Encountered arrhythmia in patients with diabetes mellitus
Posted on October 16, 2009
Filed Under Dilated cardiomyopathy | Leave a Comment
Arrhythmia in patients with diabetes, one of the more common complications. When people with diabetes experience cardiac arrhythmia, the how to do? On this issue, the reporter interviewed the famous cardiovascular expert of Cardiology, Beijing An Zhen Hospital, Deputy Director, Professor Ma Changsheng, director of atrial fibrillation.
Classified according to pathogenesis, the most common arrhythmia was premature beat, premature beat, but many people no symptoms, most of them good prognosis, so diabetics do not stress; the second most common is atrial fibrillation, which is a result of arrhythmia in patients with diabetes mellitus to out-patient clinic and hospital up to the start of reasons for that; third of idiopathic ventricular tachycardia, but clinical rare, more common in young people, not very dangerous; the fourth is pathological ventricular tachycardia, diabetic patients with myocardial infarction prone to this disease.
When should you install defibrillator?
If you have diabetes pathological malignant ventricular tachycardia, we often syncope, falls, eye black symptoms, if suffering from coronary heart disease, there had been myocardial infarction, it is even more dangerous. Treatment for these patients often had an onset heart rate reached 150 ~ 200 times per minute, if the blood pressure instability and even a faint, you should use cardiac defibrillators (ICD), since the event of ventricular fibrillation, for some patients would be a fatal blow. ICD is an implantable heart defibrillators, doctors in the patient’s right chest or left chest to make a skin incision, buried inside a cardiac defibrillator, the electrode on the heart, there is the problem will look at electric shock, dangerous situation, ie the can be lifted. This diabetes is a life-saving treatment can extend life span. Diabetic patients with coronary heart disease in particular, the merger likely to be such cases, this time should consult a doctor need to consider whether the heart defibrillator installed.
Treatment of atrial fibrillation in two kinds of programs
Many patients with diabetes complicated with atrial fibrillation. Is divided into paroxysmal atrial fibrillation and persistent, paroxysmal atrial fibrillation in the beginning when the disease may be 1 to 2 years attack once, and then probably every day, hair, or hair several times a week, every few minutes, a few hours or even days, when patients often find it hard to be, irregular heartbeat; and persistent atrial fibrillation can attack every minute, you may jump a month or several years, a dozen years.
Diabetic patients with atrial fibrillation is the biggest trouble of stroke. In addition, the heart is also very easy to form thrombosis, life-threatening, the annual mortality rate is about 5%, if it is for patients over 70 years old, then every year up to 5% ~ 10%. In the treatment, if patients with diabetes have high blood pressure, heart failure or more than 70 years old, provided that they meet any one of the three, it must take warfarin and other anticoagulant drugs to treat and the chances of stroke can be reduced by 50 % ~ 60%, but the need can be long-term use of these drugs have a preventive effect.
In other countries, if the diabetic patients with atrial fibrillation can be taken with warfarin, while the domestic new treatment guidelines is relatively conservative, and would like to add high blood pressure, heart failure, more than 70-year-olds in any one of three conditions. Of course, there are two risk factors for the time must serve warfarin. The role of warfarin to prevent thrombosis good, but easily lead to bleeding, diabetic patients taking warfarin, the greater the risk of bleeding. Relatively speaking, the role of aspirin weaker, but small bleeding side effects. The use of warfarin needed to pay attention, in order to reduce the risk of bleeding and achieve the purpose of prevention of thrombosis must be frequent monitoring of blood coagulation indicators cumbersome. Patients living in large and medium cities to facilitate inspection, you can consider the use of warfarin therapy.
Another alternative is radiofrequency ablation, its assembly power can reach 80% ~ 90%, and the impact is not diabetes. Atrial fibrillation by radiofrequency ablation will be converted to normal rhythm, can reduce the risk of stroke. At present, radiofrequency ablation is as important as the choice of drug therapy.
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