关于心律失常你需要知道的

• 正常情况下，特殊的心脏细胞会产生电信号 travels through the heart. 电流引起心肌 收缩，这就是心跳.

• 心律失常是指心脏没有以正常的节奏跳动. 这可能会引起从轻微症状到心脏的任何症状 arrest and death.

• 由于不同的节律障碍需要不同的治疗方法， 准确诊断心律失常的类型很重要.

• 先进的治疗方法包括药物治疗，破坏细胞 产生不寻常的信号并将设备插入体内 generate proper heart rhythms.

我应该什么时候叫救护车?

• 如果有人感到严重的胸痛, shortness of breath, 心悸时间延长或心跳加速

• 如果有人失去知觉. You may need to perform cardiopulmonary resuscitation (CPR) if the heartbeat or breathing has stopped, 使用自动体外除颤器(AED)

What is an arrhythmia?

An arrhythmia is an abnormality in the timing or pattern of the heartbeat. When you have an arrhythmia, 你的心跳可能太快或太慢, or you may experience an irregular rhythm in which your heart feels as if it is "skipping a beat."

有些类型的心律失常可能不严重. 其他类型的可能会引起很大的关注，因为它们会导致昏厥, 心脏衰竭甚至猝死. 如果你认为自己有心律失常，请咨询医生.

正常的心律是如何工作的?

心脏由四腔肌组成，负责泵血, 它携带氧气和营养物质, throughout the body. 心脏上部的两个腔室，左心室和右心室 atria (心房的复数)，接收和收集血液. 下心室，左右心室 ventricles，将血液泵送到身体的其他部位.

• The right atrium receives oxygen-depleted blood from the body and pushes it to the right ventricle. The right ventricle pumps blood through the pulmonary artery to the lungs, where it picks up oxygen.

• In the same beat, the left atrium receives oxygen-rich blood from the lungs and pushes it to the left ventricle. The left ventricle pumps it through a large artery, called the aorta, to the rest of the body.

心脏节律取决于电

心脏利用肌肉收缩将血液输送到全身. 一阵小电流会使肌肉收缩.

In normal heart function, an electrical impulse starts in the upper right chamber of the heart in the sinus node (窦房结)，通常被认为是心脏的天然起搏器. The sinus node is a group of specialized cells capable of generating a momentary electrical current. 电流通过心房(上腔)扩散。, causing them to contract and squeeze blood into the ventricles (lower chambers).

然后电信号传递到房室结, 心房的位于心房和心室之间的. 房室结会将信号延迟几分之一秒. 这种延迟使心室有时间完全充满血液.

一旦心室充盈, 电脉冲在His束中迅速传播, 特殊纤维网由特殊纤维组成的网络. 他的枝子分成左右两个枝子, which conduct the electrical impulse into the right and left ventricles. With that burst of electricity, the ventricles contract and pump blood out to the body.

Normally, the heart’s electrical system triggers the resting heart to beat in this precise sequence 60 to 100 times each minute. 这就是正常的窦性心律. With exercise, the heart rate will increase to above 100 times per minute. A person’s peak heart rate can be calculated by subtracting their age from 220. 例如，一个40岁的人的心率峰值为220−40 = 180.

心律失常有哪些症状?

心律失常可引起各种各样的症状，例如:

• Palpitations: a racing, skipping or fluttering sensation in your chest

• Dizziness or light-headedness

• Fainting

• Low blood pressure

• Chest pain

• Shortness of breath

• Fatigue

• Heart failure: heart can’t pump enough oxygenated blood through the body

• 心脏骤停:心脏停止跳动

• 喂养困难(婴儿)

Sometimes arrhythmias are silent, meaning they cause no obvious symptoms. A doctor can detect an irregular heartbeat during a physical exam by taking your pulse, 倾听你的心脏或进行诊断测试.

心律失常有哪些不同类型?

• Palpitations:心律失常的心跳. Occurs when the electrical signal does not originate from the sinus node

• Supraventricular tachycardia 心房(心脏的上腔)的快速心跳. 室上性心动过速有几种类型:

  • Atrial fibrillation:无效的心房收缩引起的迅速, 心脏上半部分多个部位的不规则信号

  • Atrial tachycardia: rapid beating of the atria, 比心室快得多, 由于心脏上半部分的“短路”

  • Atrial flutter: extremely rapid beating of the atria (between 240 and 340 times per minute) 由于心脏上半部分的“短路”

  • 阵发性室上性心动过速 (PSVT): rapid heartbeat caused by a "short circuit" resulting from an extra electrical pathway in the heart

• Ventricular tachycardia心室迅速而无效的收缩

• Bradycardia: slow heartbeat due to a failing sinus node or a blockage in the electrical circuit

What causes arrhythmia?

心律失常有许多不同的原因. Here are some examples:

• 心脏电系统的先天性异常: For example, some patients are born with an abnormal muscle fiber connecting the upper and lower chambers of the heart. 这种额外纤维的存在会导致 阵发性室上性心动过速 (PSVT) later in life.

• Inherited heart disease that causes abnormalities over time, setting the stage for an arrhythmia. One example is 心律失常性右心室发育不良 (ARVD): Patients with this inherited condition are born with normal hearts. But over time the heart muscle is replaced by fat and scar tissue, which can cause arrhythmias.

• Acquired conditions: A heart attack例如，它会导致部分心肌变成疤痕. Scar tissue may be the site of a "short circuit" and set the stage for ventricular tachycardia.

• Changes over time: The heart may change as years pass, eventually developing an arrhythmia. The best example is atrial fibrillation这种情况在50岁之前很少见，但在50岁之后就会急剧增加. 到80岁时，十分之一的人患有房颤. 

How are arrhythmias diagnosed?

Some diagnostic tests take place on site in a doctor’s office or hospital. Other tests provide monitoring at home as you follow your daily routine. 单击每种方法了解更多信息.

On-Site Diagnostic Tests

• Electrocardiogram (ECG or EKG): wires taped to various parts of your body to create a graph of your heart’s electrical rhythm

• Exercise stress test:剧烈运动时记录的心电图

• Echocardiogramor 技术超声心动图: ultrasound of the heart

• Magnetic resonance imaging (MRI): imaging of the heart that does not involve radiation and can diagnose certain rare heart conditions

• Computed tomography (CT): high-resolution X-rays; can be performed extremely quickly (ultrafast CT scans), 哪些会导致极低的辐射暴露

• Tilt table test: measurement of heart rate and blood pressure in response to upright tilt, which simulates prolonged standing; used to diagnose syncope (fainting)

• Electrophysiology study (EP): test that examines the heart’s electrical activity from the inside; used to diagnose many heart rhythm disorders and performed prior to catheter ablation

In-Home Diagnostic Monitors

• Holter monitor: a portable ECG you wear continuously from one to seven days to record your heart rhythms over time

• Event monitor佩戴一到两个月的便携式心电图仪, which records only when triggered by an abnormal heart rhythm or when you manually activate it

• Implantable monitor一个电池寿命可达几年的微型事件监视器, 插入你的皮肤下，记录非常偶然的事件

How are arrhythmias treated?

治疗决定是基于对你病情的全面分析, medical history, lifestyle and other factors. 点击每个治疗了解更多.

• Procedures

  • Catheter ablation: procedure to cauterize the specific heart cells that cause abnormal heart rhythms

  • Cardioversion: procedure delivering a precisely controlled shock to your heart to “reset” an atrial fibrillation or atrial flutter; performed under anesthesia

• Medications

  • Your doctor may recommend medications based on your type of arrhythmia, 病史和目前的药物和医疗状况

• Implanted devices

  • Pacemakers:插入锁骨下的皮肤下, 心脏起搏器通过薄板传送常规电脉冲, 高度耐用的电线连接在心脏上. Pacemakers are used to treat bradycardia, heart block and some types of heart failure

  • 植入式转复除颤器 (ICDs): a small implanted device that delivers an electrical pulse to the heart to reset a dangerously irregular heartbeat. 常用于治疗室性心动过速或心力衰竭

  • 心脏再同步化治疗 (CRT): a pacemaker or ICD used to treat certain types of heart failure that are caused by dyssynchronous contractions (when the chambers of heart beat out of time with each other)

• Lifestyle changes

  • Controlling hypertension

  • Losing weight

  • Limiting alcohol

  • Treating sleep apnea