Atrial fibrillation forms: | Paroxysmal | Variable arrhythmia Self-sustained recovery of rhythm for 2-7 days | | Persistent | Requires medical intervention to restore sinus rhythm Duration of episode more than 7 days | | Persistent | Pacing for 1 year when there isthe possibility of surgical treatment | | Constant | Absence of the effect of therapy Patient's refusal from treatment | Atrial flutter Accelerated, regular atrial contraction. Men are more often ill. Up to 50 years, the occurrence of 5 cases per 100 thousand population, with increasing age, the frequency of occurrence is growing exponentially.  It has a paroxysmal character, extremely rare is the chronic form. In the absence of treatment, 20% of the sick suddenly die. In 20-35% of cases it is combined with atrial fibrillation. The clinical picture of a similar nature, but flutter quickly leads to heart failure with edematous syndrome. Ventricular tachycardia
The source of the pathological excitation pulse is located in the ventricular myocardium or the terminal branches of the conducting system. The cause is only cardiac factors( 70-80% ischemic disease).  The lack of treatment leads to ventricular fibrillation and cardiac arrest. Rare forms of - atrioventricular( nodular and focal);
- sinus and atrial.
 occur in 1-10% of tachyarrhythmias. The focal form is more often diagnosed in children, when the heart beats with a frequency of up to 210 per minute. Interruptions in the heart are paroxysmal, rarely change into permanent form. They respond well to treatment. Treatment of Two approaches to therapy: - Restore normal rhythm and maintain it.
- Monitor the level of tachycardia without restoring the rhythm.
The choice is individual. Regardless of what needs to be done, there are general rules: - to restore the rhythm in young people without disturbances of cardiac function;
- maintain a heart rate of up to 90 per minute at rest and not above 115 with the load in elderly people with cardiac pathology;
- use anticoagulants( warfarin, low molecular weight heparins) - prevent the formation of thrombi in the heart chambers;
- to treat the causes of tachyarrhythmia.
Embodiments recovery rate | method | Specific action agents | | Cardioversion - "restart» | heart Drug( Propafenol, Flecainide) Electric( discharge current) Hybrid  | | Medication | Beta blockers Calcium channel blockers Glycosides | | ablation - the destructionfoci with pathological electrical activity | Catheter( endovascular, using burning or freezing) Open heart surgery( used in casesthe need for an operation on other occasions)  | | Installation of pacemakers | Installing a pacemaker or cardioverter defibrillator  | The choice of tactics depends on the symptoms and degree of circulatory disturbance. Severe cardiopulmonary failure is an indication for an emergency electrical cardioversion. In non-threatening conditions, drug therapy is used, followed by a decision to perform ablation. Control of the level of tachycardia For this use the same antiarrhythmic drugs as for restoring the rhythm. A combination of several drugs is often required. The effectiveness of treatment is determined by the causes. Without a primary pathology of the heart or its secondary change against a background of a prolonged absence of a sinus rhythm, a complete cure is possible. In tachycardia due to chronic diseases, antiarrhythmic therapy is lifelong. Extrasystoles Extrasystoles are an extraordinary reduction of the heart muscle.  Its forms: | Its localization: | Sinus Atrioventricular Atrial Ventricular | | At frequency per hour | Rare( & lt; 10) Average frequency( 10-30) Frequent( & gt; 30) | | Density | Single Paired | Extrasystoles occur for the same reasons as tachycardia. Often provoke the onset of paroxysm of tachyarrhythmia. Extrasystolia in most cases is asymptomatic, sometimes there are: - a heart failure;
- sensation of an intensified heart beat or stop, heart sinking.
In heart failure, the course of the disease worsens, and the risk of death increases. Single extrasystoles occur in healthy people, do not require correction. Respond well to treatment. Treatment of extrasystole associated with cardiac muscle damage includes: - beta blockers;
- ablation of foci of high-frequency extrasystole.
Bradycardia Bradycardia is the contraction of the atria and / or ventricles with a frequency of less than 60 per minute. Medical intervention requires bradyarrhythmia of the ventricles.  | types | type sinus syndrome syndrome Atrioventricular blockades( in simple language - blockade of cardiac pulses in the heart) | | | paroxysmal Chronic | Sinus node weakness  Decrease or turn off electrical activity of the main pacemaker -sinus node. The disease affects people of elderly and senile age, is rarely diagnosed in young people. Occurrence - 3 cases per 5000 population. In the early stages without a decrease in the rhythm of less than 40 per minute, there are no symptoms. Distinguishes progressing course. Treatment improves overall well-being, but does not always affect life expectancy. Atroventricular blockade of  There is a disturbance in the excitation wave along the conducting pathways to the ventricles. The occurrence is 2-5%.Progressing current. There are 3 degrees of severity as the excitation wave is disturbed. Blockades of 2-3 degrees are distinguished by a high risk of cardiac arrest. Causes of - Cardiac factors, as with tachyarrhythmias.
- Increase in the level of potassium, magnesium.
- Diseases of the esophagus, stomach.
- Side effect of antiarrhythmic drugs, analgesics of the morphine group.
- Vagotonia( predominance of the action of the parasympathetic nervous system).
- Low level of thyroid function.
- Causeless.
Symptoms of - Reduced heart rate.
- Interruptions in the heart, a sense of stopping it.
- Expressed, growing weakness, inability to perform ordinary business.
- Unstable blood pressure level, often - episodes of an increase with a low effect of treatment.
- Impaired consciousness to deep fainting.
- Chest pain without physical stress.
Treatment of What to do in this pathology: - to treat the underlying disorder that caused a decrease in rhythm;
- to correct bradycardia with medicines( xanthines, anticholinergics);
- install a pacemaker( pacemaker) - with a high risk of cardiac arrest.
Tactics depends on the stage of bradyarrhythmia, the presence of the clinic. If the slowing of the rhythm is associated with the defeat of the myocardium - there is no complete recovery. Physiological bradycardia in trained people and asymptomatic bradyarrhythmias do not require treatment. Diagnosis of the heart in its work with interruptions - Thorough examination of the patient to identify characteristic complaints.
- ECG - the "gold standard" in the installation of the type of arrhythmia. In paroxysmal forms, an episode of the disorder is not always recorded.
- ECG registration during the day( holter monitoring) or weeks( event monitoring) - diagnosis of arrhythmia paroxysms.
 - ultrasound of the heart through the thorax and( or) the esophagus. To assess the function of the myocardium, the examination of the heart cavities on the subject of clots.
Prognosis for All arrhythmias of non-cardiac origin are completely curable when correcting the original pathology. For forms associated with myocardial damage, the prognosis depends on the degree of circulatory disturbance. Chronic cardiac pathologies require constant treatment and gradually progress.
Paroxysmal forms of heart failure are a common cause of sudden death.
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