New theory of arrhythmia. Conceptual substantiation of arrhythmia mechanisms

Aims

A new attempt is made to substantiate the concept of the mechanism of arrhythmia and sudden cardiac death.

Methods

The paper is based on a theoretical analysis of special literature, personal experience of participation in conferences and discussions with leading Russian cardiologists.

Results

We have succeeded in demonstrating the fact that researchers ignore the fact that cardiomyocytes can be excited by mechanical pulses, when considering the arrhythmia mechanisms. We have conducted trials using the Cardiocode device. Under stress in a human, opened may be large and small arteriovenous anastomoses, via which blood under high pressure is ejected into veins. It leads to pressure surges in arteries and veins. The vena cava dilates, its tonus increases. In some cases, the pulse waves travel via anastomoses along the vena cava walls to the atria and the ventricles. An above-threshold concentration of tensions from mechanical pulses may excite cardiomyocytes from different points of the myocardium, disturbing the sinus rhythm. As a result, extrasystoles, tachycardia attacks, blocking of blood circulation in the peripheral segments of the venous arterial networks, edemata, thrombosis and metabolism disorders appear. Arrhythmia, tachycardia attacks and concomitant myocardial ischemia lead to progression of heart fibrosis. Such changes increase the probability of fibrillations and sudden cardiac death.

Conclusion

Unhealthy lifestyle, the presence of opening and not properly closing anastomoses may provoke a number of diseases. To avoid the cardiac arrhythmia attacks and prevent SCD, it is necessary to suppress travel of the mechanical waves within the following circuitry: aorta – artery – anastomosis – vein – vena cava – atria – ventricles. The travel of the mechanical waves within the same vessel circuitry explains the fact that the fixed couplings under extrasystoles are observed, and the beat-to-beat RR intervals under tachycardia remain constant. Obviously, we may consider that the reentry mechanism is rather of biomechanical, but not of bioelectrical nature, as it is generally accepted.

Imprint

Vladimir I. Ermoshkin. New theory of arrhythmia. Conceptual substantiation of arrhythmia mechanisms. Cardiometry; Issue 8; May 2016; p.6–17; DOI:10.12710/cardiometry.2016.8.617 Available from: http://www.cardiometry.net/issues/no8-may-2016/new-theory-of-arrhythmia