Classification of cardiac arrhythmias

According to medical statistics, in the first place among all diseases are pathologies of the heart and the vascular system. Than it is caused? The state of the cardiovascular system is affected by many negative factors. One of them - constant stress and lack of time for a full rest. Its negative role in the growth of similar pathologies is played by air pollution. But a person suffers not only from all the deteriorating environmental conditions. The health of the inhabitants of our planet is adversely affected by magnetic storms. From these splashes on the Sun, the cores are especially bad. The initial stage of more serious pathologies, often threatening a fatal outcome, is arrhythmia.

The essence of the disease

Often the term "arrhythmia" is not perceived by us as a diagnosis. But do not treat this violation of health so irresponsibly. Normally, the number of heart beats should not exceed 90 per minute. However , this value should not be less than 70. But many people do not know this information. And, as a rule, we do not control our pulse, we do not visit a cardiologist and we do not go on our own initiative ECG. However, such actions are the most minimal measure, contributing to the preservation of their own health.

Many failures in the work of such an important organ as the heart can not only be prevented, but also stopped. And the first bell for the most urgent measures is the slightest deviation from those rhythm indicators that are considered the norm.

Some of the reasons for the change in the pulse level are:

- fatigue;
- severe stress;
- an overdose of alcohol;
Congenital heart disease.

The essence of arrhythmia is that it is a violation of the cardiac system.

Cardiologists distinguish different degrees of severity of such a deviation. For example, simpler treatment is given to states in which only a few beats are short of the required frequency. However, quite often patients suffer from a significant increase in myocardial contractions. This is very dangerous for humans and can lead to death.

Types of diseases

A single classification of arrhythmias is currently lacking. This is connected with all the ongoing discussions about the grounds that should be put in its basis. After all, despite the century-old scientific studies of this pathology, the specialists did not receive the desired result in its treatment.

For example, in 2014, it was suggested that the classification of arrhythmias included three basic types of pathologies. Among them:

1. Arrhythmias, which are a normal reaction of the body, manifested in conditions of adaptation, but at the same time leading to various violations dangerous to the body.
2. Arrhythmias that arise for the regulation of cardiac activity.
3. Arrhythmias caused by disorganization of the anti-nucleic functioning of the cardiac muscle.

Classification of cardiac arrhythmias (WHO) identifies three large groups of these pathologies. They include the following diseases:

- caused by violation of formation in the cardiovascular system of an electrical impulse;
- associated with conduction disorders;
- combined type, due to both the first and second cause.

Arrhythmia is also classified because of its origin. So, they distinguish congenital, acquired and idiopathic pathology. The first of these three species is found already from the moment of the appearance of man to the light. Idiopathic arrhythmia has an unclear origin. As for the acquired disease, it occurs throughout the life of the patient and is the result of some dangerous diseases, including ischemic heart disease, diabetes and hypertension.

When an arrhythmia occurs, the heart muscle continues to pump blood as before. However, this pathology can cause the development of pathologies such as thromboembolism and heart failure. And this speaks of the danger of arrhythmia.

Heart rate abnormalities

This is one of the reasons for the development of pathology. In connection with this, there is a classification of arrhythmias in terms of heart rate. It includes:

1. Sinus tachycardia. This pathology is associated with a disruption in the sinus node, which is the main mechanism for the formation of electrical impulses of the heart.

With a tachycardia of this type, the heart rate exceeds the upper threshold, which is ninety beats per minute. A similar condition is felt by the patient as a heartbeat.
2 . Sinus arrhythmia. This pathology is an abnormal alternation of cardiac contractions. Most often sinus arrhythmia is observed in children, as well as in adolescents. Often it is functional and has a direct connection with breathing. At the time of inspiration, cardiac contractions increase, and when exhaled, on the contrary, they become more rare.
3. Sinus bradycardia. Its main symptom is to reduce the heart rate to 55 strokes within a minute. This phenomenon can be observed even in healthy and physically strong people during sleep or at rest.
4. Paroxysmal ciliary arrhythmia. In this case, there is a very rapid heartbeat, which has the right rhythm. The heart rate of a person sometimes reaches 240 beats per minute. In doing so, it causes weakness and pallor, increased sweating and a pre-stupor condition. The cause of this phenomenon is the additional impulses that arise in the atria. As a result of their occurrence, there is a very strong reduction in rest periods of the myocardium muscle.
5 . Paroxysmal tachycardia. This pathology is a correct, but very frequent rhythm of the cardiac muscle. The heart rate in this case is in the range from 140 to 240 beats within a minute. Paroxysmal therapy, as a rule, arises and disappears suddenly.
6 . Extrasystoles. This type of arrhythmia is an extraordinary (premature) contraction of the muscle of the myocardium. Thus the person can feel and the strengthened pushes in the field of heart, and its fading.

To help the cardiologist

The most convenient from a practical point of view is the classification of arrhythmias according to Kushakovsky. It includes three groups of pathology. In doing so, they have a detailed description of all the pathologies included in them. Let us consider in more detail the typology, which includes this classification of arrhythmias.

Violations in the formation of rhythm

This group consists of three subsections. In the first of them, which the classification of arrhythmias allocates under the letter "A", include nomotopic pathologies. They represent disturbances in the operation of the sinus node. Thus allocate:

1. Sinus tachycardia.
2. Sinus baricardium.
3. Sinus arrhythmia.
4. SSSU, or syndrome of weakness of the sinus node.

The following subsection includes ectopic causes of cardiac arrhythmia .

The classification distinguishes this list of pathologies under the letter "B". This subsection includes disturbances caused by heterotopic rhythms, which arose in connection with the prevalence of automatism in the work of ectopic centers. In this list are:

1. Substituting (slow) slipping rhythms and complexes, including atrial and ventricular, as well as from AB-compounds
2. Migrations observed in the supraventricular rhythm driver.
3. Non-paroxysmal types of tachycardia or accelerated rhythms of ectopic type.

In the next subsection, the arrhythmia of the heart not related to the violation of automatism is indicated. The classification distinguishes the pathology data under the letter "B". This includes:

1. Extrasystolia (ventricular, atrial and from AB-compounds).
2. Paraxisal view of tachycardia.
3. Atrial flutter.
4. Atrial fibrillation (fibrillation).
5. Ventricular fibrillation.

Conductivity disorders

This group includes several other ventricular arrhythmias.

Classification according to Kushakovsky singles out in this case:

1. Sinoatrial blockade.
2. Intraarrhythmic blockade.
3. AB blockade.
4. Intragastric blockade of branches of the bundle of the Hisnia, including mono-, bio- and triophas- cicular pathologies, affecting one, two or three branches of the atrioventricular bundle, respectively.
5. Ventricular asystole.
6. Syndromes of premature excitation of the ventricles.

Combined pathology of rhythm

This group includes such violations:

1. Paraxystopy.
2. Ectopic rhythms, characterized by blockade output.
3. AB-dissociation.

International scheme

It is worth mentioning that when defining such an ailment as an arrhythmia, WHO classification treats similar groups in almost the same way. At the same time, pathology is divided into diseases caused by various causes of cardiac muscle disorders. Thus, WHO identifies the following arrhythmia groups:

1. Caused by violations of automatism, including:

A) drivers of rhythm in the sinus node (sinus tachycardia, baricardium and arrhythmia, as well as SSSU and non-respiratory sinus arrhythmia);
B) drivers of rhythm outside the sinus node (lower atrial, atrioventicular and idioventical rhythms).

2. Excitability caused by disturbances, including:

A) sources of pathology (ventricular, atrial and atrioventicular);
B) the number of sources (mono- and polytropic);
C) in time of appearance: early (during atrial contraction), late (at the time of relaxation of the cardiac muscle) and interpolated (with the point of localization between contractions of the atria and relaxation of the heart);
D) in frequency: group (for several consecutive), paired (two simultaneously), single (five or less) and multiple (more than five);
E) orderliness (quadrugemia, trigeminy, bigemini);
E) Paroximal tachycardia.

3. Caused by conduction disturbances, that is, its increase (WPW syndrome) or decrease (different types of blockages).

4. Mixed (fibrillation / flutter of the ventricles / atria).

All types of diseases are accompanied not only by violations in the anatomical structure of the heart. They lead to imbalance and all metabolic processes occurring in the muscle of the myocardium. This causes different in nature and duration of arrhythmia. Only a cardiologist can make a true diagnosis. They will establish the cause of cardiac arrhythmia, classification, etiology, pathogenesis, a clinic based on the received electrocardiographic data.

A ciliary type of pathology

The classification of this type of disease is based on the nature of its clinical course, electrophysiological mechanisms, as well as etiological factors.

What happens atrial fibrillation? The classification distinguishes the following types:

- chronic (persistent);
Persistent;
- Transient (paroxysmal), lasting from 24 hours to seven days.

At the same time, chronic and persistent forms of pathology can become recurrent.

Also distinguish atrial fibrillation by the type of violation of heartbeats. In this case, distinguish flutter and atrial fibrillation.

At the frequency with which the ventricles contract, distinguish atrial fibrillation:

- Tachystolic (90 or more times per minute);
- normosystolic (60-90 times per minute);
- Bradisystolic (less than 60 times per minute).

Extrasystolia

This variant pathology is characterized by extraordinary contractions of the heart muscle or its individual parts (extrasystoles). In this case, a person feels anxiety, lack of air, a strong heart beat or his fading. Such pathology sometimes leads to angina and disorders in the cerebral circulation.

Any extrasystole is characterized by a mass of parameters. That is why, when it is fully classified, there are more than ten sections. However, for practical use, only those that are most approximate can reflect the course of the disease.

Classification of arrhythmias by Laun was an important step in the history of cardiology. Using the proposed grouping, the practitioner is able to adequately assess the patient's pathology and the severity of its course. The fact is that the gastric extrasystole of the heart (VES) is very widespread. This pathology is noted in almost fifty percent of patients who consulted a cardiologist. In some of them, the disease is benign and does not carry any threat to life in itself. However, there are patients who have a malignant form of VES, which requires a certain course of therapy.

The main function performed by the Laun classification is to separate the malignant pathology from benign pathology. In this case, five classes of the disease are distinguished:

1. Monomorphic ventricular extrasystole, whose frequency is less than 30 per hour.
2. Monomorfic VES with a frequency of more than 30 per hour.
3. Polytopic.
4. In the fourth grade there are two subsections (paired VES and ventricular tachycardia with three or more VES consecutively).
5. Extrasystolia when the tooth R is on the first 4/5 teeth of T.

This classification is used in cardiology and cardiosurgery. For many years, it has been used by doctors of other specialties. It appeared in 1971, it became a reliable support for specialists in arranging arrhythmia, classification and treatment of this pathology.