心房 心动过速

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.

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, 使十大赌博平台排行榜能够确定心脏中电流流动的模式，并诊断心律失常和心脏损伤.
• 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. 运动压力(跑步机)测试使十大赌博平台排行榜能够记录您在休息时可能不会发生的心脏电活动.
• 事件记录器. An event recorder (loop recorder) is a small portable transtelephonic monitor that may be worn for several weeks. This type of recorder is good for patients who don't experience 症状 very often. 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. Magnetic source imaging (MSI) is used as an overlay to magnetic resonance imaging (MRI). 该装置可以感知由心肌组织产生的弱磁场，并在无创的情况下定位心律失常，从而节省有创研究的时间.
• 倾斜台试验. 倾斜试验是用来诊断晕厥或昏迷(血管迷走神经性晕厥)，试图重现昏迷发作. 您将在一张特殊的桌子上直立倾斜约60度一段时间，并连续记录您的心电图和血压.
• 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

某些抗心律失常药物可以改变心脏中的电信号，帮助防止异常部位引发不规则或快速的心律.

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.

导管消融包括将一根微小的金属头导线导管穿过腿部的静脉或动脉进入心脏. 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. 然后将金属头的导管移动到每个问题部位，射频波——与用于广播和电视传输的能量相同——轻轻地烧掉每条不需要的组织链. 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, 一根发丝般细的组织在上下心室之间创造了一条额外的电通路, 射频消融提供了一种治疗方法. 它已经成为对药物治疗反应不佳或有心率加快倾向的患者的首选治疗方法.

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. 对于容易遭受药物治疗副作用的老年患者和由于潜在的胎儿健康风险而不能服用药物的育龄妇女来说，这也是一个有吸引力的选择.

While studies have shown that catheter ablation is more cost effective than drug therapy or surgery, patients who undergo the procedure also experience remarkable improvement in quality of life. 最近的一项研究对近400名心率异常快的消融患者进行了研究，其中近三分之一的患者被认为是心脏直视手术的候选者。研究发现，手术一个月后，98%的患者不需要药物治疗，95%的患者报告说他们的整体健康状况有了明显改善. 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

1991年，加州大学旧金山分校医学中心开发了将心房颤动和心房扑动转化为正常窦性心律的内部转复术. 内部心律复律是一种低能量的电击(1到10焦耳)，通过插入腹股沟静脉的两根导管和胸部的一个小电极垫在心脏内部传递. This procedure is performed in the electrophysiology lab by our electrophysiologist.

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. 体外心脏复律是通过连接在胸部的两个除颤器垫输送50到300焦耳的高能量冲击. 在某些情况下, 体外心脏复律失败是因为电流在到达心脏之前必须先通过胸部肌肉和骨骼结构. 当药物和体外心律转复不能使患者的心律恢复到正常的窦性心律时，就进行内心律转复.

加州大学旧金山分校将患者从心房颤动转化为正常窦性心律并进行内部心律转复的成功率为95%. 患者心房颤动的时间越短, 就越容易恢复到正常的心律, 但即使是长期慢性心房颤动的患者也可以通过内部心律转复成功地转化为正常的心律. 加上内部心脏复律, 我们的电生理小组成功地转化了一个患有慢性心房颤动八年的病人.

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. 美国食品和药物管理局(FDA)最近批准了第一种新型心脏起搏器，这种起搏器可以调节心脏的两个心室的速度，以协调它们的收缩，提高它们的泵送能力. 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, 电传导系统以高度有序的收缩方式向左心室传递电脉冲，从而非常有效地将血液泵出心室. 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.