May be caused by functional, toxic, organic causes. The first type of arrhythmia does not pose a threat to life, health and is associated with the influence of external factors on the vagus nerve. These include:
- Excessive consumption of caffeinated drinks.
- Vegetative dysfunction.
- Psycho-emotional and physical overstrain.
Often, such an extraordinary contraction of the myocardium can be detected in pregnant women.
Intoxication have a favorable prognosis and occur in the following cases:
- Digitalis poisoning.
- Alcohol consumption.
- The use of antiarrhythmic drugs.
- Coronary heart disease.
- Arterial hypertension.
- Valvular defects.
Other diseases leading to supraventricular extrasystole:
- Electrolyte changes.
Such arrhythmia is not considered the norm, it is a signal of dystrophic disorders in the myocardium.
The appearance of an extraordinary ventricular complex is associated with the presence of an inactive focus of excitation, which begins to function under the influence of various factors.
Along with this, there is a theory of re-entry, when an impulse from a branch with a normal functioning ability passes late to another, where there is a violation of conduct.
In this case, the excitation wave follows a short path, which leads to an early contraction of the ventricles.
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- clinical picture
- Neurogenic factors
- Heart Disease
- Other diseases
- Classification and stages
- By Ryan and Laun
- Causes of the disease
- Symptoms, diagnostic methods and features of the treatment of extrasystole
- Supraventricular extrasystole: causes, types, diagnosis, treatment
- Symptoms, diagnostic methods and features of the treatment of extrasystole
- What is supraventricular (supraventricular) extrasystole and how to treat it
- General recommendations
- Extrasystole during pregnancy
- Therapeutic activities
- The main danger and complications
By localizing the source of the pulse:
By the frequency of occurrence for a certain time interval:
- Rare (up to 5 per minute).
- Medium (6-15 per minute).
- Frequent (more than 15 per minute).
By the number of successive reductions:
- Group (two in a row).
- Paired (more than three).
- Bigeminia (alternation of the normal ventricular complex with extraordinary).
- Trigeminia (two normal complexes are followed by extrasystolic).
- Quadrogeminia (premature contraction follows three normal ones).
Paired extrasystoles have an unfavorable prognosis, since three or more abnormal complexes are considered paroxysmal tachycardia.
Single and rare supraventricular extrasystoles in a negative way do not affect well-being. Often patients do not feel health problems. Under such circumstances, they speak of an acceptable version of the norm.
Frequent extrasystoles reduce diastole, during which the maximum blood filling of the myocardium occurs, the intake of nutrients. As a result of this, ischemia of the heart tissue will occur, which will be manifested by acute, short-term pain.
In patients suffering from coronary pathology, frequent extraordinary contraction of myocardial fibers is manifested by severe dizziness and general weakness, a feeling of lack of air. This is due to hypoxia of the brain against the background of a violation of its blood supply.
Recognizing supraventricular extrasystole is not difficult. Diagnosis can be made at the beginning of a diagnostic search. During the survey, patients will describe characteristic complaints of heart failure. Examination reveals an uneven pulse, as well as symptoms of coronary diseases (increased blood pressure, heart murmur, discoloration of the skin, and others).
- Previously, the appearance of undeformed ventricular (QRS) complex.
- P wave change before early contraction.
- The presence of an incomplete compensatory pause.
From atrioventricular connection:
- The appearance of premature QRS complex.
- Negative P wave in 2,3, and VF leads after an extraordinary contraction.
- Incomplete compensatory pause.
Additionally, according to indications, ultrasound and laboratory tests are performed.
Therapeutic tactics include the following rules for stopping premature contractile activity of the myocardium. First of all, it is necessary to eliminate bad habits, organize the regime of the day and rest, normalize the emotional atmosphere, drink coffee and strong tea in moderation.
Such measures are effective when arrhythmia is functional in nature and is not a deviation from the norm.
When an extrasystolic disorder adversely affects the patient’s well-being, arises due to cardiac pathology and risks initiating tachyarrhythmia paroxysm antiarrhythmic therapy is appropriate. For this purpose, the following drugs are used:
- Grade 1a (procainamide).
- Grade 2 (beta blockers).
- Grade 4 (calcium channel antagonists).
Supraventricular extrasystole refers to common heart rhythm disturbances. In many patients, the disease is asymptomatic. Rare, sporadic premature contractions in healthy individuals do not lead to menacing health consequences.
Normally, the pulse generator that controls the contraction of the heart is the sinus node. While it is functioning normally, standby sources of impulse are suppressed.
Extrasystole indicates that such a (secondary) source of impulse has intensified its activity.
It is in the intraventricular system (Purkinje fibers, the trunk of the bundle of His, its branching or legs) that extraordinary impulses arise, causing the ventricles to contract without first reducing the atria. This can be seen on the electrocardiogram: there is no complete P wave, indicating the work of the atria.
Specialists gave the name to this phenomenon – the reentry mechanism. This means that the impulse conducting the excitation passes through a closed path and repeats its action. Such a mechanism, according to scientists, often causes various forms of arrhythmias.
With an extraordinary contraction of the ventricles, blood is not pumped, transient function is not carried out. This is an unsuccessful waste of heart forces, which at that moment was supposed to “rest”, and as a result – “work for wear”.
There are relative norms for the number of extrasystoles outside the sinus rhythm that occur during the day:
- 600-950 – are considered as a non-life-threatening condition, if there are no other abnormalities in the work of the heart and disturbing symptoms (tachycardia, causeless shortness of breath).
- 1000-1200 are polymorphic extrasystoles. They are accompanied by a noticeable malfunction of the heart, which is not only displayed on the ECG, but also the patient himself feels.
- 1200 or more extraordinary contractions of the ventricles per day are a direct threat to human life and health.
In healthy people, up to a hundred rare extraordinary extrasystoles can occur during the day, which do not affect the overall functioning of the heart and the well-being of a person. In a child, VES and other cardiac arrhythmias (abbreviated as LDCs) are often observed during puberty.
The general list of causes of ventricular extrasystole can be divided into 2 groups:
- functional disorders – ventricular contractions that arose under the influence of short-term physiological factors;
- organic disorders – inserted extrasystoles, provoked by pathological changes (heart and vascular diseases).
They are also called idiopathic (extracardiac) causes of extrasystoles.
- alcohol consumption;
- passion for strong coffee (increased tone of the sympathetic nerve);
- frequent stress, depressive tendencies;
- insomnia, overeating, or mental work (vagus nerve irritation occurs;
- great physical activity.
Neurogenic factors provoke an increased activity of the sympathetic-adrenal system. As a result of this, extraordinary contractions of the ventricles of the heart arise.
A direct trigger of ventricular extrasystoles can be a number of pathologies of the cardiovascular system:
- Coronary heart disease (CHD).
- Myocardial infarction, post-infarction cardiosclerosis.
- Arterial hypertension.
- Atrial tachycardia.
- Pathologies of an inflammatory nature (endocarditis, myocarditis).
- Heart defects in the stage of decompensation.
- Supraventricular extrasystole.
- Heart failure (chronic and acute).
- Mitral valve prolapse.
- The presence and activation of extra conductive beams of electrical impulse (a bundle of James or Kent).
Pathological conditions also include ventricular extrasystoles, provoked by an overdose of cardiac glycosides.
Among other pathologies of a non-cardiological nature, experts note:
- Violation of the thyroid gland. This is excessive or low production of the necessary hormones.
- Vegetovascular dystonia (VVD), neurocirculatory dystonia, vagotonia.
- Pulmonary diseases (ZhES at the same time provoke many drugs used in the treatment – Eufillin, Berodual, Salbutamol and others).
- Cervical osteochondrosis of the spine.
- Diseases in which diuretics, antidepressants, ß-adrenostimulants are used.
- The classification of ventricular extrasystoles covers all the characteristics of the phenomenon.
- This is necessary for specialists in order to adequately assess the threat to health, prescribe effective treatment (if necessary) and make a prognosis.
- Therefore, on the outbreak of ZhES there are:
- Monotopic – with one ectopic focus of the pulse (in one ventricle).
- Polytopes – with several secondary foci of impulse (left ventricular and right ventricular at the same time).
By the duration of the compensatory pause:
- A full compensatory pause means that the sum of the pre- and post-ectopic interval is equivalent in duration to the two main cardiac cycles.
- Incomplete compensatory pause – if the sum of the intervals is less than the duration of two main cardiac cycles.
According to Laun-Wolf-Ryan (B. Lown, M. Wolf, M. Ryan) ventricular extrasystoles are divided into 5 degrees to take into account the risk of fibrillation:
- 1 degree – monomorphic extrasystoles (less than 30 per hour is allowed).
- 2 degree – monomorphic, more than 30 per hour.
- Grade 3 – polymorphic (group, paired) extraordinary contractions.
- 4th degree – is divided into subcategories “a” – paired, “b” – salvo.
- Grade 5 – salvo polymorphic ZhEs (3-5 in half a minute), fix paroxysmal supraventricular tachycardia. In such a situation, a person needs emergency care.
Allocate also 0 (zero) degree. It means a complete absence of extrasystoles (single).
Graduation by time of occurrence:
- Early – arising during the passage of the impulse through the atria.
- Interpolated – there is a simultaneous contraction of the right and left ventricle with the atria.
- Late – extrasystoles during the “rest” of the upper chambers of the heart.
Classification and stages
The classification of ventricular extrasystoles covers all the characteristics of the phenomenon.
This is necessary for specialists in order to adequately assess the threat to health, prescribe effective treatment (if necessary) and make a prognosis.
Therefore, on the outbreak of ZhES there are:
By rhythm, they are divided into allorhythmias (periodic) and sporadic (single, irregular) extraordinary contractions.
Alorrhythmia is divided into:
- Bigeminia – for every second normal reduction there is 1 extrasystole.
- Trigeminia – for every third.
- Quadrigeminia – every fourth contraction is interrupted by an extraordinary one.
If we take into account the main characteristics, among which the frequency of contractions and the localization of signs of manifestation, pathology is divided into the following types:
- a single extrasystole is a condition characterized by rare contractions (after 24-29 ordinary);
- group – about three to five ectopic;
- bigeminia – one-time, repeated through each normal rhythm;
- trigeminia when extraordinary occur after every 3rd normal.
Based on the field of diagnosis of extrasystole, it happens:
- left ventricular;
- right ventricular, which is not so common, which is due to structural features of the heart muscle.
At the place of formation:
- supraventricular extrasystole (supraventricular);
- combination of forms.
Depending on the time of manifestation:
Classification of the disease is carried out according to such parameters as the degree of development and associated symptoms. Based on the data that are obtained with a daily ECG, the pathological condition has the following classes:
- zero, when manifestations of pathology are not observed;
- the first – in a day about 30 single contractions of a monomorphic nature;
- the second – more than 30 frequent extrasystoles;
- the third is characterized by polymorphic ventricular extrasystoles;
- 4a – paired monomorphic;
- 4b – paired polymorphic;
- fifth – group polymorphic.
Due to the fact that contractions can be diagnosed at an early stage, there is the possibility of timely initiation of therapeutic measures.
By Ryan and Laun
It is also important to have an idea of the types of disease, based on diagnostic methods. For example, Ryan gradation classifies the disease into classes:
- 0 – no visible symptoms, no exception and ECG;
- 1 – monotopic, rarely occurring;
- 2 – frequent monotopic;
- 3 – polytopic;
- 4a – monomorphic paired;
- 4b – paired polymorphic;
- 5 – ventricular tachycardia.
- zero – no serious signs are observed;
- the first is infrequent monotopic reductions, the repetition of which is 30/60;
- the second is often monotopic;
- the third is polymorphic;
- 4a – paired;
- 4b – paroxysmal tachycardia;
- the fourth is characterized by the manifestation of early ventricular extrasystole, which falls on the first 4/5 T of the tooth.
Causes of the disease
Among the main factors in the development of the disease, there are disturbances in the work of the heart.
Organic lesions include:
- Coronary artery disease. It occurs as a result of the fact that coronary circulation is disturbed. It has two forms – chronic and acute.
- Deficiency is congenital and acquired.
- Heart failure when blood circulation is disturbed. Against this background, there may be insufficient blood fluid intake, which provokes acidosis, oxygen deficiency and other metabolic changes.
- Myocarditis is an inflammation, as a result of which there is a violation of the heart rhythm, impulse conduction.
- Cardiomyopathy is the primary lesion leading to an increase in the size of the heart muscle and atypical strokes.
The development of the disease can be provoked by the use of certain medications, such as:
- sympathomimetics, M-anticholinergics;
- cardiac glycosides.
In addition, other pathologies that are not related to the cardiovascular system contribute to the development of ZhES:
- adrenal gland disease;
- diabetes mellitus type 2;
Functional causes include:
- excessive physical exertion;
- stressful situations, overstrain at an emotional level;
- alcohol abuse and uncontrolled smoking;
- menopause, abortion, that is, any hormonal changes;
- overeating at night;
Sometimes extrasystole manifests itself in a dream, which indicates dysfunction of the vagus nerve. A disease of the prostate, esophagus, uterus and intestines can provoke this condition.
Symptoms, diagnostic methods and features of the treatment of extrasystole
The manifestation of idiopathic ZhES is caused by organic lesions of the heart. Symptoms of pathology are quite pronounced, which allows you to diagnose the disease in the early stages of development.
The most common symptoms are:
- aching pains in the chest;
- violation of contractions;
- noticeable malfunctions in the myocardium, which is accompanied by painful and unpleasant sensations;
- dizziness for a long time;
- fainting conditions;
- feeling lack of oxygen even in the fresh air.
Among the general symptoms are:
- constant fatigue;
- worse night sleep;
- pain in the head.
The rhythmic disturbance of the heart muscle is one of the most obvious manifestations of the VES. That is why in the first place it is necessary to pay attention to the rhythm of contractions.
If the patient does not have background cardiac pathologies, then, paradoxically, ventricular extrasystole is more difficult for him to tolerate than with the presence of diseases.
This is due to some compensatory capabilities of the body.
In a young, relatively healthy person, ZHES will manifest itself:
- The feeling of “cardiac arrest” followed by a series of tangible beats. Trying to describe their condition, patients say that their heart is sinking.
- A few strong beats of the heart against the background of a calm state.
Women during pregnancy also often feel extraordinary jolts in the heart area. This is due to the restructuring of the hormonal background, but if the symptoms are disturbing, you need to see a doctor and measure all the indicators.
Even with all of the above symptoms and signs, it is possible to claim the presence of ventricular extrasystole only on the basis of diagnostic results.
Important: if any interruptions in the work of the heart occur, you should consult a general practitioner or cardiologist.
Extrasystole is a condition that refers to cardiac muscle rhythm disturbances. Or just a form of arrhythmia, expressed in extraordinary contractions of the heart or its individual sections.
There is supraventricular extrasystole, which is called supraventricular. This is due to the location of the focus of excitation. The foci are ventricular, atrial, and atrioventricular.
Depending on this, the patient may be diagnosed with supraventricular extrasystole or other types of disorders.
Treatment of extrasystole depends on the characteristics of the course of the disease and the causes.
The arrhythmia resulting from extrasystole manifests itself in the form of additional contractions against the background of normal organ function. Extrasystoles are able to spread only to one of the departments (chambers) of the heart muscle or immediately to the entire organ. This disorder is considered the most common form of arrhythmia.
In 70 – 80% of people, a similar pathology occurs, but in different forms of extraordinary contractions. The formation of extrasystoles is due to the presence of additional foci of pulses in the heart that are not connected with the main sinus node, that is, a pacemaker.
The conductive system is activated, which is why an additional reduction appears.
Extrasystoles can be:
- functional (they are neurogenic), which are caused by the harmful effects of external factors;
- pathological (or organic), caused by violations of the integrity of cardiac tissues.
The volume of blood entering the aorta through the left ventricle with extrasystoles is less than normal. Because of this, a pathological condition is potentially dangerous with the ability to disrupt blood flow to internal organs.
If this is a single arrhythmia, that is, extrasystoles occur once in a healthy person, there is no danger in such a manifestation. Treatment is not necessary. The situation is different if additional heart contractions occur against the background of existing diseases of the cardiovascular system.
Properly selected treatment of cardiac extrasystole and compliance with the rules of prevention will allow you to slightly change your lifestyle and have minimal impact on further health.
Such disorders or malfunctions in the rhythm of heart contractions have their own causes. They resemble factors that can lead to tachyarrhythmias.
This is due to their general development mechanism.
It is important for specialists to know exactly what the causes of extrasystole occur and development, which served as an impetus for the violation of the heart rhythm, and whether there is a potential threat to human health or life.
The appearance of extrasystole may include:
- damage to heart fibers;
- pathological processes in the endocrine system;
- low blood oxygen saturation;
- side effects of medications;
- metabolic disorders (poor metabolism);
- dysfunctions of the autonomic system;
- injuries, diseases of the thoracic and cervical spine;
- violations of the sinus node;
- allergic reactions;
- autoimmune diseases, etc.
It is important for the doctor to understand what contributed to the appearance of extrasystole, and which pills or treatment methods to choose in a given situation. Having ascertained the causes, it is possible to competently build further tactics for influencing the patient’s cardiovascular system.
In medicine, it is customary to distinguish extrasystole by the type of prognosis and other signs. This allows you to accurately diagnose and give specific recommendations to the patient.
There are several ways to classify a disease.
- At the place of development. Pathology is sinus, atrial, ventricular, mixed or atrioventricular. The most common are atrial and ventricular forms.
- By frequency of occurrence. Measured in 1 hour and divided into frequent, rare and medium extrasystole.
- By density of occurrence. Paired and single types are distinguished here.
- In connection with the cycles of the heart muscle. The earliest occur immediately after the ventricles contract. The middle type occurs with the beginning of the cardiocycle, and the latter appear in the second half of the cycle.
- By the rhythm of manifestation. They are periodic and non-periodic.
- The last sign is the number of foci. It can be single or multiple.
But the main focus in medicine is on the prognosis of extrasystole. There are 3 types of violations:
- Safe. These are all extraordinary cardiac contractions and increases in rhythm, not accompanied by clinical symptoms. Characteristic for people without pathologies of the cardiovascular system. With this kind of violation, treatment is not required.
- Potentially health hazard. Rhythm disturbances, asymptomatic, but due to the presence of cardiac diseases.
- Dangerous. Periodic persistent rhythm disturbances occur and are accompanied by symptoms of changes in blood flow. A similar form develops in parallel pathologies of the heart tissue or impaired myocardial function.
With extrasystole, symptoms are checked and only qualified specialists prescribe treatment. Self-treatment at home without the supervision of a doctor is strictly prohibited.
Before treating extrasystole, the patient needs to seek the help of doctors. This is a big problem, because people often ignore the symptoms, do not pay attention to them and refer to ordinary fatigue or physical overwork. Even with extrasystole, symptoms are often absent. This is especially true with single manifestations of additional contractions.
The signs of a manifestation of a violation, doctors include:
- temporary fading of the myocardium;
- strengthening or increasing the severity of strikes;
- a feeling of interruption in muscle work;
- the feeling of a temporary stop;
- increased anxiety;
- inexplicable feeling of fear;
- the difficulty of performing a regular breath.
Such symptoms do not always indicate arrhythmia. Based on these signs, it is impossible to accurately diagnose and determine the severity of the disease. This is due to different thresholds of perception in people. Any extrasystole is normally and without consequences transferred by a person.
But if you observe a feeling of well-being, become more susceptible to stress, this indicates a malfunction of the cardiovascular system. Extrasystole is manifested against the background of the underlying disease, therefore all efforts should be directed against the main disease.
If you quickly got rid of the cause of the rhythm disturbance, then the extrasystole itself will pass. The only question is whether it is possible to cure this disease, which provoked changes in contractions of the heart muscle.
Some pathologies are chronic in nature, therefore they are not amenable to treatment, but need constant monitoring.
Relying only on patient complaints, the doctor will not be able to confirm the presence of extrasystole. An anamnesis is needed, but it only allows you to clarify the onset of symptoms and potential causes of its development. In order to make an accurate diagnosis and determine how to get rid of extrasystole in a specific situation, you need to undergo a comprehensive examination.
Diagnostics includes several procedures:
- Electrocardiography An ECG is necessary to confirm the fact of extraordinary heart contractions. It also helps to find the place of occurrence of additional impulses.
- ECG under physical exertion. Using this method, violations that occur in humans during physical activity are determined. In normal condition, they may not appear.
- Keeping a daily record of electrocardiogram data. For this, the patient wears a special device and simultaneously records all his actions. Assessment is carried out in a day. This helps in determining the relationship between additional abbreviations and external factors.
- Method of electrophysiological research. Actual in the presence or suspicion of heart failure, tachyarrhythmia and other pathologies of the cardiovascular system. It is recommended to carry out the procedure with a pronounced symptomatology of impaired blood flow.
- Echocardiogram. It is necessary to check the functional status of all heart chambers. Helps to find organic factors that caused a change in heart rhythm.
Supraventricular extrasystole: causes, types, diagnosis, treatment
The following methods are used to diagnose the disease:
- ECG. Allows you to fix everything that happens to the human heart during systole (contraction) and diastole (relaxation). When decoding a cardiogram, the occurrence of an expanded and deformed ventricular complex QRS, a complete compensatory pause, the absence of a P wave before an extraordinary contraction, a change in the refractory period are observed.
- ECG monitoring according to Holter. This is a diagnostic method, during which a special device with sensors is attached to a person, with whom he must live his normal day. It is such a daily observation that gives specialists the opportunity to track the periods and frequency of occurrence of extraordinary ventricular contractions. Holter monitoring is the main diagnostic method for ZhE.
- Bicycle ergometry. The method is used to confirm or refute the relationship of pathology with physical activity.
As additional diagnostic methods use:
- General and biochemical blood analysis (to detect cholesterol, which could provoke the development of atherosclerosis).
- Blood test for thyroid hormones.
- Treadmill test.
- Transesophageal ECG.
Usually, in order to determine the correct diagnosis, the patient only needs to undergo an ECG and Holter study, but in some cases a detailed blood test and stress tests may be required.
Supraventricular or supraventricular extrasystole is one of the variants of cardiac rhythm disturbance with the appearance of extraordinary contractions, which are caused by pathological impulses generated by foci of ectopia. With this type of arrhythmia, ectopic zones are not in the ventricles, but in the departments of the heart located above them.
Unlike organic extrasystole, functional extraordinary contractions occur without obvious diseases from the cardiovascular sphere.
As a rule, in such cases, patients are diagnosed with a single atrial extrasystole, when the number of prematurely generated impulses does not exceed 30 per minute.
Functional extrasystoles include:
- neurogenic contractions caused by pathological activity of nerve structures;
- extraordinary impulses of endocrine origin associated with hormone imbalances;
- extrasystoles of dyselectrolyte origin;
- premature contractions that result from the regular or abnormal use of certain medications;
- rhythm disturbances by the type of extrasystole of toxic genesis.
According to current generally accepted classification, a disease such as supraventricular extrasystole has several main types. According to the localization of ectopic zones generating pathological impulses, it is customary to distinguish:
- atrial extrasystole (impulses occur in the upper chambers of the heart);
- atrial ventricular extrasystole (when an ectopic node occurs in the septum between the atrium and the ventricle).
By the time of occurrence, it is customary to distinguish such types of extrasystoles as:
- early ones that develop from the atria;
- interpolated, occurring at the border of the atria and ventricles, but above the thickness of the ventricular part of the myocardium.
In frequency it is:
- single supraventricular extrasystoles, which are single extraordinary excitations in an amount of up to five contractions per minute;
- multiple extrasystoles in an amount of more than five per minute;
- paired extrasystoles, arising in two between physiological contractions;
- group contractions or extrasystoles in an amount of two or more between normal complexes.
When determining the type of extrasystole, the number of ectopic zones also plays a role, in relation to which they distinguish:
- monotopic extrasystoles (one focus);
- polytopic extrasystoles (two or more ectopic zones).
As a rule, patients with a diagnosed supraventricular form of extrasystole do not have specific symptoms of the disease.
The disease is manifested by a classic set of signs characteristic of most pathological conditions of the cardiovascular sphere, which are accompanied by functional and organic lesions of the myocardium and other structural elements of the heart. The main manifestations of NZhES include:
- panic attacks with fear of death, anxiety or unmotivated anxiety;
- a sharp feeling of weakness, soreness;
- shortness of breath, which is accompanied by a feeling of lack of air, suffocation;
- the appearance of tangible interruptions in the work of the heart and a feeling of its specific revolution in the chest;
- sometimes characteristic “tremors in the chest” appear.
Extrasystole of supraventricular origin in children is a common phenomenon that does not manifest itself clinically, but is determined mainly during a routine examination of the child.
This type of arrhythmia is not able to harm the children’s body, but its complications and consequences can easily do this, among which the worst is atrial fibrillation with subsequent cessation of heart contractions.
In babies, extrasystole does not cause babies any concern. At an older age, children may complain of shortness of breath, a feeling of palpitations and heartbeats.
In any case, the disease in babies needs a detailed and expanded diagnosis with the identification of the main etiological factors for the development of the pathological process and the adoption of measures to eliminate them.
Diagnosis of the disease is an important part of the treatment of supraventricular extrasystole, which allows you to determine the form of the disease, its main source and severity of pathological manifestations.
During diagnostic measures, the doctor takes into account the patient’s complaints, collects an anamnesis of the disease and life of the sick person, and also evaluates the results of laboratory and instrumental studies, among which electrocardiography, ECG monitoring by Holter, and ultrasound examination of the heart are especially informative.
Supraventricular extrasystole on the electrocardiogram is manifested by the following symptoms:
- incomplete compensatory pause;
- deformation of extrasystolic tooth P;
- a change in the polarity of the P wave in the extrasystole complex;
- premature appearance of tooth P;
- QRS extrasystolic complex changed slightly.
Supraventricular extrasystole, which has a functional origin and is not the result of myocardial diseases or endocrine gland pathology, as a rule, does not need medical treatment. With this form of the disease, when it is asymptomatic and does not threaten the normal functioning of a person, doctors offer their patients to adhere to general recommendations:
- adhere to the correct daily routine;
- create all conditions for proper rest and sleep;
- Avoid intense physical exertion;
- eat right, beware of spicy, fatty and salty foods;
- stop smoking and drinking strong alcoholic beverages;
- stop drinking coffee;
- spend a lot of time in the fresh air;
- regularly organize walking marathons;
- avoid emotional stress, stressful situations, nervous shocks.
Indications for drug correction of this type of change in cardiac rhythm are intolerance to the symptoms of the disease, when the latter cause significant disturbances in the general condition of the patient, sharply progressive forms of the autologous process with a high risk of developing atrial fibrillation, the presence of heart disease in a sick person, frequent supraventricular extrasystoles in an amount of more than 1 thousand . per day.
Conservative treatment of the disease includes the appointment of medications, among which:
- antiarrhythmic drugs to normalize the heart rhythm, the choice of which depends on the type of underlying disease, the patient’s contraindications for taking medications, individual characteristics of the body;
- cardiac glycosides that reduce the load on the heart muscle;
- antihypertensive drugs with high blood pressure;
- antiplatelet agents that improve blood rheology and prevent blood clots.
In the absence of the effect of drug therapy, specialists recommend patients the surgical treatment of the disease. Surgical treatment of supraventricular extrasystole is indicated mainly for young people, since in old age there are risks of developing postoperative fatal complications.
Treatment of atrial extrasystole with the help of surgical techniques is implemented in practice by applying radiofrequency catheter ablation, when the foci of ectopia are destroyed in the thickness of the heart muscle with a special catheter inserted through a large vessel. In exceptional cases, radical people undergo radical surgery using open access to the heart.
By itself, supraventricular extrasystole is not a condition dangerous to the normal life of a person, therefore patients with infrequent episodes of supraventricular extraordinary contractions lead a normal lifestyle and do not lose their performance. On the other hand, frequent atrial extrasystole can become the main reason for the development of more complex variants of cardiac rhythm disturbance, the course of which can hardly be called favorable.
Among the possible complications and consequences of a pathological condition, there are:
- a change in the configuration of the atria, which in most cases leads to a frequent supraventricular extrasystole;
- heart failure, which is accompanied by the inability of the myocardium to cope with the function assigned to it;
- atrial fibrillation;
- atrial flutter, it is dangerous to cause a heart attack and sudden cardiac arrest.
Symptoms, diagnostic methods and features of the treatment of extrasystole
Not so long ago, one of the most common extrasystoles in childhood was considered ventricular. However, recently, all types of pathology have been equally often diagnosed. This is due to the rapidly growing body of the child, as a result of which the myocardium is not able to cope with increased loads. As soon as growth slows down, the disease goes away on its own.
However, in this case too, extrasystole cannot be ignored, since it can indicate serious disturbances in the activity of the heart muscle, lungs, or thyroid gland. Complaints in children are almost the same as in adult patients. If appropriate signs are present, examination is required.
When identifying a VES in a child, the need for treatment does not always arise. However, dispensary accounting is necessary with a frequency of examinations of once every 12 months. The importance of this procedure is explained by the need not to miss the deterioration and development of complications.
Drug treatment is prescribed if the value close to 15000 is exceeded. In such situations, antiarrhythmic therapy is necessary.
Diagnosis of heart pathologies in men occurs several times more often. This is due to the fact that they smoke more often, drink alcohol and are more susceptible to the effects of negative factors. Pathology is observed in people in adulthood.
In women, sinus type extrasystole can also occur frequently, but in a non-critical form.
What is supraventricular (supraventricular) extrasystole and how to treat it
Depending on the cause of the pathology, the specialist individually chooses the method of treatment of the patient.
There is one general rule: therapy should be comprehensive. This is the only way to relieve symptoms.
First of all, patients should exclude idiopathic factors that provoke ventricular extrasystoles and possible complications:
- Stop smoking (completely).
- Reduce the amount of coffee and strong tea to 1 cup per day.
- Abstain from drinking.
- Daily do simple exercises (exercise).
As for athletes, then if they feel tremors in the heart after physical exertion and this can be seen on electrocardiography – it should be moderated or eliminated for a while. If the symptoms of ZhES do not manifest themselves as characteristic episodes, or they are single, then you can engage in sports.
Diet is what doctors prescribe for almost any disease. Indeed, properly organized nutrition at home will help the cardiovascular system cope with pathology faster.
It is necessary to refuse:
- products with synthetic food additives (yogurts, chips);
- salty (salt raises the level of arterial pressure that can become frequent attacks of an extrasystole).
Overeating is strictly prohibited. Eating should be slow, you should leave the table with a feeling of pleasant satiety, and not heaviness.
It will be useful to include in the diet:
- dried fruits;
- natural dairy products;
- raw vegetables, nuts.
If pathological contractions of the ventricles of the heart occur more often than 30 times per hour, and the correction of lifestyle and nutrition did not help, and the patient complains of a palpable, sharp heartbeat, doctors prescribe medication.
Its purpose is to eliminate symptoms and prevent the development of severe types of arrhythmias:
- Stage 1 – sedative phytopreparations, ß-blockers (Obzidan, Anaprilin, Nebilet), blood thinners (Aspirin, Cardiomagnyl), Panangin, Asparkam.
- Stage 2 – the introduction of antiarrhythmic drugs (in the absence of the treatment effect in stage 1). The safest reviews of cardiologists are class 2 antiarrhythmics. These are Allapinin, Amiodarone, Propranolol, Metoprolol, Verapamil. “Etatsizin” (1 class), “Lidocaine”, “Mexarithm”.
- Stage 3 – taking class 3 antiarrhythmic drugs (Amiodarone, Cordaron) – drugs of choice to prevent ventricular fibrillation.
- Stage 4 – the use of a combination of drugs (ß-blockers, antiarrhythmics).
Important: these drugs have a pronounced cardiological effect, so only a doctor can take into account all the risks and prescribe it to the patient. The choice of remedy and dosage should be entrusted to a cardiologist, self-medication with antiarrhythmics is unacceptable.
The opinions of cardiologists regarding surgical intervention with this pathology agree on one thing – it is shown to the patient only if the medication failed to get rid of the extrasystole.
The most commonly used method is called Radio Frequency Ablation (RFA). During the procedure, using radio waves, the sources of pathological impulses are destroyed.
A contraindication to surgery in adults may be that the patient is not able to tolerate general anesthesia.
Supraventricular, or supraventricular, extrasystoles (SVES) are premature heart contractions caused by the extraordinary formation of an impulse in areas of the atrial conduction system located below the sinus node.
In this case, an ectopic focus is generated in the wall of one of the atria, generating premature electrical impulses. They cause a reduction in the atria, and then the ventricles. After extrasystole, the normal sinus rhythm resumes.
AECS make up about a third of all extrasystoles. They are divided into extrasystoles from the atrioventricular connection and from the atrium (atrial). Atrial extrasystoles make up the majority of supraventricular.
Therefore, most often they talk about supraventricular extrasystole, without distinguishing between its individual species.
Pathology of the thyroid gland can contribute to arrhythmias.
In about a third of cases, AECS is not accompanied by organic changes in the heart and is functional. They can also occur in healthy people. In this case, AECS are caused by autonomic disorders, often accompanied by a rare heartbeat, arterial hypotension, an increase in the tone of the vagus nerve, in particular, sweating of the extremities.
Often, AECS appear with the excessive use of tea, coffee, alcohol, as well as with smoking. They can be provoked by emotional or physical stress, a change in body position. With functional extrasystole during the daytime, patients often do not notice arrhythmia. Extrasystoles begin to bother them in the evening, in a supine position, before bedtime.
AECS accompany many heart diseases.
Most often they are recorded in chronic coronary heart disease (angina pectoris, post-infarction cardiosclerosis), as well as against the background of an active rheumatic process.
The appearance of this arrhythmia is facilitated by an increase in the atria and an extension of their walls, for example, with mitral stenosis. In this case, supraventricular extrasystole is subsequently replaced by atrial fibrillation.
AECS can occur in acute myocardial infarction, accompany the course of myocarditis, hypertension, congenital heart defects.
They are found in chronic pulmonary heart, pheochromocytoma (hormone-producing tumor of the adrenal gland), thyrotoxicosis, menopause myocardial dystrophy.
In addition, AECS may be due to hypokalemia, that is, a lack of potassium in the blood. In rare cases, they appear with an overdose of cardiac glycosides (digitalis intoxication).
AECS are found in acute and chronic infections, tonsillitis, as well as in chronic cholecystitis and other diseases of the abdominal organs.
Complaints of patients with supraventricular extrasystole depend on many factors. It is believed that young people with functional extrasystole are less likely to tolerate AECS. They may complain of a variety of sensations in the chest, neck, reminiscent of turning over, “fluttering fish”, fading. In some cases, extrasystole is accompanied by dizziness and weakness.
If extrasystole has arisen against the background of an organic heart disease, it is often not felt, patients get used to it and do not pay attention to it. Complaints are mainly caused by the underlying disease.
AECS is diagnosed using electrocardiography (ECG) at rest and daily monitoring of ECG according to Holter.
Atrial extrasystole is characterized by the premature appearance of an altered P wave, which displays the excitation of the atria from the ectopic focus. It is most often followed by a normal or slightly deformed ventricular complex.
Sometimes ventricular contraction does not occur, in this case they talk about blocked AECS. After an atrial extrasystole, an incomplete compensatory pause is usually recorded.
This means that the distance between the two complexes adjacent to the extrasystole is less than twice the distance between two normal sinus contractions.
If the ectopic focus is in the atrioventricular junction, a premature unchanged ventricular complex is recorded on the ECG. The tooth P is not determined. In other cases, excitation is performed retrogradely at the atrium, therefore, a negative P wave appears after an extrasystolic ventricular complex.
When analyzing the daily monitoring of ECG by Holter, the functional diagnostics doctor determines the total number of AECS, clarifies their topic (source), paired and group AECS are identified.
Therefore, daily monitoring of ECG is an important part of the examination of the patient.
The patient is recommended to refuse to drink coffee, strong tea, alcohol, and to exclude smoking. He should not overeat. In the diet, it is necessary to increase the potassium content. A full sleep and a favorable psychological situation at work and at home are necessary.
It is recommended to take herbal sedatives: valerian, motherwort, Zelenin drops. If extrasystole is not associated with heart disease and appears at rest, anticholinergics can be used, in particular, preparations containing belladonna. When it appears on the background of the load, beta-blockers help.
In the absence of effect, drugs that are effective both in supraventricular and ventricular extrasystoles can be used. These include amiodarone, disopyramide, allapinin, rhythmorm and others.
NZhE develop due to many reasons. Even banal sneezing or fright can cause an extraordinary contraction of the myocardium. The most common culprits of extrasystoles are various heart diseases: coronary heart disease, cardiomyopathies, congenital and acquired defects, myocarditis, pericarditis, chronic heart failure, etc.
Also, supraventricular extrasystole develops with the following factors, conditions and diseases:
- violation of autonomic regulation (autonomic dysfunction syndrome);
- physical and emotional stress;
- neurotic disorders;
- reflex irritation of the heart nerves in diseases of the gastrointestinal tract: peptic ulcer of the duodenum, gallstone disease;
- the presence of bad habits;
- taking pills: antidepressants, psychostimulants to reduce appetite, vasoconstrictor nasal drops, drugs for high blood pressure. Even some antiarrhythmic drugs in some cases cause NJE;
- infectious diseases;
- severe diseases of the respiratory system: bronchial asthma, chronic bronchial obstructive pulmonary disease;
- pathology of endocrine organs: Graves disease, Hashimoto’s thyroiditis, diabetes mellitus;
- excess or deficiency in the body of minerals (calcium, magnesium, sodium);
- chest injuries.
Extrasystole during pregnancy
In pregnant women, in the absence of any pathological abnormalities, rare ZhES may occur, which is most often observed during the 2nd trimester, since there is a violation of the electrolyte balance, a high position of the diaphragm.
When diagnosing diseases of the gallbladder, esophagus or stomach, there may be reflex extrasystole.
If a pregnant woman complains of rhythm malfunctions, they must be examined.
For the treatment of failures, the obstetrician-gynecologist gives the following clinical recommendations:
- taking magnesium and potassium preparations;
- adherence to a special diet.
If there is a group ZhES of persistent type, there is a need for a visit to a cardiologist who will establish the reason for the development of this pathological condition.
Even if the patient was diagnosed with ventricular extrasystole against a background of heart disease, treatment should be started as early as possible, not deviating from the pill regimen prescribed by the doctor and leading a healthy lifestyle. Only in this case, the prognosis will be favorable and the person will be able to cure the pathology, live a long, full life.
Even if the heart does not bother with interruptions in its work, it is very important to understand that many pathologies proceed secretly and are detected too late (especially in men). Therefore, it is extremely important to undergo a routine physical examination and an ECG every year.
In most cases, VES is detected during a routine examination on an ECG. If the symptoms are pronounced, then the patient himself comes to the examination.
In order to accurately make a diagnosis, it is necessary to identify the root cause that provoked the pathology.
First of all, the doctor conducts a survey of the patient in order to identify characteristic complaints, and also measures the pulse and blood pressure. Already during such actions, an irregular reduction will be detected.
After the initial examination, an electrocardiogram is prescribed. An ECG allows you to immediately determine the presence of ventricular extrasystoles. On the cardiogram, this condition is manifested by the following symptoms:
- extraordinary ventricular complexes QRS;
- there is no scar P before the extrasystole;
- expansion and deformation of extrasystolic QRS complexes;
- pause after ES.
If the examination showed pathological disorders, then daily monitoring is carried out, which allows you to determine the frequency of occurrence of extraordinary contractions, as well as the presence of group and paired extrasystoles.
In order for the result from treatment to be as positive as possible, patients should adhere to some recommendations:
- exclude smoking, alcohol, coffee and black tea;
- include potassium-rich foods (carrots, oatmeal, nuts, bananas, potatoes, prunes);
- avoid heavy loads;
- abandon hard diets that promote weight loss;
- take a mild sedative with frequent stress.
If, with daily monitoring, extrasystoles exceed 200, then medications are prescribed.
From antiarrhythmic drugs are prescribed:
- Anaprilin, Cordinom, Atenolol;
- Lidocaine, Novocainamide;
- Verapamil, Amlodipine;
- Aspirin – as a preventative measure to prevent thrombosis.
The treatment regimen is determined individually for each patient. Two months later, the patient’s condition is monitored by an ECG.
The operation is advisable only if the treatment with drugs does not bring a positive effect.
- installation of a pacemaker;
- radiofrequency ablation.
Pacemakers are also recommended for those people who throughout their life regulate heart rhythms with the help of medications.
Often, in the treatment of many forms of ZhES, unconventional drugs are used:
- Valerian root.
- Pharmacy chamomile and lemon balm, which have a good calming effect.
- Alcohol tincture of hawthorn.
When choosing folk remedies, you need to consult a cardiologist.
The main danger and complications
The presence of extrasystole increases the risk of developing cardiac arrhythmias (arrhythmias) and fibrillation (random chaotic heart contractions). It is important to diagnose the pathology in a timely manner, identify its cause and treat the underlying disease that provokes the disorder.
Complications of ventricular extrasystole
Increased risk of sudden death. The main complication of this pathology is sudden death. To assess the risk of sudden death, doctors use a number of special criteria to help you choose a course of treatment:
- With benign ventricular extrasystole, there are no signs of left ventricular dysfunction and organic heart disease. The risk of sudden death with benign is minimal.
- With a potentially malignant ventricular extrasystole, organic heart diseases and a decrease in the ejection fraction of the heart up to 30% are noted. The risk of sudden death in this case is increased.
- With malignant ventricular extrasystole, severe organic lesions of the heart and ventricular extrasystoles of any gradation are observed. The risk of sudden death in this situation is greatest.
Complications of supraventricular extrasystole
The development of supraventricular tachycardia.
In rare cases, when the cardiac cycle gets into a vulnerable period and there are other conditions for the occurrence of re-entry, the disease can provoke the development of supraventricular tachycardia.
Supraventricular tachycardia is characterized by suddenly beginning and stopping pathologically rapid cardiac activity. During an attack, the heart rate rises to 220-250 beats per minute.
The development of atrial fibrillation. Atrial fibrillation (atrial fibrillation, AF) may be one of the consequences of this disease.
AF is characterized by a disturbance in the heart rhythm, which is accompanied by chaotic and frequent arousal and contraction of the atria, as well as twitching of some groups of atrial muscle fibers.
During an attack, the rhythm frequency increases significantly, the correct heart rhythm is lost. The risk of atrial fibrillation may be a criterion for malignancy of supraventricular extrasystole.
|Paroxysmal tachycardia||Complications of extrasystole||Questions and Answers|
In the absence of therapeutic effects, ventricular extrasystole can provoke certain negative consequences:
- heart failure;
- more severe course of the disease;
- changes in the structure of the ventricle;
Among the most dangerous conditions, sudden cardiac arrest is distinguished.
To minimize the risks of cardiovascular disease, it is necessary to lead a healthy lifestyle, constant monitoring of cholesterol, blood pressure and thyroid activity.
At the first signs of pathology, you must immediately seek medical help.
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