- Treatment paroxysmal atrial fibrillation
- Treatment of permanent atrial fibrillation
- Treatment of patients with concomitant diseases
- Medication to thin the blood
Atrial fibrillation of the heart, depending on the causes and symptoms require different treatment. Usually at first use of drug therapy and only in case of its ineffectiveness transferred to other methods of impact on the heart.
Effective antiarrhythmic drugs in atrial fibrillation propafenone, sotalol, dronedarone, procainamide, ibutilide and others. The effectiveness of treatment with these drugs for each patient individually.
Treatment paroxysmal atrial fibrillation
How do we treat atrial fibrillation depends on its shape. In most cases, mild asthma is carried out using intravenous drugs, and later atrial fibrillation of the heart during treatment is kept under control pills.
In the treatment of paroxysmal atrial fibrillation effective drugs procainamide, quinidine, aymalin and beta-blockers.
Pronounced antiarrhythmic effect quinidine. Its action is associated with a decrease in the excitability of atrial muscle is by lengthening the refractory period and slow down the passage of impulses through the bundle branch block. It is administered intravenously, gradually increasing the dose, for 5-7 days. After the relief of the paroxysm the patient should continue to take maintenance doses of the medication under medical supervision.
Usually first assigned trial dose of a drug because in some patients, it provokes an allergic reaction (fever, skin rash, thrombocytopenia). Sometimes there is a sharp reaction in the form hinidinovogo shock, resulting in possible reduction of blood pressure, loss of consciousness, death. When using this medication in atrial fibrillation the heart, the physician monitors the heart rate and blood pressure, watching the atrioventricular permeability. Quinidine is not prescribed to patients with serious lesions of the heart muscle.
A good effect is the introduction of beta-adrenoblokatorov (it may be isoptin or obsidan), sometimes it helps ajmaline. If paroxysmal atrial fibrillation treatment medication can not be, the next step will be the application of the countershock.
Treatment of permanent atrial fibrillation
In the treatment of permanent atrial fibrillation the task of the doctor is to restore normal heart rhythm, or transfer tahisistolicescie forms of the disease in it’s bradycardic with the elimination of the deficit of the pulse and circulatory failure, if any.
To restore a normal rhythm can be used quinidine. Beta-blockers, potassium salts and other anti-arrhythmic drugs at a constant atrial fibrillation heart used to maintain the restored rhythm.
Many drugs for the treatment of atrial fibrillation of the heart have the potential proaritmicski action, that is able by themselves to provoke various disorders of heart rhythm.
Treatment of patients with concomitant diseases
In people with congestive heart failure have a tendency to develop ventricular arrhythmias due to antiarrhythmic therapy. This phenomenon is due to myocardial dysfunction and electrolyte disturbances. For such patients, according to studies, safe amiodarone and dofetilide.
In ischemic heart disease sotalol effective drug with pronounced beta-blocking properties. Compared to amiodarone, it has fewer long-term side effects. Use flecainide and propafenon not recommended.
In the presence of left ventricular hypertrophy high risk of tachycardia type pirouette. This phenomenon is associated with early ventricular postdepositional. In such a situation, the optimal use of a drug which lengthens the QT interval. In the absence of coronary heart disease fit propafenon and flecainide.
If the patient has atrial fibrillation combined with the syndrome of predposlednij ventricles, it is recommended to avoid digoxin (due to the high risk of paradoxical acceleration of the ventricular rhythm). Beta-blockers are not able to reduce the holding of additional conductive ways and can cause hypotension in patients with unstable hemodynamics. Sufficiently effective drug cordarone not suitable for patients with increased susceptibility to iodine, thyroid disease, atrioventricular block, electrolyte disorders.
Medication to thin the blood
The lack of full atrial provokes circulatory disorders. The result can form clots that can clog blood vessels of the heart, spleen, kidney, limbs. To avoid these serious consequences and permanent atrial fibrillation should consider taking medication to thin the blood.
There are several groups of drugs that prevent the formation of blood clots. In permanent atrial fibrillation of the heart is often used pills warfarin. The basis of action of the drug influence on the cascade of blood clots. It reduces the risk of thrombosis, helps to ensure that existing thrombotic mass resolve. Warfarin must be taken under medical supervision, as it can provoke nasal or gastrointestinal bleeding.
It is not recommended to start taking anti-arrhythmic drugs. The attending physician, after examining the symptoms and diagnosed atrial fibrillation, will select the best method of treatment with medicines. In addition, drug therapy should be supplemented with the exception of those factors that could provoke an attack. Quitting Smoking, alcohol and excessive exercise combined with careful compliance with doctor’s recommendations will help the patient to continue to live a full life.