Absolute Arrhythmia - You Should Know That
introduction
In an absolute arrhythmia, the atria of the heart beat much too quickly, as is usual with atrial fibrillation.
In addition, however, the rapid atrial movement causes the chambers of the heart to beat irregularly, so that the heart twitches completely irregularly. As a result, the blood that is to be pumped through the heart comes to a standstill due to the many twitches and no more blood gets into the circulation. Such a condition is very dangerous and carries several risks.
These concomitant symptoms occur in an absolute arrhythmia
In most cases, absolute arrhythmia goes unnoticed because there are no typical symptoms. Possible symptoms and complaints that can occur with atrial fibrillation are attacks of dizziness, in rare cases even with fainting, fear and inner restlessness, as well as increased awareness of one's own pulse or a racing heart.
Severe forms of absolute arrhythmia that occur together with heart disease can lead to a deterioration in heart function and, as a result, symptoms of cardiac insufficiency. These include primarily the reduced resilience with accompanying shortness of breath, dry cough, fluctuations in blood pressure, water in the legs and frequent nocturnal urination. Another serious accompanying symptom of atrial fibrillation can be the result of a blood clot, such as after a stroke. If atrial fibrillation is present, there is a greatly increased risk of a blood clot developing in the atrium and the risk of sputum expectoration into the body's circulation with potentially serious consequences, such as the occlusion of one of the blood vessels supplying the brain.
Please also read:
- Recognizing arrhythmias
- Atrial flutter and atrial fibrillation
Causes of Absolute Arrhythmia
Atrial fibrillation or absolute arrhythmia can occur as a result of many different diseases. Only in the very few cases of absolute arrhythmias diagnosed is no underlying cause found. In these cases one speaks of idiopathic atrial fibrillation.
The most common causes include diseases of the heart, such as a history of myocardial inflammation, constriction of the heart valves, coronary artery disease, chronic heart failure, heart damage or congenital heart defects.
But diseases far from the heart can also cause atrial fibrillation and should therefore not be disregarded in the diagnosis. These include hyperthyroidism, acute obstruction of the pulmonary artery by a blood clot, persistent stress on the heart caused by a chronic lung disease such as chronic obstructive pulmonary disease (COPD) or the incorrect use of some medications. In young people with healthy hearts, atrial fibrillation can also occur after excessive alcohol or as a result of many years of endurance sports.
Also read our topic: Heart rhythm disorder due to stress
How is absolute arrhythmia diagnosed?
The diagnosis of atrial fibrillation is made using the ECG. However, a detailed medical consultation and clinical examinations can confirm the diagnosis of atrial fibrillation in advance. It is important to find out whether there is a known trigger for atrial fibrillation, such as physical strain, alcohol consumption or infections. In addition, it should be determined whether competitive sports have been practiced in the past or whether there have already been heart attacks or strokes.
The physical exam that follows should focus on the heart exam. A first indication of the presence of atrial fibrillation can be shown here as soon as the pulse is felt. An irregularly palpable pulse or a difference between the sensed pulses and the heart action audible through a stethoscope are useful here. When listening to the heart, the volume of the first heart sound may vary.
Absolute arrhythmia score
Various scores are used in the diagnosis and therapy planning of absolute arrhythmia. Probably the most important of these is the so-called CHA2DS2VASc score, which is used to assess the risk of a stroke. With a score of 2 points or more, a blood-thinning drug should be administered for the prophylaxis of a stroke. The CHA2DS2VASc score includes the following risk factors, which are each rated with one or two points: Chronic heart failure or left ventricular dysfunction, hypertension (high blood pressure), age> 75 years, diabetes mellitus, stroke or thrombosis, vascular diseases (e.g. CHD or PAD ), Age 65-74, and gender.
You may also be interested in this article: Signs of a stroke
The EKG for cardiac arrhythmias such as absolute arrhythmia
The EKG is the method of choice for diagnosing cardiac arrhythmias and, in the course of this, also for diagnosing an absolute arrhythmia.
The atrial fibrillation or absolute arrhythmia shows up as a visual diagnosis on the printed ECG. Typically EKG complexes are usually seen, with each peak reflecting a specific heart action. In simplified terms, a complex can be described as the sequence of a small wave (the P wave) followed by a high spike (the R wave). The p-wave stands for the contraction of the atria, followed by the high R-wave, which reflects the action of the ventricles. If there is an absolute arrhythmia, there is an irregular sequence of R waves. The chamber spikes, which otherwise always appear at the same intervals, are now irregular and vary in their time intervals. In the case of an absolute arrhythmia, the P wave is no longer recognizable in the ECG; instead, as a result of the uncontrolled activity of the atria, a kind of serpentine line occurs in front of the R waves. If the atrial fibrillation is not permanent, the diagnosis can be made using a long-term ECG.
Also read: What are the ECG changes in atrial fibrillation?
Therapy of absolute arrhythmia in cardiac arrhythmias
The therapy of absolute arrhythmia is based on the prognosis and the complications that can arise from this disease. In this context, four fundamental pillars of therapy for absolute arrhythmia can be defined.
- prophylaxis
- Frequency control
- Rhythm control
- Generalized therapy
The first pillar of therapy includes prophylaxis and is probably the most important for every patient. Atrial fibrillation causes the blood to flow irregularly in the atria, which tends to cause the blood to clot. These clots can later get into the heart chamber and from here are ejected into the body's circulation. Here they can cause serious damage, such as the closure of a vessel that supplies the brain. The result is a stroke with severe deficits, some of which are irreversible. For this reason, every patient with atrial fibrillation should receive so-called thromboembolism prophylaxis, which can prevent blood clots from forming.
The second pillar of therapy is frequency control. This is used when the atrial fibrillation cannot be stopped. However, since the atria move significantly faster with absolute arrhythmia than the normal heart rate, there is always the risk that the fast rate will be transmitted to the ventricles and cause a life-threatening palpitations or even cardiac fibrillation.
The third pillar of therapy includes rhythm control, an attempt is made to bring the absolute arrhythmia back into the normal heart rhythm by means of drugs or electrical impulses.
The fourth and thus last pillar of therapy deals with the mostly existing secondary or underlying diseases that can have a significant influence on atrial fibrillation. Here, for example, the correct setting of high blood pressure.
More information on this topic: Therapy of cardiac arrhythmias
Macumar against an absolute arrhythmia
Probably the most important therapeutic approach in the treatment of absolute arrhythmia is thromboembolism prophylaxis. For this purpose, blood-thinning medication is administered permanently.
The best-known representative of these drugs is the so-called Marcumar®. One of the oldest blood thinners used in the prophylaxis of absolute arrhythmias. Marcumar® is a very reliable drug which, if the blood levels are correctly adjusted, significantly reduces the risk of a stroke caused by a blood clot.
Unfortunately, Marcumar® is metabolized very individually, which makes regular blood tests necessary for the correct dose setting. Compared to new blood-thinning drugs that do not need this regular check-up, Marcumar® remains a good alternative, as it is a very well-tested drug that is still superior to many new drugs in terms of its controllability and tolerability.
Read more on this topic:
- Side effects of Marcumar®
- Alternatives to Marcumar®
Cardioversion for an absolute arrhythmia
Cardioversion is a therapeutic approach that is used to control the rhythm of atrial fibrillation.
Cardioversion can either be done electrically or with medication. In the case of electrical cardioversion, the sleeping patient is given an electrical impulse which is matched to the heart's action and is intended to bring the heart rhythm into a normal rhythm. An alternative is medical cardioversion. Here, special drugs are administered under the control of the heart's action, which are also intended to end the rhythm disturbance and bring the atria back to normal heart rhythm.
Similar topics you might be interested in: Ventricular flutter and ventricular fibrillation
Stroke complications
The complication of a stroke is probably the most serious and most feared consequence of absolute arrhythmia. The irregular movement of the auricles leads to a change in the flow properties of the blood, which favors the formation of blood clots. These blood clots can travel from the atria to the ventricles and from there are ejected into the body's circulation. Depending on which route the blood clot takes, it can have more and less worse consequences. Probably the worst consequence is a stroke, when the blood clot obstructs a vessel that supplies the brain with blood. For this reason, one of the most important foundations in absolute arrhythmia therapy is blood thinning to prevent blood clots from forming.
Please also read: Stroke- What are the Signs?
What is my life expectancy with absolute arrhythmia?
Absolute arrhythmia alone can be associated with a normal life expectancy with consistent therapy. However, if there are other underlying diseases, the combination of diseases can reduce life expectancy.
In particular, diseases of the cardiovascular system, such as high blood pressure, or disorders of the sugar or fat metabolism such as diabetes can have a negative impact on the prognosis of atrial fibrillation. In general, however, a normal life expectancy is also possible here with well-treated secondary diseases. The most important thing in the case of permanent atrial fibrillation is thromboembolism prophylaxis, since the formation of a blood clot and, consequently, a stroke is one of the most serious complications of absolute arrhythmia and significantly reduces life expectancy and quality of life.
You may also be interested in this topic: Heart attack
Forms of absolute arrhythmia
Atrial fibrillation or absolute arrhythmia can be divided into different forms, with the classifications differing in terms of origin and duration. Primarily, primary atrial fibrillation can be distinguished from secondary atrial fibrillation.
- primary: Approximately 15% of all people with atrial fibrillation have primary atrial fibrillation for which there are no detectable underlying heart disease or risk factors.
- Secondary: Secondary atrial fibrillation, on the other hand, is always based on a triggering factor, such as a heart disease, a heart valve disease, disturbances in the water and salt balance or other underlying diseases such as chronic obstructive pulmonary disease (COPD).
In addition to the cause, the absolute arrhythmia can also be classified according to frequency and duration.
- Atrial fibrillation that spontaneously returns to normal heart rhythm within 48 hours to seven days is referred to as paroxysmal atrial fibrillation.
- If the atrial fibrillation lasts longer than seven days and then spontaneously returns to normal heart rhythm or is brought back to normal heart rhythm by a doctor using cardioversion, this is referred to as persistent atrial fibrillation.
- Permanent atrial fibrillation, on the other hand, describes an absolute arrhythmia which under no circumstances can be brought back into the normal heart rhythm and is therefore accepted.
More on this: Classification of cardiac arrhythmias
