In addition, intravenous disodium salt of ethylenediaminetetraacetic acid (Na 2EDTA; Trilon B), which binds Ca2 + ions. microcircuit this case, to recover sinus rhythm ventricular (cardioversion) used a defibrillator to allow feeding at the heart of a very short pulses (a few milliseconds) with a high voltage (several thousand volts). Distinguish between permanent and paroxysmal (Paroxysmal) atrial fibrillation. Acting on cardiac myocytes, quinidine blocks sodium channels and therefore slows down the process of depolarization. With the participation of cAMP activated protein kinase and phosphorylation is Ca2 + channels in membrane of cardiomyocytes. On sinoatrial node cells of quinidine has a weak inhibitory effect, since the microcircuit potential in these cells is significantly lower than in Purkinje fibers (Table and depolarization processes are mainly connected with the entrance of Ca2 Too numerous to count 3. Drug is prescribed inside, and in extreme cases is administered intravenously here intramuscularly, mainly in the ventricular, at least - with supraventricular tachyarrhythmias (for termination of atrial flutter or atrial fibrillation) and arrhythmia microcircuit . Increase microcircuit can be useful when tachyarrhythmias associated with the circulation of excitation in closed circuits of cardiomyocytes (eg, for atrial fibrillation), with an increase in ERP circulation of excitation is terminated. Adrenoceptor agonists. Main differences between the subgroups are listed in Table. At the same time eliminates the inhibitory effect of quinidine on atrioventricular vagal conductivity. Atrial fibrillation (atrial fibrillation) - random asynchronous reduction of individual bundles of muscle fibers of the heart with a frequency of 450-600 per minute. Quinidine slows phase 0 and 4 of the action potential and thus reduces the conductivity, and automaticity fibers of the atrioventricular node. Due to the increase in the duration of the action potential and decrease the excitability increases the effective refractory period (ERP - the period between the two nonexcitability propagating pulses). In connection with the slowing of phase 3 quinidine increases the duration of the action potential of Purkinje fibers. Paroxysmal tachycardia may be ventricular (ventricular) and supraventricular (supraventricular). flutter - frequent (240-340 per minute) and relatively synchronous contraction. Due to the rapid slowing of depolarization of quinidine reduces excitability and conductivity, and because of slowing of the spontaneous slow depolarization reduces the automaticity of the Purkinje fibers. Stop Atrial fibrillation (to make the conversion of atrial fibrillation to sinus rhythm) by using here defibrillator or use of antiarrhythmic funds - quinidine, procainamide, amiodarone. At the same time here the inhibitory effect of quinidine vagus nerve on the sinoatrial node (vagolytic action) and therefore may cause slight tachycardia. Receipt of Ca2 + in cardiomyocytes leads to their reduction. Quinidine enhances peripheral blood vessels (aadrenoblokiruyuschee action). Quinidine reduces excitability and increases ERP working myocardium fibers, which also prevents the pathologic circulating pulses. Stimulating 1 adrenergic receptors, dopamine increases cardiac output, by acting on dopamine D1retseptor here peripheral vessels, in particular, the vessels of the kidneys. Most often, common atrioventricular (predserdnozheludochcsy) block, at least - sinoatrial block, bundle branch block legs, etc. Arrythmia - the appearance of extrasystoles, ie additional (early) contractions of atria or ventricles. In complete atrioventricular block the ventricles begin to contract in their own, very rare rhythm (about 30 per minute) insufficient for normal blood Midline Episiotomy Application antiarrhythmic funds can be divided into: funds used for tachyarrhythmias and microcircuit funds used for bradyarrhythmia and heart block. Panangin, Asparkam (containing potassium aspartate and magnesium aspartate), was appointed interior and intravenously. Dopamine is administered intravenously. In as a cardiotonic agent in acute heart failure is also used dopamine - microcircuit drug dopamine, which In addition to stimulating dopamine receptors has adrenomimeticheskim properties. Associated with circulation of excitation in many closed chains formed by cardiomyocytes. Pronounced cardiotonic action has adrenaline. To do this, prescribers, complicating atrioventricular conduction - Newborn (blockers, verapamil. Ventricular fibrillation is accompanied by severe circulatory disorders and requires immediate therapeutic intervention (use a defibrillator or drugs, terminating atrial flutter).
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