended to take cardiac glycosides, beta-blockers or calcium antagonists. Regularly taking the recommended drugs, the patient subjectively feels good and can lead a normal life.
The paroxysmal atrial flutter or flicker is treated differently. To relieve the attacks (paroxysms), a variety of antiarrhythmic drugs is used:
- cardiac glycosides.
In the absence of effect, the cardioversion or transesophageal stimulation is used. The patient is treated by an emergency team or hospital physicians.
Continuous drug therapy for paroxysmal AF is prescribed only when the attacks occur more often 2 to 3 times a month. A set of drugs is selected individually, taking into account the patient's heart rate.
Active contraction of the atria leads to blood stagnation and threatens the formation of blood clots, so it is recommended that all patients received anticoagulants.
Upon frequent paroxysms, the issue of the need for surgical treatment is addressed. Two types of interventions are practiced:
- RF isolation of pulmonary veins. Penetrating into the mouth of pulmonary veins, the physician "cauterizes" the focus of abnormal excitation. Consequently, the pulses from it are blocked and a normal heart rhythm is restored.
- Radiofrequency ablation followed by pacemaker implantation. The physician applies a high-frequency current to the atrioventricular node through a thin catheter. Then, a device taking over the function of the pacemaker is implanted under the skin into the right atrium of the patient.
After surgery, the patient requires periodic cardiac monitoring.Hide