ECG manifestations of atrial fibrillation Disease description: Atrial fibrillation is referred to as atrial fibrillation, which means that there are 35-6 irregular impulses per minute in the atrium, and the muscle fibers in various parts of the atrium are extremely uncoordinated, thus losing effective contraction. Most of them occur in patients with heart diseases such as rheumatic heart disease, coronary heart disease and hypertension.
symptoms: during atrial fibrillation, the ventricular rate is often between 1 and 16 beats/min, the rhythm is completely irregular, the strength and speed of heart sounds are different, and the pulse strength is also different, and the number of pulses in one minute is less than the number of heartbeats. When the ventricular rate is not too fast, the patient may have no conscious symptoms; When the ventricular rate is too fast, there may be palpitations, dizziness, chest tightness, shortness of breath and so on. Atrial fibrillation reduces cardiac output by 3%, which often leads to cardiac insufficiency. In chronic atrial fibrillation, mural thrombus often forms in the atrium, and thrombus shedding can cause arterial embolism.
examination method: p wave on ECG disappears and is replaced by f wave with frequency of 35-6 beats/min, different shapes and sizes and uneven intervals. The distance between QRS complexes is absolutely irregular.
treatment methods: 1. western medicine treatment
patients with low ventricular rate and no heart failure, with no obvious symptoms, do not need special treatment, only need to be treated according to the cause.
Paroxysmal atrial fibrillation with rapid ventricular rate and obvious symptoms, or pulmonary edema or heart failure can be induced by ① intravenous injection of .1-.6mg of cedilanid plus 2 ml of 5% glucose, especially suitable for patients with heart failure. ② Intravenous injection of 5-1mg of verapamil plus 2 ml of 5% glucose, and oral maintenance for about 2 weeks after effective (forbidden for patients with preexcitation syndrome complicated with atrial fibrillation). ③ Propafenone 7mg plus 2 ml of 5% glucose is injected slowly, or 14mg can be added into 2 ml of 5% glucose solution for intravenous drip. < P > Patients with persistent atrial fibrillation who have indications of cardioversion can take ① drug cardioversion, mainly quinidine. ② Synchronous DC cardioversion, which is safer and more reliable.
2. Traditional Chinese medicine can treat
oral Chinese patent medicines, Tongmai Yangxin Pill and Xinjitong.
Precautions: 1. Atrial fibrillation is mostly caused by heart disease or other factors. Therefore, prevention and treatment of heart disease and other factors (such as hyperthyroidism with atrial fibrillation, antithyroid drugs should be used) is the key to prevent this disease.
2. Patients with atrial fibrillation should avoid strenuous exercise, especially elderly patients should avoid any form of physical activity, and be careful not to live on higher floors in daily life. The data shows that the probability of sudden death and sudden cardiac arrest in patients with atrial fibrillation is 3 times that of ordinary people.
3. After atrial fibrillation returns to normal, we should continue to take medicine and treat the primary disease to prevent recurrence.
[ Edit this paragraph] Diagnostic basis of atrial fibrillation:
1. Etiology: It is most common in rheumatic mitral stenosis, followed by coronary heart disease, hyperthyroidism, chronic constrictive pericarditis, cardiomyopathy, viral myocarditis, etc. It can also be caused by hypothermia anesthesia, chest and heart surgery, acute infection and cerebrovascular accident.
2. There are two types of atrial fibrillation: paroxysmal and persistent. The former lasts for a short time, and the latter refers to those who can't stop the attack without treatment for more than 3 months.
3. There may be palpitations, cardiac insufficiency, unequal heart sounds, absolutely irregular heart rhythm and short pulse.
4. Electrocardiogram: P wave disappears, and it is replaced by a series of tiny, different shapes and irregular frequencies, called F wave. The QRS wave has the same shape as sinus, and the ventricular rhythm is irregular, with 12-18 beats/min. If it is combined with third-degree atrioventricular block, the ventricular rate is slow and regular. When preexcitation syndrome is combined with atrial fibrillation and the accessory pathway descends, the ventricular rate can reach 2 quickly.