心房 纤维性颤动

迹象 & 症状

An abnormal heart rhythm is a change in either the speed or the pattern of the heartbeat — the heart may beat too slowly, 太快或不规律的. When the heart beats too slowly, too little blood is pumped out to the rest of the body. 当心跳太快的时候, it cannot fill completely so the body doesn't receive the blood volume it needs to function properly. 慢心率被称为心动过缓. 心率过快被称为心动过速.

心脏由四个腔室组成. 上面的腔室，称为心房，接收和收集血液. 下腔称为心室，将血液输送到全身. Working together, the chambers of the heart move life-sustaining blood throughout the body.

心律异常有几种类型, 有些发生在其中一个心房，称为心房, 另一些发生在心室，被称为心室.

房颤可引起以下症状:

• 胸压或疼痛
• 昏厥，也被称为晕厥或近晕厥
• 乏力
• 头晕或晕眩
• 心悸，可能是跳跃、飘动或胸部砰砰作响
• 呼吸急促（气促）

诊断

如果你的十大赌博平台排行榜怀疑你可能有心律失常, he or she will order one or more of the following diagnostic tests to determine the source of your 症状.

• 心电图. 心电图(ECG或EKG)记录心脏的电活动. 被称为电极的小贴片被放置在你的胸部, 胳膊和腿, 并通过导线连接到心电图机. Your heart's electrical impulses are translated into a wavy line on a strip of moving paper, enabling doctors to determine the pattern of electrical current flow in the heart and to diagnose arrhythmias and heart damage.
• 动态心电监测. 动态心电图监测仪是一种小型的便携式仪器，可以24小时佩戴. 它可以在您进行日常活动时连续记录您的心电图. 你将被要求记录你的活动和症状. This monitor may detect arrhythmias that might not show up on a resting EKG that only records for a few seconds.
• 运动压力测试. The exercise stress (treadmill) test enables physicians to record your heart's electrical activity which may not occur at rest.
• 事件记录器. An event recorder (loop recorder) is a small portable transtelephonic monitor that may be worn for several weeks. 这种类型的录音机适合那些不经常出现症状的病人. The monitor "loops" a two-minute recording into its memory that is continually overwritten. 当你出现症状时, you press a "record" button on the monitor which stores a correlating strip of EKG material. The recordings are telephoned to a 24-hour monitoring station and faxed directly to the requesting physician.
• 磁源成像. 磁源成像 (MSI) is used as an overlay to magnetic resonance imaging (MRI). The device senses weak magnetic fields generated by heart muscle tissue and localizes the arrhythmia non-invasively to save time during the invasive study.
• 倾斜台试验. 倾斜台试验ing is used to diagnose fainting or black-out spells (vasovagal syncope) by trying to reproduce the black-out episodes. You will be tilted upright to about 60 degrees on a special table for a period of time with continuous recording of your ECG and blood pressure.
• 电生理(EP)研究. 脑电图研究可以让十大赌博平台排行榜获得更准确的信息, 详细资料及, 在很多情况下, 提供治疗(i).e. 导管消融).

治疗

这取决于你心律失常的类型和严重程度, 以及各种测试的结果，包括电生理研究, 有几种治疗方案. 你和你的十大赌博平台排行榜会决定哪一个是适合你的.

药物

Certain anti-arrhythmic drugs change the electrical signals in the heart and help prevent abnormal sites from starting irregular or rapid heart rhythms.

随访电生理研究

To make sure the medication is working properly after two or more days in the hospital, 你可能会被带回实验室进行后续研究. 我们的目标是找到对你最有效的药物.

植入式装置(起搏器)

All implantable devices or pacemakers work on "demand" and are used to treat slow heart rhythms. They are small devices that are implanted beneath the skin below the collarbone and connected to a pace wire(s) positioned inside the heart via a vein; this delivers a small electrical impulse to stimulate the heart to beat when it is going too slow.

导管消融

这是加州大学旧金山分校首创的技术, radiofrequency catheter ablation destroys or disrupts parts of the electrical pathways causing the arrhythmias, 为可能对药物反应不佳的患者提供缓解, 或者不愿意或不能服药的人.

导管消融 involves threading a tiny metal-tipped wire catheter through a vein or artery in the leg and into the heart. 透视, which allows cardiologists to view on a monitor the catheter moving through the vessel, 提供路线图. 其他导管, 通常从颈部插入, 包含电子传感器，以帮助找到导致短路的区域. The metal-tipped catheter is then maneuvered to each problem site and radiofrequency waves — the same energy used for radio and television transmission -- gently burn away each unwanted strand of tissue. 当第一次尝试导管消融时, 采用直流冲击, but researchers later developed the use of radiofrequency waves — a more precise form of energy. 使用射频导管消融, 病人通常在一天内出院, 与心脏直视手术相比, 需要一个星期的住院治疗和几个月的康复.

比如沃尔夫-帕金森-怀特综合症, in which a hair-thin strand of tissue creates an extra electrical pathway between the upper and lower chambers of the heart, 射频消融提供了一种治疗方法. It has become the treatment of choice for patients with that disorder who don't respond well to drug therapy or who have a propensity for rapid heart rates.

即使是可以用药物控制的心律失常, the procedure has been shown to be cost effective because it eliminates medication failures that require hospitalization. It also is an attractive option for elderly patients who are prone to suffer side effects from drug therapy and women of childbearing age who can't take medications because of potential health risk to the fetus.

While studies have shown that catheter ablation is more cost effective than drug therapy or 手术, patients who undergo the procedure also experience remarkable improvement in quality of life. A recent study of nearly 400 ablation patients with dangerously rapid heart rates — nearly a third of whom were considered candidates for open heart 手术 — found that one month after the procedure 98 percent required no medication and 95 percent reported that their overall health had markedly improved. 加州大学旧金山分校的研究还发现，患者的工作能力有所改善, 锻炼身体，参加体育活动.

内部复律法

内部复律法 for conversion of atrial fibrillation and atrial flutter to a normal sinus rhythm was developed here at UCSF Medical Center in 1991. 内部复律法 is low energy electrical shock (1 to 10 joules) delivered internally in the heart through two catheters inserted in a vein in the groin and a small electrode pad applied to the chest. 这个过程由我们的电生理学家在电生理学实验室进行.

During the internal cardioversion, short-acting sedatives are given to make the patient sleepy. 目前, atrial flutter is successfully "cured" by radiofrequency catheter ablation; but treatment to restore atrial fibrillation to sinus rhythm has been the traditional use of medications and external cardioversion. External cardioversion is delivery of high energy shocks of 50 to 300 joules through two defibrillator pads attached to the chest. 在某些情况下, external cardioversion has failed because the electrical current has to first travel through chest muscle and skeletal structures before reaching the heart. 内部复律法 has been performed when medications and external cardioversion have failed to restore a patient's rhythm back to a normal sinus rhythm.

UCSF's success rate of converting a patient from atrial fibrillation to normal sinus rhythm with internal cardioversion has been 95 percent. 患者心房颤动的时间越短, 就越容易恢复到正常的心律, but even patients with long-standing chronic atrial fibrillation can be converted successfully to a normal rhythm through internal cardioversion. 加上内部心脏复律, our electrophysiology team was successful in converting a patient who had been in chronic atrial fibrillation for eight years.

植入式转复除颤器

An implantable cardioverter defibrillator is a device for people who are prone to life-threatening rapid heart rhythms. It is slightly larger than a pacemaker and usually is implanted beneath the skin below the collarbone. It is connected to a defibrillation/pace wire(s) positioned inside the heart via a vein. It has the capability of delivering an electric shock to the heart when it determines the heart rate is too fast. 当心脏跳动过慢时，它也能调节或刺激心脏.

摘要起搏器

美国.S. Food and Drug Administration (FDA) recently approved the first of a new type of pacemaker that paces both ventricles of the heart to coordinate their contractions and improve their pumping ability. According to the test results presented to the FDA, cardiac resynchronization therapy (CRT):

• Increases the amount of daily activities patient can perform without the 症状 of heart failure
• Extends the exercise capacity of heart failure patients as measured by the distance they can walk in 6 minutes
• 根据标准测量，提高整体生活质量
• 促进心脏解剖结构的改变，改善心脏功能
• Reduces the number of days patients spend in the hospital and the total number of hospitalizations

CRT装置通过同时对左、右心室起搏来工作, which results in resynchronizing the muscle contractions and improving the efficiency of the weakened heart. 在正常的心脏里, the electrical conduction system delivers electrical impulses to the left ventricle in a highly organized pattern of contractions that pump blood out of the ventricle very efficiently. 心脏增大引起的收缩期心力衰竭(扩张型心肌病), 失去了这种电协调. Uncoordinated heart muscle function leads to inefficient ejection of blood from the ventricles.