Understanding Cardiac Conduction System and Arrhythmias
Explore the cardiac conduction system and arrhythmias, including types of arrhythmias, their description, causes, and mechanisms of origin. Learn about common arrhythmias, such as bradyarrhythmias, tachyarrhythmias, and extrasystoles, based on heart rate and mechanism of occurrence.
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Presentation Transcript
KAREL NOVOTN P evodn srde n syst m arytmie
Pevodn systm srdce SA uzel internod ln s ov spoje Bachmann, Thorel,Wenckebach S okomorov (AV) junkce AV uzel Hiss v svazek Tawarova ram nka prav lev p edn a zadn fascikulus Purky ova vl kna
Pevodn srden systm ve vztahu systola a diastola
Srden arytmie Srde n arytmie (tak dysrytmie) je porucha srde n ho rytmu. Ve v t in p pad se jedn o posti en p evodn ho syst mu d c srde n innost (jedn se o specializovanou st srde n svaloviny, kter je schopn samostatn tvorby vzruch a jejich veden . Tento syst m je nezbytn pro spr vn stahy, rytmus a frekvence srdce). N kter arytmie jsou pova ov ny za b n , jako nap . respira n sinusov arytmie, kdy se srdce p i n dechu m rn zrychl , kde to p i v dechu m rn zpomal
Popis arytmie V srde n m svalu jsou skupiny bun k, kter maj odli nou lohu oproti v em ostatn m srde n m svalov m bu k m. Vznikaj v nich opakovan vzruchy, kter se na dal bu ky, a se roz po cel m srdci a t m doch z k opakovan m stah m srdce. Tyto bu ky tvo p evodn syst m srde n . Poruchy srde n ho rytmu zp sobuje chybn tvorba vzruch , nebo chyba v jejich en a veden po srde n m svalu (porucha v p evodn m syst mu srde n m, jizvy v srde n m svalu, atd.).
Pehled arytmii A -Dle srde n frekvence 1 Bradyarytmie (pod 60/min): sinusov bradykardie, sy chor ho sinu, sy karotick ho sinu, poruchy A-V veden , 2 tachyarytmie (nad 100/min), supraventrikul rn fibrilace s n , flutter s n , s ov tachykardie, AV junk n tachykardie, AV reentry, ventrikul rn komorov tachykardie monomorfn a polymorfn (torsade de points), fibrilace komor, 3 extrasystoly: p ed asn stahy z lo isek mimo SA uzel s ov , junk n , komorov
Pehled arytmii B- Dle mechanismu vzniku 1 Poruchy vzniku vzruchu: homotopick sinus arrest, sick sinus syndrome, heterotopick extrasystoly, spu t n aktivita (triggered activity) 2 poruchy veden vzruchu: en vzruchu p davn m svazkem (WPW, LGL), blok dy veden vzruchu, SA blok da I. III. st., AV blok da I. III. st., blok dy Tawarov ch ram nek, RBBB, LBBB, LAH, LPH, bifascikul rn blok da (RBBB + LAH nebo LPH), trifascikul rn blok da, reentry (s ov , AV, komorov ), fibrilace (s n , komor), flutter s n , tachykardie
Piny arytmi Nej ast j p inou arytmie je ICHS (isch mie, hypoxie, acid za, reperf zn po kozen ). D le pak: iontov poruchy (hypokal mie, hypomagn zie, hyperkal mie, hyperkalc mie); poruchy acidobazick rovnov hy; poruchy myokardu: dilatace nebo hypertrofie srdce (kardiomyopatie, nap . kardiomyopatie prav komory se p mo ozna uje jako arytmogenn dysplazie prav komory); z n t (myokarditida); vrozen a z skan srde n vady; naru en rovnov hy vegetativn ho nervov ho syst mu (stres, zkost, ok, kompenzace jin ho patologick ho stavu); arytmogenn l tky (drogy, kofein, alkohol, digoxin, diuretika, antiarytmika); jin onemocn n (endokrinopatie); dal .
Obecn projevy arytmi mohou b t troj ho typu: hemodynamick ; elektrick ; subjektivn .
Klinick obraz Mezi klinick p znaky srde n ch arytmi ad me: palpitace, du nost, navu, synkopu, hypotenzi, minutov srde n v dej, stenokardie, ok nebo n hlou srde n smrt.
Terapie prava ivotn ho stylu. Farmakologick l ba (antiarytmika). Vagov man vry (Valsalv v man vr, okulokardi ln reflex, sinokardi ln reflex). Implantace kardiostimul toru (do asn nebo trval kardiostimulace). Implantace implantabiln ho kardioverteru-defibril toru. Elektrick kardioverze (defibrilace). Radiofrekven n kat trov ablace. Chirurgick l ba.
