Ciliary arrhythmia

Description:

The ciliary arrhythmia is an irregular cordial rhythm which often causes deterioration in inflow of blood to various bodies.
Blinking (fibrillation) of auricles, or ciliary arrhythmia, is such disturbance of a heart rhythm, at which throughout all cardial cycle it is observed frequent (from 350 to 700 in a minute), chaotic, chaotic excitement and reduction of separate groups of muscle fibers of auricles, each of which actually is a peculiar ectopic center of an impulsation now. At the same time excitement and reduction of an auricle as whole are absent.
This arrhythmia is called also fibrillation of auricles. In our country the most widespread term is "ciliary arrhythmia".
On character of a current distinguish paroxysmal and constant (or chronic) forms of a ciliary arrhythmia. Paroxysms of blinking last from several seconds to several days. Short paroxysms often pass spontaneously.
The standard temporary criterion of differentiation затянувшегос:я a paroxysm and a constant form of arrhythmia does not exist and on installations of various authors it fluctuates of 2 weeks up to 2 months. Taking into account modern tactics of prevention of thromboembolisms the ciliary arrhythmia is subdivided sometimes on passing, prescription to 48 h, steady - 48 h up to 2 months and a constant, lasting more than 2 months.

Depending on ChSS the ciliary arrhythmia can be takhisistolichesky, normosistolichesky and bradisistolichesky.

Atrial fibrillation - the most widespread of all arrhythmias. Its prevalence among adult population substantially depends on age. So, if among persons aged up to 40 years its frequency makes less than 0,5%, then aged people have 40-70 years - 1-5%, and the c is aged more senior than 70 years - more than 10%. The ciliary arrhythmia meets at men a little more often.

Symptoms of the Ciliary arrhythmia:

In some cases patients do not feel arrhythmia, and it can accidentally be found.

The most widespread complaints are heartbeat, short wind, dizziness and weakness. These complaints, however, are not specific and are often noted at a sinoatrial rate. Rather more rare symptoms are faints at long pauses and stenocardia, up to unstable. Also increase of an urination which can be connected with increase in formation of atrial natriuretic hormone or the raised tone of a sympathetic part of the autonomic nervous system is described. Occasionally to the first and the long time the only manifestation of a ciliary arrhythmia is a stroke. At most of patients arrhythmia arises for no apparent reason. It is possible to establish its connection with an alcohol abuse, strong coffee, smoking, a stress and a considerable exercise stress less often.

At clinical trial irregular pulse without any patterns of changes of its rhythm and frequency attracts attention owing to what the ciliary arrhythmia is figuratively called by "arrythmia completa" (full arrhythmia). All pulse waves of different filling that causes continuous fluctuation of sizes of arterial pressure. In most cases pulse frequent (a takhisistolichesky form of a ciliary arrhythmia), but can be noted also the bradycardia inherent to atrial fibrillation at a sick sinus syndrome or caused by use of the medicamentous drugs which are slowing down atrioventricular conductivity. At tachycardia the deficit of pulse connected with considerable decrease in shock emission after a short diastole often is defined. At auscultation of heart unequal sonority of the I tone is noted. After a short diastole the I tone clapping. These clinical signs do not allow to distinguish atrial fibrillation from other arrhythmias, however, rather reliably.

Reasons of the Ciliary arrhythmia:

The major etiological factors are system arterial hypertension, the ischemic heart diseases various forms, defects of the mitral valve (a stenosis and insufficiency) of a rheumatic and not rheumatic origin and a hyperthyroidism. According to P. Piystowsky and coauthors (1996), the frequency of these diseases at the ambulatories observed by them with a ciliary arrhythmia - residents of the USA - made respectively 56, 19, 4 and 11%. At 35% of these patients visible symptoms of a heart disease were absent. On the materials P. Podrid and P. Kowey (1996), among the reasons of a ciliary arrhythmia the dead on the first place had an ischemic heart disease in all cases complicated by congestive heart failure (34%) on the second - rheumatic heart diseases (24%). The pulmonary heart is revealed at 13,5% of the dead and system arterial hypertension - at 9,4%. At 8% of the dead organic heart diseases were absent.

Treatment of the Ciliary arrhythmia:

Active treatment of diseases which can lead to development of a ciliary arrhythmia, first of all arterial hypertension and congestive heart failure is necessary. At patients with dysfunction of a sinus node its prevention is promoted by carrying out two-chamber EX-instead of single-chamber ventricular. At patients to whom cardiac intervention is shown purpose of ß adrenoblockers before operation is effective.