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Cardiac arrhythmias

Factors of rhythm disturbance:

1. Functional dirorders of nervous system;

2. Neuroreflex influence on cardiovascular system in diseases of GIT, urinary system, ENT-organs, spinal column and others;

3. Neurocirculatory dystonia;

4. Diseases of central and vegetative nervous systems;

5. Myocardial ischemia;

6. Inflammatory injuries of the myocardum of different genesis;

7. Cardiomyopathies;

8. Myocardiodystrophies of different genesis;

9. Electrolyte balance disorders;

10. Hypoxia and hypoxemia of different origin;

11. Effect of toxic substances on the heart;

12. Intoxication caused by medicinal agents, side effects of drugs. Often the causes of arrhythmias are combined.

Primary diagnosis of arrhythmias is carried out by ECG findings. They allow to find out a disturbance of nomotopic rhythm — of sinus node, different kinds of conduction, to diagnose heterotopic foci of excitation (irregular foci) — active and passive heterotopias.

For the diagnosis of arrhythmias on the ECG it is necessary to determine:

— Regularity and sequence of waves and intervals;

— Regularity and stability of the form, size of waves and intervals.

Arrhythmias are differentiated depending on the changes of automatism, excitation and conduction. Until now a unified classification of arrhythmias does not exist, one of the latest is recommended by the united plenum of cardiologists and cardio-surgeons in 1999. However, it seems to us that the below-given classification is more convenient to be used in anesthesiologic practice.

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