Full characteristics of ventricular extrasystole: symptoms and treatment. Extrasystole. Causes, diagnosis and treatment of pathology After spinal anesthesia, frequent extrasystoles began

Extrasystole of the heart can be tracked on the ECG graph, where they appear as single or paired jumps

Extrasystole is another type of heart rhythm disturbance. This type of disorder can be observed in most physically healthy people. The norm is up to 200 extrasystoles (extraordinary contractions) per day. They can be tracked on the ECG graph, where they appear as single or paired jumps. If there are three or more jumps, this is called unstable tachycardia, which can occur as a result of stress, physical exertion, etc.

Extrasystole for a healthy person is a completely normal phenomenon and does not cause any harm to the body. Another thing is people who have any kind of heart disease.

Causes and types of extrasystole

Extrasystole is of two types:

1. Ventricular - premature excitation of the heart muscle, resulting from impulses emanating from various areas of the conduction system of the ventricles.
2. Supraventricular - also premature excitation of the muscle, but the cause of premature excitation is impulses coming from outside the conduction system.

The most common option is ventricular extrasystole, since various heart diseases that disrupt the functioning of the heart muscle can be associated with it.

All reasons are divided into two main types:

• functional;
• organic.

Functional - arise as a natural reaction of the body to various types of reactions (smoking, physical and emotional stress, frequent use of alcoholic and caffeinated drinks, sleep disturbance, nutrition, etc.)

organic- indicate abnormalities in the work of the heart muscle. The most common reasons are:

• ischemia;
• myocardial infarction;
• myocarditis;
• heart failure.

Extrasystole of the heart: symptoms (signs)

The extrasystole itself has practically no external manifestations and it is quite difficult to distinguish it without special instruments. But with frequent occurrences of extrasystoles in patients, there may be:

• complaints of strong beats and tremors of the heart;
• sinking feeling in the chest.

It is most likely to determine the disease by the resulting consequences:

• increased sweating;
• unreasonable feelings of fear, anxiety;
• feeling of lack of air;
• angina attacks;
• frequent fainting.

It is worth remembering that the above symptoms may be signs of other diseases associated with both the cardiovascular and other systems of the human body. Therefore, do not hesitate, it is better to immediately contact a cardiologist who will prescribe all the necessary tests and help find the true cause of the symptoms.

Consequences of extrasystole

Extrasystole is divided into several classes, depending on the complexity of the manifestation.

1 class - the occurrence of up to 30 extraordinary strokes within an hour. It is not dangerous to human life, since such a number of strokes is considered the norm.

Grade 2- over 30 extraordinary strokes per hour, a more complex manifestation than class 1, but practically does not lead to negative consequences.

Grade 3 - extrasystoles in a certain section of the ECG have a different shape (they are also called polymorphic). With frequent occurrence, additional diagnostics and treatment are required.

4th grade subdivided into 2 subclasses:

• 4A - pair races, following one after another;
• 4B - from 3 to 5 extrasystoles in a row.

5th grade- the occurrence of early extraordinary strikes.

If classes 1-3 practically do not harm the body and with timely treatment, the symptoms completely disappear, then 4 and 5 can lead to ventricular fibrillation and tachycardia, which in turn causes a complete cardiac arrest. This is especially true for people over the age of 50 and those with heart disease.

With a large number of extrasystoles, the performance of the heart also decreases, since the main function of the heart is disrupted.

Methods for diagnosing extrasystole

The disease can be diagnosed in several ways. The most common option is that a patient with appropriate complaints and symptoms comes to the doctor, who, in turn, prescribes the most common daily ECG. After that, depending on the identified class of the disease, treatment is prescribed. The latter happens only if it is really necessary.

The main diagnostic methods include:

• daily ECG monitoring;
• analysis of patient complaints;
• differential diagnosis.

If it is not possible to detect a rhythm disturbance in a calm state using an ECG, special tests are prescribed in which the body is physically loaded (running, walking, physical exercises).

The most common tests:

• treadmill test - the use of a treadmill with an electrocardiograph and devices for measuring blood pressure connected to the patient;
• bicycle ergometry - the use of an exercise bike to create physical activity, equipment for measuring ECG and blood pressure during the actual exercise, as well as at the rest stage.

In the presence of possible concomitant abnormalities in the work of the heart, the following can also be prescribed:

• Ultrasound of the heart;
• magnetic resonance therapy of the heart (MRI);
• stress Echocardiogram.

Extrasystole of the heart - methods of treatment

Based on the analyzes obtained and the presence of the number of daily extrasystoles in the amount of more than 200, treatment is prescribed. The very process of getting rid of the disease is aimed at eliminating the cause of its occurrence. In some cases (if extrasystole is manifested as a result of neurogenic factors), an additional consultation with a neurologist is required, who will prescribe complex therapy aimed at normalizing the functioning of the nervous system. This may be taking various decoctions of herbs, for example, motherwort, or the use of sedative medications.

The treatment of extrasystole of physiological origin, depending on the stage, will be dealt with therapist, cardiologist, general diagnostician or cardiac surgeon.

In the treatment, drugs against arrhythmias are used, strictly in an individual amount. The patient is under constant supervision, and each change (in a positive or negative direction) is strictly controlled and recorded. If the current drugs are ineffective, others are prescribed.

If stage 4 or 5 of development is detected, it may be necessary to install a defibrillator-cardioverter (aka a pacemaker), since there is a rather high probability of cardiac arrest.

Depending on the forecasts for the development of extrasystoles, you can install the device temporarily or permanently. If the heart needs constant stimulation, the device is sewn under the fat layer.

In this case, only local anesthesia is used and the patient is conscious during the operation.

Surgical intervention during implantation is not dangerous and leaves practically no traces. The place of implantation (left or right) will be determined with each patient individually.

The defibrillator-cardioverter will stop fibrillation if necessary, and in case of cardiac arrest it can deliver up to 6 discharges, which will help the organ to work again.

In any case, if a disease is detected, it will be necessary to refuse:

• alcoholic and tobacco products;
• drinks containing caffeine (coffee, tea, cola, etc.);
• excessive physical activity;
• as with most diseases of the cardiovascular system, regulate food intake (especially fatty foods), and, if necessary, with the help of a nutritionist, draw up an appropriate diet course

Medications / drugs in the treatment of extrasystole

Modern classical medicine, unfortunately, is not yet developed enough to completely treat diseases without the use of medicines.

Supraventricular extrasystole:

• ethacizin;
• beta blockers;
• propafenone;
• verapamil,
• amiodarone.

Ventricular extrasystole:

• sotalol,
• amiodarone,
• etatsizin,
• propafenone.

The most commonly used treatment is propafenone.

propafenone is a drug that belongs to the class 1C antiarrhythmic drugs. It normalizes the rhythm of contraction of the heart muscle, and also dilates blood vessels, thereby reducing excessive cardiac workload. During its existence, with proper application, it shows efficiency results of more than 70%.

The drug can be administered orally or intravenously. With intravenous administration, the dose is calculated based on the total weight of the patient. It is administered under ECG monitoring, and if side effects occur, the dose and rate of administration are reduced.

Side effects: dizziness, double vision, feeling of heaviness in the head.

Contraindications: if the patient has renal or hepatic insufficiency, impaired excitation of the conduction pathways of the heart, as well as intraventricular conduction; in case of circulatory insufficiency, as well as pregnant women, it is used only under the close supervision of the attending physician.

Medicines and methods of treatment are offered for information only and in no way for self-treatment. Examination and treatment is carried out by a specialist doctor.

Despite the fact that the initial stages of extrasystole do not pose any threat to a healthy human body, it is still necessary to periodically undergo a preventive examination, since this is the best way not only to cure the disease at an early stage, but also to prevent its occurrence with all the negative consequences.

In any case, when symptoms are detected, you should not rely on the fact that this is temporary, but you should immediately seek advice from the appropriate specialist. Such an action will help save health, nerves, as well as money for treatment.

Any surgical intervention is an additional trauma for the body, therefore, when determining the indications for its implementation, it is necessary to correctly correlate the risk of complications, the benefits of the operation and the severity of the consequences if it is refused. Anesthesia for concomitant heart diseases in itself is associated with a certain risk of complications; special indices are used to assess the likelihood of their development, which take into account the influence of risk factors:

• early or late postinfarction period;
• ischemic heart disease, angina pectoris;
• rhythm disturbances: extrasystole, atrial fibrillation, bigeminia;
• high or low blood pressure;

Patients with hypertension are at risk due to possible complications during surgery

• operated and non-operated heart disease;
• age, the presence of concomitant diseases of other systems and organs.

Each item, depending on the severity and severity of the manifestation of violations, is assigned a certain number of points, and according to their sum, a conclusion is made about the magnitude of the risk of complications during and after the operation. If the risk is low, it is possible to perform a full surgical intervention, and the type of anesthesia is chosen in accordance with the scope of the intended intervention. Problems during local anesthesia or anesthesia in patients of this category occur no more often than in healthy patients.

A special risk index is used to determine the indications, choose the method of surgery and pain relief in patients with heart pathology, which is calculated based on the history of a cardiac disease after determining the current state.

With an average level of risk of cardiovascular complications, the least traumatic surgical technique is chosen, with the help of which the desired effect can be achieved. In patients with coronary artery disease and rhythm disturbances, especially atrial fibrillation, local regional anesthesia in combination with sedation is preferred if possible; with heart defects, this issue is resolved individually, depending on the type of pathology. With a high risk of complications, operations are performed exclusively for health reasons, in this case, as a rule, general anesthesia is used.

Endotracheal anesthesia

Operations on the respiratory organs, heart and blood vessels are performed exclusively under general endotracheal anesthesia, as this is the only method of pain relief that can provide adequate analgesia and maintenance of vital functions during such interventions. Open abdominal operations on the abdominal cavity are also performed under general anesthesia, since it is impossible to provide a good level of pain relief and muscle relaxation for a long period with the help of a spinal or epidural block without the risk of additional complications.

When performing laparoscopic operations, interventions on the pelvic organs, perineum, rectum, lower extremities, the choice of anesthesia is carried out taking into account the volume of the operation and the type of concomitant heart pathology. In the process of preparing for a planned operation, the patient should be examined by an anesthesiologist in advance. In this case, he will be able to prescribe all the necessary studies and consultations of related specialists after his examination, and this makes it possible to choose the right technique and tactics of local anesthesia.

Preparing for surgery under general anesthesia

To prepare for surgery, patients with cardiovascular pathology are prescribed an extended examination. In addition to the ECG, echocardiography, ultrasound of the heart, and exercise tests are prescribed. For patients with extrasystole, cardiac arrhythmia, especially its atrial form, as well as with clinical manifestations of sinus bradycardia, 24-hour Holter monitoring is necessary. In addition, blood pressure is regularly measured and the whole range of laboratory tests provided for by the standard scheme is carried out.

The decision to stop taking medications for maintenance therapy is made by the cardiologist together with the attending physician and the anesthetist, usually as follows:

• Nitropreparations, adrenoblockers and vasodilators, calcium channel blockers are taken until the very day of the operation. Cardiac glycosides are canceled a few days before it, to maintain the contractility of the heart, the anesthesiologist will inject special short-acting drugs intravenously;
• Indirect anticoagulants, which are usually taken by patients after valve replacement, stenting or coronary artery bypass grafting 4-5 days before surgery, are replaced with direct ones (heparin, fraxiparin are administered) to make it easier to manage hemostasis during surgery.

Direct acting anticoagulant

• Patients operated on for congenital and acquired defects of the valvular heart system and having endoprostheses can be operated on only after a prophylactic course of antibiotic therapy, this is necessary to prevent the development of infective endocarditis.

In the presence of cardiac arrhythmia, additional therapeutic measures are taken:

• When detecting cardiac arrhythmia, it is important to determine its cause and take measures to eliminate it. It can be caused by ischemia of a portion of the myocardium, improper selection of drugs, or their side effects. Ventricular extrasystole may be associated with a sharp smoking cessation in patients with a long smoking history.
• Atrial fibrillation is a relative contraindication to elective surgery. Surgical intervention is possible only in the normosystolic form, that is, when the contraction of the ventricles, despite inadequate atrial work, occurs in the "normal" mode. If the rhythm in atrial fibrillation cannot be restored with the use of antiarrhythmic drugs, the placement of a temporary pacemaker should be considered.

Important to know: preparation for surgery for patients with diseases of the cardiovascular system includes examination by a cardiologist and correction of previously recommended prescriptions. Especially carefully examine patients with atrial fibrillation.

Man consulting a cardiologist

Physiological sinus bradycardia in trained individuals does not adversely affect the course of anesthesia, in the presence of clinical symptoms, this condition requires correction or the installation of a pacemaker. In addition, additional drugs can be prescribed to correct the rhythm in atrial fibrillation and extrasystole, as well as to improve coronary circulation.

Features of general anesthesia in cardiovascular pathology

Regardless of the method of anesthesia in the presence of coronary artery disease, angina pectoris, cardiac arrhythmia, including atrial fibrillation and extrasystole, it is necessary to conduct continuous cardiorespiratory monitoring throughout the operation. A cardiogram is recorded, pulse, blood pressure and blood oxygen saturation are measured. This helps to recognize bradycardia, an increase or decrease in blood pressure, as well as myocardial hypoxia in time and prescribe drugs that will help restore heart function.

When performing general anesthesia, drugs with a minimal effect on hemodynamics should be chosen. To minimize the negative impact, combined anesthesia is used. For the prevention of bradycardia, anticholinergics (atropine) are introduced into the sedation.

Anticholinergic drug for premedication

How anesthesia can affect the work of the heart and how to get rid of the consequences?

Modern drugs for anesthesia and local anesthesia are completely eliminated from the body within a day after anesthesia and cease to have any effect on the heart. Only intranarcotic complications can affect the work of this organ: acute disturbances in the rhythm and blood supply of the myocardium, disturbances in the rhythm of breathing and electrolyte balance during surgery. Such complications are diagnosed even while the patient is in the hospital, so the doctor has the opportunity to prescribe adequate treatment.

Heart disease is always accompanied by increased patient anxiety for their own health. After all, this organ is the main motor in the human body, on which life and general well-being depend. One of the most common diagnoses today, established by doctors, is cardiac arrhythmia. An ailment develops due to an organic lesion of the heart muscle, manifested by unstable work, a violation of the strength and frequency of heart beats. This pathology is characterized by uneven contraction of the myocardium and any disturbances in the rhythm of the heartbeat.

What can cause illness?

Failures of the heart and blood vessels occur for many reasons. The onset of the disease can be provoked by concomitant pathologies of other organs and systems, external factors, and an unhealthy lifestyle. There are three types of causes that cause the development of arrhythmia:

• extracardiac factor. This includes emotional and physical overload, the influence of medications, and the abuse of bad habits. Hyperfunction of the thyroid gland, various lesions of the central nervous system. Dehydration, dysfunction of the autonomic nervous system, trauma, genetic predisposition, insect bites.

Cardiac arrhythmia is a violation of the heart rhythm in myocardial infarction, heart defects, dysfunction of the autonomic nervous system

• cardinal reasons. These include heart failure, coronary heart disease, hypertension. Heart defects of various etiologies, infectious and non-infectious myocarditis, anesthesia during surgical interventions and diagnostic measures on the heart, age-related degenerative processes in the muscle of an important organ.
• idiopathic factors. The development of the disease occurs without an established cause.

You can not ignore the dangerous signals of the body. At the first signs of failures in the work of the cardiovascular system, consult a doctor who will help to find out the cause of the development of the disease, select an adequate therapy.

A variety of arrhythmias

By the nature of the clinical manifestations of failures of the heart are divided into permanent and transient. The disease manifests itself in acute and chronic forms. All arrhythmias, combined into a common classification according to international standards, slightly differ in symptoms. Some types of diseases are life-threatening, carry a mortal threat. According to the generally accepted classification, the disease is divided into the following varieties:

• Extrasystoles. With this type of disease, there is no definite sequence of contractions, and they begin from the ventricles or atria. Whereas in the normal state they come from the sinus node. Often the disease goes away without visible signs and complaints in most people. The characteristic signs of the disease are considered premature contractions of the heart, accompanied by increased anxiety, fading or a strong heartbeat, lack of air. The symptoms must be taken very seriously in order to prevent oxygen starvation of the brain and the development of angina pectoris.

If the heart at rest begins to beat at high speed, and even in the wrong rhythm, then you can suspect atrial fibrillation

• Atrial fibrillation or atrial fibrillation. It often develops as a result of ischemic myocardial disease. The cause of the onset of pathology can also be thyroid disease. The following symptoms are characteristic of this type of ailment: violations of intensity, rhythmic contractions of the myocardium, fainting, lack of air, shortness of breath, increased anxiety, fear, pain in the chest. Often, atrial fibrillation attacks go away on their own without drug therapy. With prolonged paroxysms lasting weeks, you need to consult a doctor.
• Ventricular tachycardia. It is characterized by an acceleration of the rhythm of myocardial contractions originating from the ventricles. Such tachycardia leads to incomplete blood filling of the organ, which leads to a decrease in the volume of extruded blood. The disease is severe. It happens in an unstable and persistent form, in which a sudden stop of blood flow is possible.

Atrial fibrillation can most often occur with severe heart disease and much less often with functional disorders.

• . Pathologies are characterized by coordinated contractions of the heart, but at irregular intervals. It does not carry the danger of developing complications, but it can be a concomitant symptom of pathologies and heart failure. It develops as a result of the abuse of alcohol and nicotine. May be a consequence of some physiological conditions (overeating, excessive exercise, reaction to intimacy).
• Myocardial block. It is characterized by a complete stop or slowing of the patency of impulses in the cardiovascular system. The development of the disease is accompanied by concomitant pathologies of the heart. Significant symptoms of heart block are convulsions, periodic loss of pulse, a state of depression, decreased performance.
• Ventricular fibrillation. Characterized by continuous, disordered impulse flows coming from the ventricles and causing fibrillation. This leads to improper contraction of the ventricles, contributing to a violation of the pumping of blood through the body. This condition is extremely life-threatening and requires immediate resuscitation. A characteristic symptom of ventricular flutter is a contraction rate of 300 beats per minute. In this case, the myocardium does not fully perform its functions, as a result of which blood circulation stops. Clinical death occurs, the pupils do not react to light, the pulse and breathing disappear, the skin becomes cyanotic.

Atrial fibrillation can be suspected in a patient with thyrotoxicosis, if his shortness of breath increases, pallor of the skin appears, a tendency to lose consciousness

• Atrial flutter. A characteristic symptom is the frequency of myocardial contractions of 400 beats per minute, a strong pulsation of the veins in the neck. Manifested by rapid myocardial rhythm, hypotension, dizziness, fainting.
• sinus node dysfunction. It is characterized by a violation of the rhythm that occurs due to the cessation or dysfunction of automatism in the sinus node of the atria. The disease is provoked by other dangerous pathologies of the heart. Often this arrhythmia is asymptomatic. Sometimes it is manifested by memory impairment, convulsions, fainting.

The danger of surgery under anesthesia

All these factors become even more dangerous if surgical treatment is to be performed. After all, the use of anesthesia for arrhythmias is highly undesirable. Anesthesia for myocardial pathologies is accompanied by the risk of complications. It is determined using special indices that take into account the influence of hazard factors. The sum of points obtained by adding the scores corresponding to each of the risk points determines the risk of development after surgical complications.

The decision to use general anesthesia or full anesthesia is made by the anesthesiologist after a thorough review of the patient's medical history and research data.

In the case of low rates, surgical treatment is carried out in full, and the type of anesthesia is selected in accordance with the extent of the operation. With sinus arrhythmia of the heart, surgical manipulations under anesthesia are possible after a complete examination and a residual verdict of the anesthesiologist. In each case, the doctor selects anesthesia individually. Complications from the use of local anesthesia in cardiac pathologies appear with frequency, as in healthy patients.

With an average risk factor, a less traumatic method of surgical intervention is chosen, but giving a full therapeutic effect. Arrhythmia and general anesthesia are in some cases compatible. The doctor chooses its type from the severity of the pathology, according to vital indications. In other cases, local regional anesthesia is possible.

How to prevent the consequences?

High-quality agents for general and local anesthesia are excreted from the body during the day, ceasing their effect on the myocardium. Complications that appear during surgery can affect the work of the main motor of the body. A similar condition is diagnosed during the patient's stay in the hospital. Therefore, the patient receives adequate treatment on time.

From this article you will learn: what is ventricular extrasystole, its symptoms, types, methods of diagnosis and treatment.

Article publication date: 12/19/2016

Date of article update: 05/25/2019

With ventricular extrasystole (this is one of the types), untimely contractions of the ventricles of the heart occur - in another way, such contractions are called extrasystoles. This phenomenon does not always indicate any diseases, extrasystole sometimes occurs in completely healthy people.

If extrasystole is not accompanied by any pathologies, does not cause inconvenience to the patient and is visible only on - no special treatment is required. In the event that ventricular extrasystole was provoked by a violation of the heart, you will need an additional examination by a cardiologist or arrhythmologist, who will prescribe medications or surgery.

This pathology can be completely cured (if treatment is necessary) if the defect that caused it is surgically corrected - or you can achieve a lasting improvement in well-being with the help of medications.

Causes of ventricular extrasystole

The reasons for this phenomenon can be divided into two groups:

1. organic - these are pathologies of the cardiovascular system;
2. functional - stress, smoking, excessive coffee consumption, etc.

1. Organic causes

The occurrence of ventricular extrasystole is possible with such diseases:

• Ischemia (impaired blood supply) of the heart;
• cardiosclerosis;
• dystrophic changes in the heart muscle;
• myocarditis, endocarditis, pericarditis;
• myocardial infarction and postinfarction complications;
• congenital heart defects (open ductus arteriosus, coarctation of the aorta, ventricular septal defects, and others);
• the presence of extra conductive bundles in the heart (Kent's bundle in WPW syndrome, James's bundle in CLC syndrome);
• arterial hypertension.

Also, untimely contractions of the ventricles appear with an overdose of cardiac glycosides, so always consult your doctor before using them.

Diseases that cause ventricular extrasystole are dangerous and require timely treatment. If untimely contractions of the ventricles were found on your ECG, be sure to undergo an additional examination to check if you have the heart pathologies listed above.

2. Functional reasons

These are stress, smoking, drinking alcohol, illegal substances, a large number of energy drinks, coffee or strong tea.

Functional ventricular extrasystole usually does not require treatment - it is enough to eliminate its cause and once again undergo a heart examination in a couple of months.

3. Idiopathic form of extrasystole

In this condition, a completely healthy person has ventricular extrasystoles, the cause of which has not been elucidated. In this case, the patient usually does not have any symptoms, so treatment is not carried out.

Classification and severity

To begin with, we suggest that you familiarize yourself with what types of ventricular extrasystoles exist:

Three scientists (Laun, Wolf and Ryan) proposed the following classification of ventricular extrasystoles (from mildest to most severe):

• 1 type. Up to 30 single extrasystoles of the ventricles per hour (up to 720 pieces per day with a Holter study). Most often, such extrasystole is functional or idiopathic in nature and does not indicate any diseases.
• 2 type. More than 30 single untimely contractions per hour. It may indicate, and may be functional. By itself, such an extrasystole is not very dangerous.
• 3 type. Polymorphic ventricular extrasystoles. May indicate the presence of additional conducting bundles in the heart.
• 4A type. Paired extrasystoles. More often they are not functional, but organic in nature.
• 4B type. Group extrasystoles (unstable). This form occurs due to cardiovascular disease. Dangerous development of complications.
• 5 type. Early group ventricular extrasystoles (visible on the cardiogram in the first 4/5 of the T wave). This is the most dangerous form of ventricular extrasystole, as it often causes life-threatening forms of arrhythmias.

Symptoms of ventricular extrasystole

Rare single extrasystoles of a functional or idiopathic nature are usually visible only on the ECG or during the daily. They do not show any symptoms, and the patient is not even aware of their presence.

Sometimes patients with functional ventricular extrasystole complain of:

• feeling as if the heart stops (this is due to the fact that an extrasystole can be followed by an extended diastole (pause) of the ventricles);
• feeling of tremors in the chest.

Immediately after exposure to the cardiovascular system of an adverse factor (stress, smoking, alcohol, etc.), the following signs may appear:

• dizziness,
• pallor,
• sweating,
• feeling as if there is not enough air.

Organic ventricular extrasystole, which requires treatment, is manifested by symptoms of the underlying disease that caused them. There are also signs listed in the previous lists. They are often accompanied by bouts of squeezing pain in the chest.

Attacks of unstable paroxysmal tachycardia are manifested by the following symptoms:

• severe dizziness,
• fainting state,
• fainting
• "fading" of the heart,
• strong heartbeat.

If the treatment of the disease that caused this type of ventricular extrasystole is not started on time, life-threatening complications may appear.

Diagnostics

Most often, ventricular extrasystole is detected during a preventive medical examination during an ECG. But sometimes, if the symptoms are pronounced, the patients themselves come to the cardiologist with complaints about the heart. For an accurate diagnosis, as well as determining the primary disease that caused ventricular extrasystole, it will be necessary to undergo several procedures.

Initial inspection

If the patient himself came with complaints, the doctor will interview him to find out how severe the symptoms are. If the signs are paroxysmal in nature, the cardiologist must know how often they occur.

Also, the doctor will immediately measure blood pressure and pulse rate. At the same time, he can already notice that the heart is contracting irregularly.

After the initial examination, the doctor immediately prescribes an ECG. Focusing on its results, the cardiologist prescribes all other diagnostic procedures.

Electrocardiography

According to the cardiogram, doctors immediately determine the presence of ventricular extrasystoles.

Not on the cardiogram, ventricular extrasystole manifests itself as follows:

1. the presence of extraordinary ventricular QRS complexes;
2. extrasystolic QRS complexes are deformed and expanded;
3. there is no P wave before the ventricular extrasystole;
4. after an extrasystole there is a pause.

Holter examination

If pathological changes are visible on the ECG, the doctor prescribes daily ECG monitoring. It helps to find out how often the patient has extraordinary contractions of the ventricles, whether there are paired or group extrasystoles.

After a Holter examination, the doctor can already determine whether the patient needs treatment, whether extrasystole is life-threatening.

Ultrasound of the heart

It is carried out to find out which disease provoked ventricular extrasystole. It can be used to detect dystrophic changes in the myocardium, ischemia, congenital and acquired heart defects.

coronary angiography

This procedure allows you to assess the condition of the coronary vessels that supply oxygen and nutrients to the myocardium. Angiography is prescribed if the ultrasound showed signs of coronary heart disease (CHD). After examining the coronary vessels, you can find out exactly what provoked coronary artery disease.

Blood test

It is carried out to find out the level of cholesterol in the blood and to exclude or confirm atherosclerosis, which could provoke ischemia.

EFI - electrophysiological study

It is carried out if there are signs of WPW- or CLC-syndrome on the cardiogram. Allows you to accurately determine the presence of an additional conductive bundle in the heart.

Therapy of ventricular extrasystoles

Treatment of untimely contractions of the ventricles is to get rid of the cause that provoked them, as well as stopping attacks of severe ventricular arrhythmia, if any.

Treatment of the functional form of extrasystole

If ventricular extrasystole is functional, then you can get rid of it in the following ways:

• quit bad habits;
• take drugs to relieve nervous tension (valerian, sedatives or tranquilizers, depending on the severity of anxiety);
• adjust the diet (refuse coffee, strong tea, energy drinks);
• observe the regime of sleep and rest, engage in physiotherapy exercises.

Organic Form Treatment

Treatment of the organic form of type 4 disease involves taking that helps get rid of attacks of ventricular arrhythmia. The doctor prescribes Sotalol, Amiodarone or other similar medicines.

Also, with pathologies of types 4 and 5, the doctor may decide that it is necessary to implant a cardioverter-defibrillator. This is a special device that corrects the heart rate and stops ventricular fibrillation if it occurs.

Treatment of the underlying disease that caused ventricular extrasystole is also required. Often, various surgical procedures are used for this.

Surgical treatment of the causes of ventricular extrasystole

Consequences of ventricular extrasystole

Type 1 ventricular extrasystole, according to the classification given above in the article, does not pose a threat to life and usually does not cause any complications. With type 2 ventricular extrasystole, complications may develop, but the risk is relatively low.

If the patient has polymorphic extrasystole, paired extrasystoles, unstable paroxysmal tachycardia or early group extrasystoles, the risk of life-threatening consequences is high:

To avoid life-threatening consequences, do not delay starting treatment if you have a ventricular premature beat.

Prognosis for pathology

With extrasystole of the ventricles of types 1 and 2, the prognosis is favorable. The disease practically does not affect the quality of life of the patient and does not cause serious consequences.

With ventricular extrasystoles of type 3 and above, the prognosis is relatively favorable. With timely detection of the disease and the beginning of therapy, you can completely get rid of the symptoms and prevent complications.