How is the heartbeat disorder?

Heartbeat disorder refers to abnormal heartbeat frequency and rhythm. The heartbeat of a normal adult is 60 ~ 100 beats per minute. Arterial pulsation (measured on the wrist, neck or other parts) is consistent with ventricular contraction. The upper chamber of the heart, called the atrium, can also contract to help fill the ventricles. Atrial contraction intensity is weak, which occurs before ventricular contraction, and the pulse cannot be felt. Under normal circumstances, the electrical pulse of heart beating comes from sinoatrial node. Sinus node is a normal pacing point located in the upper part of right atrium. The electrical pulse propagates from the sinoatrial node to the atrioventricular node located in the atrium, then passes through the His bundle located between the two ventricular muscles, and then propagates to the ventricular muscles, causing the ventricular muscles to contract and produce a heartbeat. Arrhythmia, according to the source of impulse, can be divided into ventricular arrhythmia (impulse comes from ventricle) and supraventricular arrhythmia (impulse comes from heart parts other than ventricle, such as atrium); According to the influence on heart rate, it can also be divided into sinus bradycardia (heart rate is lower than 60 beats per minute) and sinus tachycardia (heart rate is higher than 0/00 beats per minute/kloc). Common arrhythmias include: sinus node dysfunction-which usually causes the heart rate to slow down to less than 50 beats per minute (bradycardia). The most common reason is the generation of scar tissue, which eventually replaced the sinus node. The cause of this injury is still unknown. Sinus node dysfunction can also be caused by coronary artery disease, thyroid insufficiency, severe liver disease, typhoid fever or other diseases. Excessive activity of vasovagal nerve (super vascular nerve) can also cause sinus node dysfunction. Supraventricular tachycardia-various arrhythmias can cause supraventricular tachycardia, mostly caused by abnormal atrioventricular node or pathological conduction bypass. Atrial fibrillation-is a supraventricular arrhythmia that causes the heart to beat rapidly and irregularly. At this point, the atrium replaced the normal heartbeat with "fibrillation". During atrial fibrillation, heartbeat signals come from many different parts of the atrium, not the sinus node. Although these abnormal signals can induce atrial contractions of 300 ~ 500 beats per minute, and these excessive heartbeat signals will inhibit the signal of atrioventricular node, which will eventually lead to scattered and irregular signals from atrioventricular node to ventricular muscle, resulting in irregular rapid heartbeat of 80 ~ 160 beats per minute. Abnormal heartbeat induced by atrial fibrillation will make the heart unable to pump blood effectively, which will make blood accumulate easily in the heart cavity, and there is a danger of blood clots forming in the heart cavity. The main risk factors of atrial fibrillation are age, coronary heart disease, rheumatic heart disease (caused by rheumatic fever), hypertension, diabetes and hyperthyroidism. Atrioventricular block-this kind of arrhythmia mainly refers to the failure of the conduction process of heartbeat signal from sinoatrial node to ventricular muscle. The atrioventricular block is divided into three degrees: degree I atrioventricular block: the signal can pass, but the conduction time from sinoatrial node to ventricular muscle is prolonged; Ⅱ degree atrioventricular block: some electrical signals are lost during conduction between atria and ventricles; Ⅲ degree atrioventricular block: no signal reaches ventricles, and ventricles beat slowly by their own rhythm. Common atrioventricular block is caused by coronary heart disease, myocardial infarction or digitalis overdose. Ventricular tachycardia is caused by abnormal left and right ventricular rhythms. It may last for a few seconds (transient ventricular tachycardia), or minutes or hours (persistent ventricular tachycardia). Persistent ventricular tachycardia is a very dangerous heart rhythm, which will often develop into ventricular fibrillation if left untreated. Ventricular fibrillation is an ineffective ventricular fibrillation, not a real heartbeat, which will suddenly lead to loss of consciousness, brain damage and death in a few minutes. Ventricular fibrillation is an emergency, which can be caused by myocardial infarction, electric shock, lightning stroke or drowning. Symptoms of various types of arrhythmia include: sinus node dysfunction may be asymptomatic, or dizziness, syncope and extreme fatigue. Supraventricular tachycardia can cause palpitations (I can feel my heart beating fast), hypotension and syncope. Atrial fibrillation sometimes has no symptoms; Symptoms such as palpitation, syncope, dizziness, fatigue, shortness of breath and angina pectoris may also occur; Angina pectoris is chest pain caused by decreased myocardial blood supply; The heart rate of some patients with atrial fibrillation changes alternately between irregular heart rate and normal heart rate for a long time. Atrioventricular block: I degree atrioventricular block does not cause any symptoms; Second degree atrioventricular block causes irregular pulse or pulse deceleration; ⅲ atrioventricular block can cause extremely slow heartbeat, dizziness and syncope. Ventricular tachycardia (VT) A brief VT may have no symptoms or a slight tremor in the chest. Persistent ventricular tachycardia often leads to dizziness, loss of consciousness and even death. Ventricular fibrillation can lead to pulse loss, unconsciousness and death. The diagnostician will ask if you have a family history of coronary heart disease, arrhythmia, syncope, sudden death and other diseases, and will also ask about your personal medical history, including those risk factors that may induce arrhythmia, such as coronary heart disease, rheumatic fever, thyroid dysfunction, and certain drug treatments. The doctor will also ask you to describe the symptoms, including the possible triggers of these symptoms. During the physical examination, the doctor will check your heart rate, rhythm and pulse. This is because some arrhythmia will lead to the inconsistency between pulse and heart sound. The doctor will also check whether you have heart enlargement and heart murmur (which can indicate the existence of heart valve disease). Electrocardiogram (EKG) can diagnose arrhythmia. However, because some arrhythmias are paroxysmal, ECG examination may be normal. This situation requires dynamic electrocardiogram. During dynamic electrocardiogram examination, patients carry a portable electrocardiograph called Holter monitor, which usually needs to be worn for 24 hours, and sometimes it may need to be monitored for a longer time. The doctor will teach you how to use the keys correctly, so that you can record the ECG well when symptoms appear. This method is especially effective when the symptoms are sporadic. When the patient has ventricular fibrillation, it indicates that the situation is critical. At this time, the patient lost consciousness and had no breathing and pulse. If possible, electric shock cardioversion should be implemented as soon as possible; Otherwise, CPR should be implemented immediately. To prevent arrhythmia caused by coronary heart disease, the following measures can be taken to reduce risk factors: healthy diet, that is, eat more vegetables, fruits, fish and plant protein, and avoid eating full and fat and trans fatty acid foods. Control cholesterol and hypertension. Quit smoking. Control your weight. Regular physical exercise. Professionals or pharmacists can be asked to understand the interaction between drugs in order to reduce arrhythmia caused by drugs. Therefore, you may have to switch to other drugs or reduce the dose of this drug. Observing the precautions of electricity safety or looking for shelter in lightning weather can prevent ventricular fibrillation caused by electric shock. Not all arrhythmias can be prevented. Treatment is based on different reasons: patients with frequent and severe symptoms of sinus node dysfunction should usually be fitted with permanent pacemakers. Supraventricular tachycardia should be treated according to different reasons. Some patients can return to normal only by carotid sinus massage; Other patients need medication, such as β-blockers, calcium channel blockers, digoxin and amiodarone. Some patients need radiofrequency catheter ablation, that is, to destroy the tissue cells of the atrioventricular node to prevent excessive electrical pulses from conducting from the atrium to the ventricle. Atrial fibrillation caused by hyperthyroidism can be treated with drugs and surgery; Atrial fibrillation caused by rheumatic heart disease can be replaced by surgery; Beta blockers (atenolol, metoprolol), digoxin, amiodarone, diltiazem, verapamil and other drugs. Can be used to lower the heart rate; Drugs such as amiodarone can also be used to reduce the recurrence of atrial fibrillation; Other treatment measures include radiofrequency catheter ablation or electrical cardioversion, that is, sending electrical pulses to the heart to restore normal heart rhythm. Patients with atrioventricular block I degree atrioventricular block do not need any treatment; Patients with degree ⅱ atrioventricular block may only be monitored by ECG, especially those with no symptoms and abnormal heart rate, which will not have much impact on daily life. Some patients with ⅱ degree atrioventricular block need to install permanent pacemakers. Most patients with ⅲ atrioventricular block need permanent pacemakers. Patients with transient ventricular tachycardia do not need any treatment if their heart structure is not damaged. Persistent ventricular tachycardia requires medication (intravenous injection) or emergency defibrillation, which can usually restore the normal rhythm of the heart. Ventricular fibrillation must be defibrillated to restore normal heart rhythm. In case of emergency, electric shock can be performed on the chest surface. Implantable automatic cardioverter defibrillator can be considered for patients who survive after ventricular fibrillation and patients with high risk of ventricular fibrillation. The device is similar to a pacemaker, with one end connected to the heart and the other end connected to the subcutaneous power supply. These operations were all done in the operating room. Most people know that the heartbeat should be regular and tidy, so when they hear of "arrhythmia", many people think it is an abnormal phenomenon. Although there are no symptoms, you should seek medical advice everywhere and seek experts to cure the "disease" quickly. But doctors often say, "Don't treat it." These people are playing drums again. Are they incurable? Actually, sinus arrhythmia is a normal physiological phenomenon, not a disease. "Sinus arrhythmia" is most common in children and adolescents, and it is not uncommon in adults. The beating of a normal person's heart is commanded by a high-level command called sinoatrial node. Sinus node sends out signals to stimulate the heart to beat. This kind of heart beat caused by the signal from sinus node is called normal sinus rhythm, and its frequency is about 60- 100 times per minute. The number of beats per minute, that is, the heart rate, comes from this. But this frequency may be affected by many factors, even breathing. Generally speaking, the heartbeat rhythm is regular and tidy. If the heart beats irregularly, we call it arrhythmia. From this point of view, "sinus arrhythmia" is the most common arrhythmia, which is caused by irregular signals from sinus node. But this kind of "arrhythmia" mostly belongs to "respiratory sinus arrhythmia", which is a normal physiological phenomenon. Its characteristic is that it changes with the change of breathing. When inhaling, the heart rate can be accelerated by several jumps, and when exhaling, it can be slowed down by several jumps. Its fast and slow cycle is exactly equal to a breathing cycle, and when you hold your breath, your heart rate becomes regular. This kind of "sinus arrhythmia" which changes with breathing is completely normal, so there is no need to worry or treat it. Therefore, people diagnosed with sinus arrhythmia can pay attention to whether the acceleration and deceleration of their heart rate are related to breathing. As long as there are no other symptoms, you don't need treatment and you can engage in normal study and life. Now many doctors have noticed the panic caused by sinus arrhythmia, so they will write "sinus rhythm" when diagnosing. In addition, mental stress and other factors may also cause "sinus arrhythmia", which does not need treatment.