Ciliary arrhythmia

[dau]

Good afternoon, the dear colleague!
Wished to learn or find out from you more in detail about tactics of treatment of a ciliary arrhythmia.
To me - 40 years. In the summer of this year I had extrasystoles, feeling of delicacy. Extrasystoles basically were marked or celebrated after reception of nutrition and at weather changing. Has done holterovsky monitoring and an echocardiography. On holtere it is noted nearby 380 politopnyh not widened ectopic complexes PQRST (from time to time alloritmirovannyh as bi, trigemenii, often with abberantnym carrying out) and 160 monotopnyh widened kopleksov QRST. (76 % ekstrasiitol are necessary for day time time). On EhoKG - parameters of contractility of a myocardium in norm or rate. Insignificant prolabirovanie cusps MK and trikuspidalnogo valves. Diffusive or diffuse changes of a myocardium.
Our cardiologist on consultation has told or said, that basically the given kind of a pathology of medicamental correction does not demand, but if the status of faults is subjective is transferred or carried badly it is possible to accept - etatsizin, propafenon, sotalol. I have decided to do without medicines. However soon after night watch there was a paroxysm of a ciliary arrhythmia. During the moment of an attack of a BP - 150/100, PS - 85-100, the CARDIAC CONTRACTIONS RATE 100-120 in minutes of the Loss of consciousness was not, perens I an attack in general am satisfactory. The attack by introduction of 1000 mg novokainamida i.v. in 2 hours from the beginning in current 10 minutes is stoped Then I have started to accept etatsizin 50 h 3 in day. Approximately through 1,5 mes reception I have tried to cancel a preparation, gradually having lowered a dose. In two days after a full cancelling again a paroxysm MA. The BP--100/80, Ps - 100 ud in minutes Is removed or taken off an attack novakainamidom in a dose of 1000 mg. As I transferred or carried etatsizin not so well. Depression of physical strength and the general or common delicacy especially oppressed. According to the cardiologist (the best pernosimost, the greater or big therapeutic breadth, a greater or big level of scrutiny) has started to accept propanorm in a dose of 300 mg h 2 times.
And a question my following - in connection with sharp falling of quality of a life for the last half a year (constant sensation of delicacy, restriction of daily activity). The Aggravation of symptoms are especially shown at changes of weather. Whether on a correct way I stand or cost. What organs and systems it is necessary doobsledovat in connection with the expressed vagotonic influence? That it is necessary to supervise during treatment. Also that is criterion or the terminations or endings or corrections .:confused:
Thanks for the answer

[VOLKON]

Hello, the colleague!

I do not know, where you studied, but when I studied in institute in all textbooks it has been written, that the reason of a ciliary arrhythmia can be 3 diseases: a mitral stenosis, an atherosclerotic cardiosclerosis and a thyrotoxicosis. Certainly, since then much in representations about a pathogenesis of a ciliary arrhythmia has changed, but, nevertheless, this are necessary for excluding three reasons (a heart disease by data EHOKG at you is not present). Enough the frequent reason MA can be various dystrophias of a myocardium, for example, alcoholic, or other intoxications (quite often arrhythmias met at surgeons and the anaesthesiologists working with Ftorotanum). The reason MA can be and congenital anomaly of spending system of heart (WPW, etc.), A sick sinus syndrome. At last, MA can be reflex character (at ZHKB, for example), or the "central" parentage at lesions of diencephalic area. Differently, it is necessary to exclude all these reasons. I think, that you should make EFI. It is necessary to check up a level of a cholesterin of a blood and in case of its or his rising to spend correction of a lipide spectrum of a blood. It is necessary to exclude also all others risk-factors of an atherosclerosis - smoking, AG, superfluous mass of a body (if is), etc. Well and the most effective preparation for prophylaxis of attacks MA is kordaron. It or he can be accepted on 1/2 tablets once a day week (if, certainly, there are no contraindications to its or his purpose or appointment).

[dau]

Dear Vladimir Olegovich!
Thanks for the answer. Briefly about itself - has finished I MMI it or him. IT or HIM of Setchenov in 1986 Now kmn, the surgeon-oncologist in the field of pulmonary surgery. Probably therefore my knowledge on some questions of a cardiology are a little bit sketchy. I do not drink and do not smoke 5 years. In sense of the physical form I rise run on 5 floor practically without a dyspnea or short wind. And the form voobshchem I try to support or maintain. The thyrotoxicosis (I have not noted above), but has been excluded by one of the first. ZHKB also it is noted. My question laid in some other plane. What tactics of conducting a similar pathology on prospect. To accept medicines constantly or how long (for this reason I and do not accept Amiodaronum as long application of the given preparation causes an irreversible damage of a thyroid gland and a pulmonary fibrosis, and also has series of other rather serious by-effects, in difference from propafenona). Me the question sensation of delicacy for today it also interested is display of negative inotropic action propafenona and etatsizina or otsutsvie atrial pumping or disability of a myocardium to provide necessary emission at augmentation of a load under influence of the specified medicines. Voobshchem a question on quality of a life, on the forecast of a course of a disease and my actions at negative consequences. (and more excuse me, please, but I do not know that such EFI)
With uvaeniem Uskov YES

[VOLKON]

Hello, the colleague!

EFI this electrophysiological research. It unpleasant enough, i.e. a thin electrode to you will thrust in an esophagus to remove or take off an electrocardiogram from different departments of heart, but also will try to impose by means of electric impulses a rhythm which can provoke a ciliary arrhythmia. This research, nevertheless, is capable to define or determine presence of additional fascicles in spending system of heart. If they are, it can be eliminated or erased;removed surgical by (now there is a mass non-invasive or maloinvazivnyh procedures). But it in my opinion should be made. Amiodaronum or kordaron in such small doses will not cause or call all those by-effects about which you write. At me very much wide experience of application of this preparation and never would be however or as was serious by-effects. But, nevertheless, all over again it is necessary to specify the diagnosis. As to negative inotropic action propafenona and etatsizina hardly it can be reflected in state of health at initially normal sokratitelnoj functions of a myocardium.

[dau]

Many thanks for answers. We shall continue to specify

[Aritmolog]

I invite to familiarize with my translation or transfer American-European gajdlajna on treatment of fibrillation of auricles (http: // www.cardiosite.ru/clinical-lectures/article.asp? id=1588).