Certain rhythm disturbances
In the following, the individual rhythm disturbances are described in more detail and explained how they arise and with which symptoms they are associated. The most important instrument for diagnosing cardiac arrhythmias is the ECG (electrocardiography). Various cardiac arrhythmias lead to characteristic changes in the ECG.
These are also described here. Unfortunately, being able to “read” an ECG correctly is a very difficult thing that requires a great deal of knowledge of the physiological processes of the heart. Following the description of the individual cardiac dysrhythmias, you will find some explanations of the basic functioning of an ECG.
General therapy
Not every cardiac dysrhythmia requires immediate therapy, since many forms – especially in otherwise heart-healthy patients – pose no threat and do not lead to physical limitations. The most frequent rhythm disturbance in healthy hearts is the extra beats, also called extrasystoles. Therapy is therefore only necessary if a rhythm disturbance is added to an already preloaded heart or if the accompanying symptoms lead to subjectively strong physical or psychological impairments.
In general, a distinction is made between one: whereby the type of rhythm therapy depends on the type of disorder (tachycardic, bradycardic disorder, extra beats, etc.) In drug-based antiarrhythmic therapy, several drugs are used, which are divided into four different classes: the 1st class includes substances that block so-called sodium channels in the heart (e.g. flecainide)the 2nd class includes substances that block ?1 receptors (beta-blockers, e.g.
metoprolol)the 3rd class includes potassium channel inhibitors (e.g. amiodarone) and the 4th class includes substances that inhibit calcium channels (e.g. verapamil). All these drugs aim to regulate and stabilize the heart beat frequency.
The so-called electrical therapy includes, on the one hand, the implantation of a pacemaker in the case of cardiac arrhythmia that causes the heart to beat too slowly. The electrical device stimulates the muscles of the heart to contract in a certain rhythm so that a sufficiently regular pumping is guaranteed. On the other hand, the implantation of a defibrillator is also part of the electrical therapy, whereby this is preferably used in the case of too fast rhythm disturbances (e.g. ventricular fibrillation).
If the device registers the rhythm that gets out of hand, it sends a current surge to the heart, which usually brings it back into a normal, regulated rhythm. However, an external electric shock can also be applied to restore the heart to its normal rhythm in the event of cardiac arrhythmias, especially in the atrium (e.g. atrial flutter, atrial fibrillation). This procedure is called electrical cardioversion and is performed under a short anaesthesia with a lower dose than defibrillation (drug-assisted cardioversion can also be performed without anaesthesia!)
Among the invasive rhythm therapy methods is the so-called catheter ablation. Here, the locations of the rhythm disturbances are specifically searched for during a cardiac catheter examination and then the heart tissue responsible for the cardiac arrhythmia is electrically sclerosed.
- Medication
- Electrical and
- Invasive therapy,
