5 signs of multifocal and unifocal atrial tachycardia

Atrial tachycardia (AT) is one of the types of arrhythmia (heart rhythm disturbances), in which pathological excitation is localized in the upper part of the heart chamber. Therefore, sometimes this type of tachycardia is called supraventricular. It accounts for approximately 20% of the total number of tachycardias. Atrial tachycardia causes a sharp increase in heart rate (heart rate) - from 140 to 240 beats per minute. In the absence of timely therapy, the consequence of seizures can be both a deep fainting lasting up to several minutes, and a fatal outcome.

Causes of atrial tachycardia

The disease can occur at any age, but most often occurs in older people - from 60 years of age and older. The reason for this is a general violation of all body functions, which appears against the background of age-related changes. The heart, as the organ with the highest degree of stress, suffers from such changes in the first place.

Due to a violation of the normal patency of impulses, pathological foci of excitation are formed in the atrial region, causing stimulation of the heart muscle and an increase in heart rate.

When there is only one such focus, we are talking about single-focal atrial tachycardia, if there are several foci, a diagnosis of multifocal atrial tachycardia is made.

The impulses generated in them lead to myocardial overstrain, disruption of rhythm control and the risk of separation of vascular clots, provoking the development of such a serious cardiac pathology as a heart attack.

• arterial hypertension - increased blood pressure in the arteries, extending to the region of the coronary vessels and leading to their premature wear;
• myocarditis - inflammation of the heart muscle caused by complications of viral infections, rheumatic heart disease, and allergic reactions;
• heart failure - a consequence of angina pectoris, coronary heart disease (CHD) and other chronic cardiovascular pathologies;
• congenital and acquired heart defects;
• complication of acute diseases of the bronchopulmonary system - pneumonia, bronchitis and others, or their chronic form;
• surgery on the heart, bronchi or lungs;
• intoxication with alcoholic beverages, drugs;
• pathology of the endocrine system - diseases of the thyroid gland and adrenal glands;
• violation of metabolic processes (metabolism) of various etiologies;
• overweight, which is the cause of chronic overload of the entire cardiovascular system;
• circulatory disorders as a result of the development of atherosclerotic processes.

Atrial tachycardia can also be provoked by an overdose of drugs intended for the treatment of cardiopathologies. Cardiac glycosides are especially dangerous in this regard.

This pathology, being an independent nosological unit, has specific symptoms and is included in the International Classification of Diseases. This is a list created with the aim of systematizing various diseases, depending on the damage they cause to the organs and systems of the body, localization, symptoms and other signs.

Each pathology in it has a special alphanumeric code that makes it easier for specialists to keep records when making a diagnosis. The list is periodically updated, replenishing with newly discovered types of ailments. In the tenth version of this list (ICD-10), atrial (supraventricular) tachycardia is indicated by code 147.1.

Classification of atrial tachycardia

Classification of atrial tachycardia occurs according to several criteria. Depending on the form of the course, it can be chronic, when the chaotic contraction of the myocardium lasts for several days, weeks or even months.

• sinoarterial-reciprocal, in which the zone of pathological excitation of the myocardium is located in the area where the sinoarterial node is transformed into atrial tissue;
• reciprocal, localized directly in the muscle tissue of the atria;
• focal - when several zones of excitation appear in the heart at once.

1. Trigger - occurs quite rarely, mainly in elderly patients with a large number of cardiac pathologies in history. It occurs against the background of long-term use of pharmacological cardiopreparations, primarily cardiac glycosides, as a result of their excessive accumulation in the body. The cause of the development of this type of atrial tachycardia can also be excessive exercise.
2. Reciprocal - the etiology of this type does not have a clear formulation, but is in clear connection with other types of arrhythmias, including its atrial variety. The fluttering effect occurs against the background of atrial fibrillation when the atrial tissue is excited by the passage of an electrical impulse inside it.
3. Polytopic, diagnosed both in people of mature and old age, and in young people. Accompanied by diseases of the respiratory system and heart failure.
4. Automatic, which affects mainly young people and adolescents. This type of atrial tachycardia is usually the result of significant physical exertion. In the absence of treatment, the condition worsens, the appearance of acute heart pain, progressing up to a state of shock, is possible.

People who, due to the above reasons, are at risk for atrial tachycardia, should be especially attentive to the state of their heart. At the first symptoms of the disease, they should immediately contact a specialist.

Symptoms and diagnosis of atrial tachycardia

Sometimes atrial tachycardia is asymptomatic and is detected not as a result of the patient's specific complaints, but during his examination for other reasons. But more often it has quite clear symptoms. In young and elderly patients, the symptomatic picture of atrial tachycardia may look different.

Elderly people who have been suffering from various forms of cardiopathology for a long time adapt to the changed state of the heart, sometimes they do not pay attention to minor heart rhythm disturbances, shortness of breath and other symptoms of PT, if they do not take on a pronounced character. Those who have not yet had time to adapt to the disease react more sharply to any pathological change in their condition.

1. Chest pain that is aching, pressing or stabbing.
2. Feeling short of breath, difficulty in breathing.
3. Severe dizziness, weakness, cold sweat.
4. A state close to fainting.
5. Cardiopalmus.

The most complete and intelligible way to diagnose atrial tachycardia is to take an electrocardiogram (ECG) using an electrocardiograph - a device that records on a paper tape the signals produced by different parts of the heart chamber during their contractions.

But since it is rather difficult to catch the moment of violation of contractile activity with the help of ECG, modern doctors use the method of round-the-clock monitoring of the patient using the Holter method.

A special device is attached to the patient's body in the region of the heart, after which he wears it without removing it for one or two days. Periodically, he must make entries in a special diary, fixing the time and nature of his activities. After the device is removed, the doctor will compare its readings with the patient's records and determine when and what activity led to a change in the biological parameters of the heart rhythm.

A more modern and informative method of examining the heart for the detection of cardiopathologies is called EchoEKG or ultrasound (ultrasound) of the heart. It is based on fixing the reflection of ultrasonic waves as they pass through the heart cavities.

Such a study shows the condition and size of the heart chambers, the thickness of the walls and the condition of the aorta and pulmonary artery, the blood pressure in them. Observing on the monitor screen an image of the internal structures of the heart - its kind of "photo" from the inside, the doctor makes a more accurate diagnosis than when reading an electrocardiogram.

Ultrasound examination allows diagnosing heart defects of various etiologies. They are one of the main causes of atrial tachycardia in people under 50 years of age.

Therapy for atrial tachycardia

Asymptomatic atrial tachycardia does not require treatment.

1. Drug therapy with Verapamil, Amiodarone, Propafenone, Sotalol. All these drugs are designed for prolonged action, therefore, in order to achieve a stable therapeutic effect, they must be used for a sufficiently long time. The attending physician determines the specific timing of the use of drugs on an individual basis.
2. Stabilization of the heart rate by exposing the heart to an electric current discharge of medium power - from 50 to 100 kilojoules.
3. When none of these techniques gives a positive result, catheter ablation is used to eliminate fibrillation (chaotic twitching of muscle fibers). To do this, electrodes are connected to the outside of the body, the same electrode is inserted into the heart using a catheter. The operation is performed under general anesthesia, but without incisions. An electric current discharge between the outer and inner electrodes destroys the focus of fibrillation. In this case, an insignificant part of the cells of the heart muscle, which was its source, dies, but this does not harm the body.

If it is not accompanied by other forms of cardiopathology, systematic treatment and constant medical supervision allows the patient to maintain a normal level of ability to work and lead a normal life.