Treatment of paroxysm of atrial fibrillation

The treatment of paroxysm of atrial fibrillation consists of two components:

  • an attack of atrial fibrillation( MA) is arrested;
  • are warned of attacks of MA.

If paroxysms occur sporadically - once a month or several times a year, do not cause serious circulatory disorders and are easy to tolerate, there will be enough restraint with cupping and short treatment procedures that will strengthen the effect.

Treatment of atrial fibrillation

Treatment of atrial fibrillation against relapse is prescribed in these cases:

  • If frequent seizures occur - 3 or more per month, which require intravenous anti-arrhythmia;
  • If there are daily, even self-limiting seizures;
  • If paroxysms of atrial fibrillation occur with severe complications: angina pectoris, collapse, and more.

The process of removal of attacks of atrial fibrillation

To begin with, it is necessary to analyze the clinical situation for determining the urgency of the urgent elimination of the paroxysm of the disease and without certain reasons for this, not to accelerate the restoration of the sinus rhythm urgently and in any ways. Of course, one can not challenge the need for an emergency withdrawal, when it goes along with a terrible hemodynamic disorder: the swelling of the lungs, acute vasoconstriction is a shock in arrhythmia. In this case electropulse therapy is chosen. If it can not be done, use anti-arrhythmia drugs that stop the process.

If it is necessary to urgently relieve an attack of the disease, it is necessary to carry out this sequence in the stages of use of funds against the disease:

  • 1 degree of treatment of the disease or selective drugs - aymalin, novocaineamide;
  • 2 stage of treatment of disease or preparations of a close stock - rhythmelen, verapamil, etatsizin;
  • 3 stage of treatment of disease or long-range reserve preparations - cordarone and its analogues.

If it was not possible to immediately restore the rhythm or clinical picture from the very beginning does not lead to excessive activity, the following methods are best used:

  • urgently slows the pace of heart activity;
  • to perform a stopping therapy according to plan;
  • is a fast process of slowing down the heart contractions with MA.

In order to slow the inhibition of cardiac contractions in this disease, it is necessary to perform:

  • intravenous injection of 2-4 ml of a 0.25% solution of isoptin, not diluted, in 30-40 seconds, with almost instantaneous but brief action;
  • immediately after it, 2-3 ml of 0.025% digoxin or 2-4 ml of 0.02% isanolide are added to the same needle, they have a delayed, but "long-playing" effect.

The next injection in an amount of 1-2 ml is produced 3-4 hours, and after twice a day.
As a result, it is required to obtain a decrease in the heart rate to less than 100 beats per minute, best of all - 70-72 beats / min.

Routine treatment of the disease

It is better to begin the planned treatment of paroxysm of atrial fibrillation with saturation with potassium-magnesium: intravenous administration of panangin with drops or a polarizing mixture with the addition of 5 ml of a 25% solution of magnesium sulfate. At the same time, anti-arrhythmia drugs are used. Variants of therapy against arrhythmia are various.

Every day a drop of cordaron 600-900 mg is introduced, that is, 12-18 ml of 5% solution in 250-500 ml of 5% glucose or a polarizing mixture, pulse control.

Intravenous drip introduction of novocainamide, and then intramuscular injection of 5-10 ml of a solution of 10% or its initial use in the muscle until the end of the attack or a total dose of 40 ml.

Oral antiarrhythmic drugs with high reliability are administered orally:
Quinidine is immediately injected - 0.6-0.8 g, then 0.2 g every 1.5-2 hours until paroxysm is removed or a dose of 1.6-1,8 grams - in total;

Immediately introduces novocainamide - 1-1.5 g and after 0.5 g in 2 or 2.5 hours( maximum per day 4-5 g);

Anaprilin is made - 60-80 mg then 40-60 mg after 4-6 hours with pulse control;

Verapamil is made - 80-120 mg sublingually or internally, followed by 80 mg after 6 hours with pulse control. Further antiarrhythmic agents that have effect, can be prescribed to the patient for self-removal of attacks of atrial fibrillation.