The prognosis of sinus bradycardia is usually good, but if it is intense, particularly in the elderly, it is necessary to assume sick sinus syndrome (SSS). Pacemaker implantation reduces the incidence of recurrent symptoms, but does not increase life expectancy. Sinus arrhythmia in children, although significant, are not associated with poor prognosis. About 20% of cases of sudden death in an outpatient setting as a result of hypoactivity nastupayug rhythm, usually caused by a decrease in sinus automaticity or the blockade of the SA and AV block do not.
In this case, the blockade occurs in the region located between the sinus node and atria, and AV relationship remains unchanged (R-QRS).
If there is a blockade of the I level, it can not be detected by conventional ECG.
If there is a degree of block II, a fixed 2: 1 type, the frequency of ventricular contractions in 2 times less than the frequency of sinus rhythm, and if it does not register on the ECG, it can exist in the form of bradycardia caused by depression, the SA node. During exercise, or it increases slightly (if previously it was 80/2 = 40 in 1 min, and then it increases to 100/2 = 50 to 1 min), or, if the blockade of 2: 1 disappears, the heart rate immediately increases by more than 2 times (for example, 80/2 = 40 min in 1 - to 100/1 in 1 minute - after). Intermittent blockade of 2:1 creates a pause in 2 times the basic rhythm.
Sinoatrial Wenckebach type of block can also be observed, and if it is a blockade of the type 3:2, it is paired complexes that are difficult to distinguish from atrial arrhythmia with bigeminy arising near the sinus node with the P wave ', is almost equal to the sinus P wave when atrial bigeminy R-R interval of basic rhythm is approximately equal to the long interval of R-R coaxial rhythm, and when sinoatrialioy blockade of type 3-2 R-R interval of basic rhythm is approximately equal to the short interval of R-R coupled rhythm.
In this case, the blockade occurs in the region located between the sinus node and atria, and AV relationship remains unchanged (R-QRS).
If there is a blockade of the I level, it can not be detected by conventional ECG.
If there is a degree of block II, a fixed 2: 1 type, the frequency of ventricular contractions in 2 times less than the frequency of sinus rhythm, and if it does not register on the ECG, it can exist in the form of bradycardia caused by depression, the SA node. During exercise, or it increases slightly (if previously it was 80/2 = 40 in 1 min, and then it increases to 100/2 = 50 to 1 min), or, if the blockade of 2: 1 disappears, the heart rate immediately increases by more than 2 times (for example, 80/2 = 40 min in 1 - to 100/1 in 1 minute - after). Intermittent blockade of 2:1 creates a pause in 2 times the basic rhythm.
Sinoatrial Wenckebach type of block can also be observed, and if it is a blockade of the type 3:2, it is paired complexes that are difficult to distinguish from atrial arrhythmia with bigeminy arising near the sinus node with the P wave ', is almost equal to the sinus P wave when atrial bigeminy R-R interval of basic rhythm is approximately equal to the long interval of R-R coaxial rhythm, and when sinoatrialioy blockade of type 3-2 R-R interval of basic rhythm is approximately equal to the short interval of R-R coupled rhythm.
 |
| The prognosis for sinus bradycardia. Sinoatrial block |
If there is a sinoatrial block III level, the atrial depolarization is absent, and the electrical state of fibrillation depends on the pop-up rhythms.
Sinoatrial (upper atrial) blockade without blockade intrasite arises where there is intranodalnaya conductivity of the conductive system, but the sinoatrial conduction in atrial myocardium is slowed down. QRS complex occurs at a time that is normal, but the P wave is delayed and usually leads to a short interval of R-R. It's interesting, because in some cases short interval P-R does not occur as a result of excitation of the ventricles, and the blockade of the SA. This disorder, which can be intermittent, voznikaeg very rare. He was seen in some versions of myocardial infarction, and valvular lesions with significant fibrillation.
When hyperkalemia sinoatrial transfer to the ventricles may be normal with delayed ventricular activation (short-range P-R) or even with the P wave, QRS complex, or a hidden log after it (sinoventrikulyarnaya conductivity). This phenomenon explains one of the causes of sinus rhythm in the absence of P wave (the other reason is the fibrosis of the atrium, which prevents the registration of P wave on surface ECG, although it exists).
The prognosis of CA blockade worse than sinus bradycardia due to decreased automaticity, usually not occurring or arising as a side effect of a drug. It is part of the sinus node syndrome, and often require pacemaker implantation.
Sinoatrial (upper atrial) blockade without blockade intrasite arises where there is intranodalnaya conductivity of the conductive system, but the sinoatrial conduction in atrial myocardium is slowed down. QRS complex occurs at a time that is normal, but the P wave is delayed and usually leads to a short interval of R-R. It's interesting, because in some cases short interval P-R does not occur as a result of excitation of the ventricles, and the blockade of the SA. This disorder, which can be intermittent, voznikaeg very rare. He was seen in some versions of myocardial infarction, and valvular lesions with significant fibrillation.
When hyperkalemia sinoatrial transfer to the ventricles may be normal with delayed ventricular activation (short-range P-R) or even with the P wave, QRS complex, or a hidden log after it (sinoventrikulyarnaya conductivity). This phenomenon explains one of the causes of sinus rhythm in the absence of P wave (the other reason is the fibrosis of the atrium, which prevents the registration of P wave on surface ECG, although it exists).
The prognosis of CA blockade worse than sinus bradycardia due to decreased automaticity, usually not occurring or arising as a side effect of a drug. It is part of the sinus node syndrome, and often require pacemaker implantation.
.png "English"){kind=small}
0 comments:
Post a Comment