Arrhythmia is a common and frequently-occurring disease in heart diseases, including supraventricular tachycardia such as atrial tachycardia, atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia and atrial flutter, preexcitation syndrome, atrial fibrillation, premature ventricular beats, idiopathic ventricular tachycardia, ventricular tachycardia with organic heart disease, etc.
Because of the different mechanisms of arrhythmia caused by various heart diseases, it is often difficult to treat arrhythmia because of the lack of means and methods in the past. In order to control arrhythmia, patients must be given various antiarrhythmic drugs. Because drug therapy can only control arrhythmia to a certain extent, the treatment of arrhythmia can only be maintained by drugs for a long time. Once the drug fails or stops taking medicine, arrhythmia may happen again. Antiarrhythmic drugs have limited curative effect and many side effects, and there are few drugs that can control arrhythmia for a long time, and the long-term drug use cost is high. Some large clinical trials have also confirmed that some patients with organic heart disease use antiarrhythmic drugs for a long time. Although patients' arrhythmia can be controlled to varying degrees, its side effects and mortality will also increase.
At present, cardiac catheter ablation has developed into a very mature treatment for tachyarrhythmia. For common paroxysmal supraventricular tachycardia, typical atrial flutter, idiopathic ventricular premature beats and ventricular tachycardia, the success rate is above 90%. Cardiac catheter ablation therapy is to introduce RF current into the heart through the cardiac catheter, locate it in the key part of arrhythmia occurrence or maintenance, and then ablate to block the reentrant loop or eliminate the focus, thus treating arrhythmia. With the improvement of cardiac electrophysiological examination and the maturity of catheter ablation technology, more and more kinds of arrhythmia can be cured.
In recent years, with the application of some new technologies and instruments, catheter ablation has also achieved good results in cases of persistent or permanent atrial fibrillation, as well as rheumatic valvular disease and other organic heart diseases complicated with atrial fibrillation.
Biventricular pacing is also a blessing for some patients with heart failure, which can improve the quality of life of most patients, reduce the number of hospitalizations due to heart failure and reduce the mortality rate. For some patients with bradycardia, pacemaker implantation is a necessary choice. More physiological pacing will be beneficial to the recovery of cardiac function and prevent atrial fibrillation. Coronary angiography and interventional revascularization are no strangers to patients with coronary heart disease. The establishment of green channel for acute myocardial infarction and emergency interventional surgery have turned many patients to safety. Intra-aortic balloon counterpulsation (IBAP) has won valuable rescue time for some critically ill patients with cardiogenic shock, giving them a chance to tide over the difficulties of the disease.
In addition, screening pathogenic genes is of great significance for the prevention and treatment of hereditary or familial heart disease. Stem cell transplantation and angiogenesis therapy have made a lot of progress in animal experiments and have good application prospects. Molecular cardiology must not only be a scientific research project discussed in the laboratory, but will eventually bring more updated diagnosis and treatment programs to the clinic.
Secondly, gene therapy is another new way to treat cardiovascular diseases. The main steps include the preparation of the target gene, the introduction of the target gene into the target cell with a suitable vector, and the expression and regulation of the target gene in the target cell. With the progress of molecular cloning technology, this new method may bring great changes to the treatment of cardiovascular diseases.
nurse
1. Dietotherapy guides patients to improve their eating habits while eliminating the cause and taking medicine. Cholesterol is controlled in the range of 5.2mmol/L, mainly through diet regulation. The diet is light, eat more fresh vegetables, melons and coarse grains, eat less greasy and high-fat foods, such as animal fat, viscera, fat, roe, egg yolk and high-fat milk powder, and eat more onions, soybeans, mung beans, peanuts, ginger, corn, celery, kelp, spinach and jujube. The daily intake of cholesterol should be controlled within 300mg, and the intake of fatty acids should not exceed 30% of the total calories. Saturated fatty acids (S) can increase plasma cholesterol, so it should be controlled within 10% of total calories, while polyunsaturated fatty acids (P) can reduce cholesterol and triglycerides, so it is recommended to eat foods with high P/S ratio and low cholesterol content. Don't be too full and salty, and eat less sweets. If the effect of diet therapy is not ideal, most of them still need drug intervention.
2. Rational use of immunosuppressants Because immunosuppressants are one of the important causes of hyperlipidemia, rational use of immunosuppressants is an important measure to prevent and treat hyperlipidemia. Removal of adrenocortical hormone and continuous application of CsA and azathioprine in renal transplant recipients can reduce plasma total cholesterol and LDL-C by 65,438 07% and 65,438 06%, respectively, and HDL-C by 65,438 08%.
3. Lipid-lowering drugs According to the recommendation of NCEP in the United States, there are three types of lipid-lowering drugs as the first choice: HMG-CoA reductase inhibitors, fibrous acid derivatives, and nicotinic acid. Fibrous acid derivatives are mainly used in patients with extremely high plasma triglycerides, and antioxidants are only used in patients who cannot tolerate other cholesterol-lowering drugs. The interaction with immunosuppressive drugs should be considered when using the above drugs.
4. Health education and exercise play an important role in circulatory system function and blood lipid regulation. For people with low blood lipids, all kinds of activities can be unrestricted, but for those with organ involvement, especially those with insufficient blood supply to the heart and obvious symptoms, it is necessary to control activities and gradually increase the amount of activities after drug treatment to prevent accidents.
Patients should also be educated to pay attention to the principle of combining medicine, food and behavior. Especially those who have long-term mental work and work pressure, some are impatient, overweight, or have ingested the inducing elements of hyperlipidemia (lead, cobalt, cadmium), so we should reduce the inducing factors of hyperlipidemia while treating hyperlipidemia.
Fish oil therapy
2009-08-06 The latest research results in the United States show that fish oil rich in omega-3 fatty acids can not only prevent cardiovascular diseases, but also treat some cardiovascular diseases. Researchers at Ozner Clinic in New Orleans reported in the August issue of the Journal of American College of Cardiology that according to the research results of nearly 40,000 people, fish oil can not only prevent cardiovascular diseases, but also be used to treat atrial fibrillation, heart attack, arteriosclerosis and heart failure. The researchers suggest that ordinary people should consume 500 mg of omega-3 fatty acids every day, while patients with heart disease should consume 800 mg to 1000 mg every day.
Treatment of cardiovascular diseases with traditional Chinese medicine
The research on prevention and treatment of cardiovascular diseases by traditional Chinese medicine has made many progress, such as activating blood circulation and removing blood stasis to treat angina pectoris of coronary heart disease, invigorating qi and activating blood circulation or nourishing yin and activating blood circulation to treat acute myocardial infarction or cardiac insufficiency, invigorating qi and nourishing yang to treat bradyarrhythmia, invigorating qi and nourishing yang to treat viral myocarditis, regulating qi and activating blood circulation to prevent restenosis after interventional therapy of coronary heart disease, etc. Although its effect on a pathological link is not as strong as that of chemically synthesized drugs, it also shows certain advantages in preventing and treating various diseases of cardiovascular system. How to make full use of the advantages of traditional Chinese and western medicine in preventing and treating cardiovascular diseases and further improve the clinical efficacy is an unavoidable practical problem for modern Chinese medicine.
Lipid excretion can promote cholesterol excretion through cholagogic effect.
(1) Inhibition of lipid absorption: How Polygonum Multiflori Radix and Semen Cassiae can increase intestinal peristalsis and inhibit the absorption of fat and cholesterol.
(2) Inhibition of lipid synthesis in vivo: hawthorn, Polygonum multiflorum, rhubarb, cassia seed, etc. It can inhibit 3- photo -3- methyl-glutathione-coenzyme A reductase, thus inhibiting cholesterol synthesis.
(3) promoting lipid transport and clearance; Such as ginseng, cattail pollen, evening primrose and Polygonum multiflorum can increase HDL-C and decrease LDL-C. Under the guidance of syndrome differentiation theory, the correct application of the above drugs can improve the clinical lipid-regulating effect.