Paroxysmal ventricular tachycardia and its treatment
Symptoms of the disease
Duration from 10 seconds to 48 hours; heart rate of the ventricular form – 140-220 pulses per minute are the main signs of a paroxysm of ventricular tachycardia.
The main symptoms of the disease:
- Sudden onset of attack
- Pulsation of the cervical vessels
- The presence of heart failure
- The increase in swelling
- Lowering blood pressure
- The manifestation of a certain picture of the disease on the ECG.
Than removed the paroxysm
Use of emergency electrical cardioversion. When hemodynamic disorders lead to emergency electrical cardioversion using a discharge in 100Дж. The ineffectiveness of this category, its increase to 200 j., in extreme cases, in the absence of the heartbeat and pressure, use 360 joules.
Conducting chest compressions. Held at impossibility of use of the defibrillator.
Adrenaline. At relapse, attack, defibrillation is repeated with the simultaneous jetting intravenous or intracardiac administration of epinephrine with a saline solution.
Introduction of antiarrhythmic drugs: lidocaine, ornida (bretilia of the tosylate or amiodarone.
“Vagal samples”. Non-drug method of relief of the attack. Applied in the absence of clinical manifestations of paroxysmal ventricular tachycardia.
Methods of treatment of tachycardia
The choice of treatment is directly depending on with or without the patient's heart failure.
Supporting antiarrhythmic therapy. Treatment with amiodarone or sotalol.
Drug therapy is used when normal blood pressure. Assigned application:
- With lidocaine
- Of procainamide
- Magnesium sulfate
- Bretilia of tosylate
The use of radiofrequency ablation.
The use of aneurysmectomy.
A heart transplant.
The installation of a cardioverter-defibrillator. Is one of the most effective methods. Indications for implantation of cardioverter-defibrillator:
- The occurrence of clinical death
- The presence of stable spontaneous paroxysms
- The inefficiency and impossibility to use antiarrhythmic drugs if Sinope with unclear Genesis
- The inefficiency of cupping with novokainamida in unstable form, zht, postinfarction cardiosclerosis and dysfunction of the left ventricle
- In the primary prevention of patients with myocardial infarction (left ventricular ejection 30-40% function)
- In the primary prevention ofpatients diagnosed with idiopathic congestive cardiomyopathy
- In secondary prevention, before a change of heart
- In secondary prevention in patients diagnosed with dilated cardiomyopathy with features of left ventricular ejection less than 30%) and persistent ventricular tachycardia or ventricular fibrillation.
Paroxysm of ventricular tachycardia is a dangerous disease that can lead to heart failure and death. Therefore, her treatment is urgent. Timely diagnosis and prompt assistance can save the patient's life and give hope for recovery.