How to get rid of extrasystoles forever - extrasystoles in the heart is it dangerous. Diagnosis of extrasystole: treatment, drugs to normalize the work of the heart Extrasystole is dangerous

Extrasystoles (extrasystoles)- a violation of the normal rhythm of the heart, characterized by an extraordinary contraction of the myocardium and / or its chambers (atria, ventricles). At this moment, at the beginning, a person may feel as if the heart stopped and lack of air, after a strong blow, and at the end - the restoration of the normal rhythm of heart contractions. This clinical picture is very well displayed on the electrocardiogram (ECG), a photo of which we will attach a little further.

Extrasystole is one of the types, and can have both a short-term (neurogenic) character, which is due to drinking coffee or alcohol, smoking, or a long course, signaling the presence of any (CHD, atherosclerosis,).

The main symptoms are discomfort and pain in the region of the heart, feelings of anxiety and lack of air, excessive sweating.

Development

To understand the principle of the pathogenesis of extrasystoles, you first need to know the mechanism of myocardial contractions. Let's make this short.

Thus, the contraction of the heart muscle (myocardium) causes an electrical impulse, which is formed in the conduction system of the heart. This neurogenic impulse originates in the sinoatrial (sinoatrial) node, then passes through the internodal pathways of the atria, causing their depolarization. Further, the signal passes through the atrioventricular node and at the end, through the atrioventricular bundle is sent to the muscles of the ventricles.

The slightest impact on the constituent elements of this system leads to a violation of the uniform passage of the impulse, the delay of which (compensatory pause) externally manifests itself in the form of an arrhythmia, or, as in our case, extrasystoles.

Statistics

According to medical statistics, in the world, extrasystoles occur in about 65-70% of healthy people. If about 200 ventricular and supraventricular extrasystoles are observed per day, then this is a normal indicator that does not cause discomfort in a person. However, with pathologies of the heart and other diseases, the number of extrasystoles per day can reach 6-10 thousand, and here it is almost impossible to do without going to the doctor.

Secondary factors, such as bad habits, unhealthy lifestyle, junk food and stressful situations, do their job, causing serious damage not only to the heart, but to the whole body as a whole.

ICD code

ICD-10: I49.3
ICD-9: 427.69

Symptoms of extrasystole

Symptoms depend on the cause of the failure of the heart, the age of the person and the state of health.

Single extrasystoles caused by stress, drinking tea or coffee may not manifest themselves and the person will not feel anything. Sometimes sharp tremors of the myocardium can be felt, which a person quickly forgets about.

Extrasystoles that develop against the background of various diseases are accompanied by the following clinical picture:

• Feeling of a sinking heart, as if it stops, lack of air and discomfort in the chest, then a sharp push of the heart muscle, after which the rhythm of the myocardium is restored;
• Anxiety, restlessness, fear;
• , increased sweating;
• Pain in the region of the heart;
• Decreased pulse.

Group extrasystoles, when violations occur repeatedly, one after another, or single, but often, due to less blood ejection, normal blood supply decreases, and, accordingly, the nutrition of the brain, coronary vessels of the myocardium, kidneys and other important organs by about 8-25%. This leads to the following symptoms:

• , fainting;
• Disorders in the work of the auditory and speech apparatus (aphasia);
• Pressing pain in the heart ();
• Paresis.

Complications

Among the most common complications of extrasystole are:

• Increase in heart rate on an ongoing basis (paroxysmal);
• Atrial fibrillation;
• Complications of cardiovascular diseases.

External causes of extrasystoles:

• Stress is the main culprit in almost all types of arrhythmias;
• , coffee, strong tea;
• smoking, drugs;
• Uncontrolled intake of drugs, in particular - caffeine, aminophylline, ephedrine, novodrine, neostigmine, glucocorticosteroids (GC), diuretics, tricyclic antidepressants and others;
• Poisoning the body or various chemicals;
• Great physical stress on the body.

Internal causes of extrasystoles:

• Diseases of the cardiovascular system -, cardiosclerosis, cardiomyopathy,;
• Neurological diseases -,;
• Diseases of the musculoskeletal system -,;
• Violation of the ion exchange of potassium, magnesium, sodium and calcium in the myocardium;
• Changes in the hormonal background -, ovulation, (overproduction of hormones by the thyroid gland, large doses of which poison the body);
• Other diseases and conditions - inflammatory processes, amyloidosis, sarcoidosis, hemochromatosis.

Classification of extrasystoles

The classification of extrasystoles is as follows:

By localization

• Ventricular - 62.5% of cases;
• Atrial - 25% of cases.
• Atrioventricular and nodal (atrioventricular) - 2%.
• Sinus-atrial (sinus extrasystole) - 0.5%.
• Combined - 10%

By etiology (cause of occurrence):

Functional extrasystoles- development occurs mainly as a result of violations of the functioning of the nervous system, in particular - with neurosis, autonomic dysfunction. They are characterized by the presence at rest, and the cessation after emotional experiences or physical exertion. The ECG displays monotopic changes in the ventricles.

Organic extrasystoles- development occurs as a result of pathologies of the heart, blood vessels, endocrine system or poisoning of the body. They are diagnosed most often in the elderly. The ECG shows extrasystoles in all departments / nodes of the heart one by one or in a group, simultaneously everywhere. An important factor in the appearance is physical overwork and stress.

According to the source of excitation:

Monotopic - a stable interval between the peaks on the cardiogram and one focus of excitation;

Polytopic - various intervals between extrasystoles and several foci of appearance.

Unsustainable paroxysmal tachycardia - group extrasystoles, going one after another.

Classification of ventricular extrasystoles "Lown & Wolf"

I class- characterized by single repetitive extrasystoles in an amount - up to 30 per hour. It does not pose a danger, it does not need correction.

II class- characterized by single repetitive extrasystoles in the amount of 30 or more per hour. Despite slight deviations in the rhythm, there are no serious health consequences.

III class- characterized by chaotic cardiac complexes with different intervals, form and number of episodes. A person requires medical assistance in correcting the work of the heart.

IVa class- characterized by paired, following one after another extrasystoles, as well as high variability, leading to pathological changes in the cardiovascular system.

IVb class- volley 3-5 extrasystoles, following one after another, high gradation and irreversible consequences in the work of the body, especially the heart and blood vessels. It poses a danger to human life.

V class- characterized by early extrasystoles (R, T) and high gradation, leading to cardiac arrest.

Diagnostics

Diagnosis of extrasystole includes:

• Initial examination, anamnesis;
• , incl. daily monitoring (ECG-Holter) and ECG under physical activity (veloergometry);
• To clarify the diagnosis, the heart may also be required.

How to treat extrasystole? The scheme for the treatment of extrasystole looks something like this:

1. Exclusion of the pathogenic factor.
2. Diet.
3. Drug treatment.
4. Surgical treatment.

The prescription of drugs and the treatment regimen directly depend on the type of pathology, its etiology, the presence of concomitant and the patient's health status.

1. Exclusion of the pathogenic factor

We have already written about what drugs and factors affect the heart in such a way that its normal rhythm of work changes (see "Causes of extrasitolia").
First of all, it is necessary to exclude these factors. If the rhythm is restored in the first or two days, then there is no need to go to the doctor. This is exactly the period when most of the drugs that can cause extrasystoles are excreted from the body.

Do not forget about peace for the body - reduce physical activity, remove the stress factor, which can be, for example, watching a news bulletin.

There is a good effect on the heart when swimming, moderate walking, slow riding or cycling.

2. Diet for extrasystoles

Magnesium (Mg)- an important macronutrient in living organisms, which has a beneficial effect and contributes to the normal functioning of the heart and other muscle tissues. A special moment should be given to the simultaneous intake of magnesium, which is responsible for the functioning of the nervous system.

The following products have a high magnesium capacity - pumpkin seeds, various nuts, cereals (buckwheat, oats, wheat), watermelon, mackerel, spinach, lettuce, persimmon, raisins, dried apricots, bananas, apples, legumes and others. It is necessary to exclude heavy fatty foods, fried foods, smoked meats from the diet.

A large amount of Omega-3 is present in sea fish, linseed oil,.

A large amount of potassium is present in candied fruits, apricots, dried apricots, wheat bran, beans, peas, tomato paste, prunes, raisins, flaxseed.

This pathology has many different causes. The heart has a protective mechanism that responds to changes in heart rate. Sometimes the cause of the violation of organ contractions is unknown and then the extrasystole is called idiopathic.

If rhythm disturbances are caused by physiological factors, extrasystoles in the heart are not a pathology. They disappear immediately after the elimination of irritants. These reasons include:

• nervous and emotional outbursts,
• increase in blood pressure,
• alcohol abuse,
• smoking,
• heavy physical activity,
• pregnancy or menopause.

Other causes of extrasystoles include:

• organic lesions of the heart,
• osteochondrosis,
• lack of potassium in the body,
• Vegetovascular dystonia.

The pathogenesis of extrasystole disease is different, it can be caused by many factors. Even periodic female cycles against the background of certain pathologies of the body. But there is a division into two large groups: functional causes and organic.

A common type of arrhythmia is a premature contraction of the heart muscle.

Untimely depolarization of the heart on the ECG

Types of extrasystoles

There are four types of this disease - sinus, atrioventricular, atrial, ventricular. The first two are extremely rare.

The types of cardiac extrasystole are different, as well as the parameters for dividing into groups. Classification according to the place of formation of ectopic foci:

• Ventricular extrasystolic arrhythmia - occurs most often.
• Supraventricular, including ventricular extrasystole.
• Atrial, including stem extrasystoles.
• Sinus or nodal extrasystole.
• Atrioventricular.
• There are also various combinations of the mentioned varieties - in 10% of cases.
• Least of all, but sometimes extraordinary impulses come from the sinoatrial node - 0.2% of cases.

A rhythm disturbance can occur both in the elderly and at a young age, regardless of the sinus - the main one. In this case, extrasystolic and sinus rhythm can be observed. This condition is called parasystole.

If there are two consecutive impulses, then these are paired extrasystoles, if more than two, group extrasystoles are also called volley.

Another classification:

1. Bigeminia - this is the name of the rhythm in which single extrasystoles alternate with normal systole.
2. Trigeminia - 2 consecutive normal systoles 1 extrasystole.
3. Quadrihymenia - 3 normal systoles turn into 1 extrasystole.

If such repetitions become constant, then a diagnosis of allorhythmia is made.

In medical practice, there are several types of extraordinary contractions of the heart muscle. Depending on this, extrasystole manifests itself in different ways and develops in the future.

Extrasystole when carrying a child

The reason for the appearance of extrasystole during childbearing is a powerful hormonal restructuring. During this period, a woman can experience all types of the pathological condition in question. Often, treatment of extrasystole of the heart in this case is not required. Discomfort conditions that are felt will pass after delivery.

It used to be that the more common form of extrasystole in children was ventricular. But now all types of extrasystoles occur with almost the same frequency.

This is due to the fact that the child's body grows rapidly, and the heart, unable to cope with such a load, "turns on" compensatory functions due to all the same extraordinary contractions. Usually, as soon as the growth of the child slows down, the disease disappears by itself.

Symptoms

Often, patients with extrasystole do not feel its symptoms. The signs of this pathology are more pronounced in people suffering from vegetovascular dystonia.

With some organic lesions of the heart, extrasystoles can be tolerated even more easily than in the absence of concomitant diseases.

With extrasystole, patients note peculiar tremors, "turning over" the heart, in other words, sharp interruptions and fading. With functional disorders, general discomfort, weakness, hot flashes, sweating, lack of air can be observed.

In people with atherosclerosis, coronary circulation disorders, dizziness, paresis, fainting are possible.

Extrasystoles are not always clinically pronounced. It depends on the functional and morphological features of the organism.

Most people do not feel this arrhythmia, but only accidentally detected on electrocardiography:

• Feeling of interruptions behind the sternum (in the heart);
• Weakness;
• Dizziness;
• Malaise;
• Labored breathing;
• restless state;
• Fear of dying;
• Panic attack.

Extrasystole can be accompanied by both a reduction and an increase in heart rate. With a disease of vegetovascular dystonia, the self-regulation of the heartbeat is disturbed and the nervous system is excessively excited.

Symptoms of extrasystole with VVD:

• Heart rhythm failures after excitement or without signs of stress on the psycho-emotional sphere;
• Panic attacks accompanied by unregulated fear;
• Anxiety for no apparent reason, it begins to seem that something bad is about to happen;
• Irritability, while you can notice that you are wrong, but it is difficult to stop an attack of anger;
• Weakness, fatigue;
• Insomnia, sleep disturbance;
• Increased or slow heartbeat with one or more missed beats;
• shortness of breath, feeling short of breath;
• When excited, or for no reason throws into a hot sweat or chills;
• Dizziness, fainting due to insufficient saturation of the brain with oxygen in case of heart rhythm failures;

The symptoms of extrasystole are not always obvious, sometimes it can only be recognized on a cardiogram, but there are no clinical manifestations. Explicit symptoms appear in people with organic heart disease. Extrasystole has different symptoms, treatment is prescribed based on them and hardware diagnostics. Specific signs of cardiac extrasystole:

1. Sensation of a strong shock in the heart, its upheaval.
2. Failing heart, failure of work.
3. Discomfort, sometimes mild pain in the heart.
4. Swelling of the veins in the neck immediately after an extrasystole.
5. Weakness, pallor, shortness of breath.
6. Increased sweating, hot flashes.
7. It becomes difficult to breathe.
8. Anxiety, fear of death.
9. Irritability, mood swings.

Night. Lying in bed relaxed, ready to fall into a deep night's sleep. Suddenly, a lump rises to the throat, you swallow convulsively and feel as if something is turning over behind the sternum.

A familiar feeling? I think that some of you have experienced something similar not only before sleep, but also in the waking state. Usually such symptoms are manifested by ventricular extrasystole. And many people ask me the question: is extrasystole in the heart dangerous?

Atrial extrasystole does not cause such discomfort and is often not felt by a person at all, only with a pronounced heartbeat.

Diagnostics

The main diagnostic method for complaints of heart rhythm failures is electrocardiography. For a more accurate picture of the disease, the doctor prescribes a general blood and urine test. Additional examinations are possible to exclude pathologies of other organs.

Conservative treatment is prescribed taking into account the patient's condition and diagnostic results. Usually it consists in taking antiarrhythmic drugs. Patients with concomitant organic pathologies of the heart are prescribed sotalol, amiodarone, and adrenoblockers.

A patient who wonders why extrasystoles are dangerous should reconsider his lifestyle, give up bad habits, and eliminate nervous stress. A balanced diet, the right mode of work and rest is the key to a quick recovery.

The prognosis of extrasystole is quite favorable, but this does not mean that the disease can be left to chance. In addition to a cardiologist, the patient may need regular consultations of other specialists - a neuropathologist, an endocrinologist and a general practitioner.

The diagnosis is established on the basis of:

The easiest way to diagnose extrasystole is with an ECG. An electrocardiogram allows you to easily and accurately calculate any type of malfunction of the heart muscle. Indeed, on the ECG tape, normal and irregular, rapid contractions clearly appear.

But, unfortunately, it is not always possible to detect extrasystoles using an electrocardiogram. The fact is that this procedure does not last long, as a result of which violations of the work of the heart muscle may not be recorded.

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Treatment

The question of the treatment of extrasystoles is very complex.

When choosing antiarrhythmic treatment and its need, one should be based on the table proposed by Bigger:

1. Arrhythmias that have a benign course - extrasystoles and ventricular arrhythmias that do not cause hemodynamic disturbances, as well as the absence of structural disorders of the heart. The prognosis is often favorable in such patients, and they are not required in antiarrhythmic treatment.
2. Arrhythmias that have a malignant course - extrasystoles and ventricular arrhythmias causing hemodynamic disturbances, as well as structural changes in the heart tissue, require etiological antiarrhythmic therapy.
3. In young people with rare extrasitols, there is no need for specific antiarrhythmic treatment; when choosing a treatment, it is enough to give preference to a sedative drug and follow all preventive measures.

In case of an overdose of cardiac glycosides, it is necessary to cancel the glycoside, apply potassium, defenin preparations and detoxify with unitol.

For the treatment of extrasystoles, it is necessary to control the ions of potassium, iron, magnesium in the blood, since with hypokalemia the effectiveness of antiarrhythmic drugs is significantly reduced.

Among drugs, beta-blockers (propranolol, metoprolol, obzidan, oxprenolol, pindolol) have the best effect.

After conducting the necessary research and revealing that extrasystoles in VVD are functional, and not organic, you need to correct your psycho-emotional state and try to get rid of fears. This is not easy to do, but necessary.

In violation of the heart rhythm as a result of overwork, you need to allow yourself a good rest. First you need to sleep well.

The ideal option is a trip to nature or a spa treatment. The duration of night sleep should be at least 8 hours, while you need to go to bed no later than 22.

00. Physiotherapy calms the nervous system and improves blood circulation.

Breathing exercises allow you to restore the correct functioning of the heart.

What to do with extrasystoles, and what is better to avoid, the doctor will tell. Treatment methods:

1. Drug therapy of the emerging disease.
2. Sometimes only work with a psychologist.
3. Ethnoscience. It is possible to cure extrasystole if there are no organic pathologies of the heart.
4. radio frequency technique. After RFA of the heart, the rhythm stabilizes even when the number of extrasystoles is 20-30 thousand per day. It is possible to significantly reduce this figure.

The choice of treatment methods for any type of extrasystole is up to the doctor, since they have different effectiveness.

In cases where ventricular extrasystole occurs without symptoms and obvious signs, special treatment is not prescribed. Doctors recommend such patients to follow proper nutrition and exclude provoking factors (smoking, alcohol, coffee). When choosing drugs for the treatment of ventricular extrasystole, it is important to use an integrated approach.

If we talk about drug treatment, then the first series of drugs includes sedatives, which include small doses of tranquilizers: Diazepam and Beta-blockers - Propranolol or Metoprolol.

In cases where sedatives are ineffective, the doctor prescribes antiarrhythmic drugs: Propafenone, Lidocaine, Novocainamide.

Sometimes such a disease requires only psychological treatment. It happens that you just need to get a person out of an anxious or depressive state in order for this disease to go away. To do this, you can contact psychiatrists and psychologists.

You can also be treated with medication. What kind of medicine to take with extrasystole of the heart from unpleasant symptoms? In this case, use the following drugs:

• Allapinin, ethacizin, which are used for arrhythmias
• Metoprolol, Sotalol, which are adrenaline blockers
• Verapamil is a calcium antagonist drug.

Before starting treatment, you must always consult with your doctor. In no case should you self-medicate, since arrhythmia is a serious disease that can lead to various complications.

The doctor will conduct the necessary examination, measure blood pressure, prescribe additional methods of examination and, if necessary, prescribe appropriate medications. Remember: only a specialist should prescribe treatment for extrasystole of the heart.

If extrasystole is not life-threatening and is not accompanied by hemodynamic disorders, you can try to defeat the disease yourself. For example, when taking diuretics, potassium and magnesium are excreted from the patient's body.

Due to the fact that single extrasystoles are recorded in most healthy people, it cannot be said that this pathology can be completely cured.

Prevention

For prevention, you should follow certain rules that will help not only avoid the recurrence of the disease, but also strengthen the body in general:

• Try to adhere to a healthy lifestyle: do not eat fatty foods, exercise within reasonable limits, give up bad habits.
• get enough sleep
• Eat all kinds of vitamins
• Spend a lot of time outdoors
• Reduce emotional stress
• Avoid caffeine and energy drinks

After all, heart health should be a priority for every person!

Forecast

Infrequent extraordinary contractions of the myocardium are recorded on the ECG in more than 80% of people. Most of them are perfectly healthy and do not require any medical attention. It is only necessary to control the ECG in dynamics. The threat is posed by rhythm disturbances against the background of organic changes in the heart.

Prognostically more dangerous is ventricular extrasystole, which, unlike other types, is associated with an increase in mortality from blood flow disorders in the heart and brain. Moreover, this type of arrhythmia is more likely a reflection of the stage of damage to the heart tissue than the very cause of lethal ventricular fibrillation.

Therefore, in the case of an asymptomatic course of the disease, extrasystoles do not require treatment. Patients are shown the correction of the underlying cardiac pathology.

If there is no pathological change in the structure of the myocardium, but ventricular extrasystolic arrhythmia of any form is recorded, the risk of sudden death increases by 2–3 times.

For patients with acute myocardial infarction and (or) insufficient function of the heart muscle, this risk increases up to 3 times. This is due to the fact that extrasystoles, especially frequent and group ones, worsen the course of any cardiac pathology, quickly leading to the development of left ventricular failure.

Despite this, ventricular extrasystoles themselves, even in severe form, are not an independent prognostic criterion for life and working capacity. In most cases, any additional heartbeats are not dangerous.

Identification of this type of violation of the rhythm of myocardial contractions is an occasion for a full examination. Its goal is to exclude diseases of the myocardium and internal organs.

“Extrasystoles in the heart” - if you hear such a diagnosis from a doctor, then first of all, some kind of incurable, even fatal disease comes to mind. But is it? In fact, extrasystoles are nothing more than a violation of the heart rhythm. This problem occurs in more than 60% of people and is a type of arrhythmia. To fight seizures, you need to figure out what kind of disease it is and whether extrasystoles are dangerous.

Characteristic features of the disease

An extrasystole is an untimely full contraction of the heart. The main reasons for the appearance of extrasystole are: the use of alcohol and tobacco, frequent stress, an immoderate amount of strong coffee and tea. In this case, the attack may be one-time or rarely occurring. Often, people suffering from extrasystole have almost the same complaints, which carry quite unpleasant sensations:

• painful internal blows in the chest area;
• lack of air;
• sudden feeling of anxiety;
• feeling of a frozen heart.

Heartache

Group extrasystoles entail cough spasm, severe dizziness and pain in the chest. When a healthy heart works, electrical impulses appear in the so-called sinus node. In this case, the rhythm is not broken. For the appearance of an extrasystole in the heart, the vagus nerve somehow blocks the rhythm-forming node. As a result, the momentum transmission is slowed down.

There are places of increased activity outside the sinus node (in the atria, ventricles). To release the accumulated energy, the resulting impulses, with the help of the heart muscle, independently cause an extraordinary contraction of the heart. Then there is a pause, which causes a feeling of a frozen heart. This is an attack of extrasystoles in the heart.

Normally, a healthy person has about 200 single extrasystoles per day. This phenomenon is normal for those who play sports. Often, extrasystole is diagnosed in infants, children in adolescence and people over 60 years of age. There are even reflex extrasystoles, for example, with bloating and gastrointestinal diseases.

Sometimes all of the above symptoms with extrasystole may be completely absent or disguised as other diseases.

Reasons for the development of extrasystoles

There can be many reasons for the occurrence of heart rhythm disturbances. It is important to understand the cause and nature of the disease. Extrasystoles are divided into several groups.

Functional extrasystole

This type of extrasystole basically does not need medical treatment. The main method of preventing heart rhythm failures is to eliminate the factor that causes extrasystoles. In this case, the development of extrasystole is provoked by the following reasons:

• psychogenic - the presence of stress, psycho-emotional overwork;
• physical - carrying weights, overwork, running;
• hormonal - menstruation, pregnancy, abortion, menopause.

Avoid overeating, especially at night. The cause of extrasystole in this case is dysfunction of the vagus nerve.

Organic extrasystole

Frequent extrasystole occurs against the background of various diseases of the cardiovascular system, so it is called organic. In this case, an electrical heterogeneity occurs in the heart muscle, which affects the myocardium. Why is this happening:

• transferred cardiological operations;
• cardiac ischemia;
• heart disease;
• myocardial infarction;
• cor pulmonale;
• pericarditis;
• sarcoidosis;
• amyloidosis;
• hemochromatosis;
• development of myocardial dystrophy.

Not only heart disease can lead to extrasystoles. Often provocateurs can be malignant and benign tumors, allergies of various types, hepatitis, HIV, and even banal osteochondrosis of the thoracic region.

Toxic extrasystole

This is the most rare cause of extrasystoles. It develops in cases where there was drug poisoning, which resulted in an overdose or side effects:

• tricyclic antidepressants;
• glucocorticoids;
• eufillin;
• caffeine.

Another extrasystole in the heart may appear in a feverish state.

Diagnosis and detection of extrasystole

The key to successful treatment of extrasystoles is a correct diagnosis. First of all, the cardiologist examines and interviews the patient. The main complaints with extrasystole are a long stop between heartbeats, heart tremors in the chest.

During the conversation, the doctor should find out the nature and causes of the arrhythmia, which will help establish the extrasystole group. An important indicator is the frequency of occurrence of rhythm failures and the anamnesis of the patient's previous illnesses.

When performing palpation of the pulse on the wrist, extrasystoles are easily identified by premature pulse waves with a further prolonged pause. This indicates low diastolic filling of the ventricles.

Confirmation of extrasystole takes place after a series of diagnostic studies. Basically, they resort to the following procedures:

• electrocardiogram (ECG) - this study is carried out within 5-10 minutes. Indicators of extrasystole are the early appearance of the P wave or the QRST complex, obvious changes and increased amplitude of the extrasystolic QRS complex and insufficient compensatory pause;
• ultrasound examination (ultrasound) - takes about 10-15 minutes and helps to identify more serious heart diseases, such as a heart attack (if there are scars on the organ). With this outcome of the study, the treatment of extrasystole fades into the background and is a concomitant disease, and not the main one;
• An ECG Holter study is the longest method for diagnosing extrasystole, it takes one or two days. This type of diagnosis is prescribed to all patients with heart pathologies, despite the presence of complaints that indicate extrasystoles in the heart.

If the doctor has doubts about the origin of extrasystole, he may additionally prescribe an MRI (heart, coronary vessels), bicycle ergometry. It should be noted that the treatment of organic extrasystole will be fundamentally different from the treatment of functional or toxic. It would not be superfluous to conduct a hormonal study of the body, especially for women, in order to determine and exclude a malfunction in the endocrine system.

Classification of extrasystoles by type

The occurrence of an extrasystole in the heart can occur anywhere in the conduction system. In accordance with where the pathological impulse arose, the following types of disease are distinguished:

• supraventricular (it includes atrial, lower atrial and mid-atrial) - 3% of patients. It is considered the rarest form of extrasystole. The main reason for the appearance of this species is an organic lesion of the heart. Volleys of heart beats should draw the attention of the doctor, as the next step will be atrial fibrillation;
• ventricular - 62% of patients. It is the most common form of extrasystole. The danger of the species lies in terms of forecasting, therefore, maximum attention and accuracy in diagnosis is necessary. Often develops into ventricular tachycardia, the result of which is unexpected, sharp outbreaks of frequent ventricular contractions;
• nodular - 26% of patients. A fairly common type of extrasystoles, often caused by functional factors. Extrasystoles that appear are of a single nature, accompanied by bradycardia (slow pulse), and in patients of the older age group - tachycardia;
• polytopic - 9% of patients. A peculiar type of extrasystole, which requires long-term observation by a doctor. The difficulty lies in the fact that the place of excitation dislocation has not yet attached to a certain area, or the damage to the heart is too extensive that the impulse occurs anywhere.

If the patient has an atrial extrasystole, then the center of the origin of the impulse is in the atrium, and then it enters the sinus node and then down to the ventricles. This form of the disease mainly appears with organic damage to the heart. Often, the extrasystole manifests itself when the patient is sleeping or simply lying down.

Atrioventricular extrasystoles can be divided into three types:

• atria and ventricles are excited simultaneously;
• defective excitation of the ventricle, after which the atrium is also excited;
• disease with atrial excitation, and then going excitation of the ventricle.

Depending on the frequency of occurrence of extrasystoles, they are classified: rare (less than 5 per minute), medium (about 6-14 per minute) and frequent (more than 15 per minute). According to the number of foci, they are divided into: polytopic extrasystoles (there are several centers of excitation at once) and monotopic extrasystoles (only one focus of excitation).

Disease and pregnancy

Almost 50% of all pregnant women in one form or another have extrasystole. The main reason for this is and will be hormonal changes in the body of a woman. Expectant mothers are very worried that this problem can cause a contraindication to pregnancy. Actually, there is nothing to be afraid of. Extrasystoles in the heart are normal. It is important that the pregnant woman does not have heart disease.

And for the prevention of extrasystoles of the heart, it will be enough during pregnancy to provide a calm environment, not to overwork (physically and emotionally), to be more in the fresh air.

Today, medicine has stepped forward and doctors have the ability to measure the heart rate of a developing fetus. In most cases, extrasystoles in the heart are found in babies. An acceptable deviation from the norm is the appearance of extrasystoles, at least every 10 heartbeats.

If a woman has “simple” extrasystoles, then natural childbirth is not contraindicated for her. But if a woman in labor has an organic pathology of the heart, then she should be observed by a cardiologist throughout the pregnancy, and it is desirable to give birth by caesarean section.

What you need to know about treatment

Specialized drug treatment in many cases of extrasystoles of the heart is not required. In most cases, it is necessary to eliminate the cause that caused the violation of the rhythm of the heartbeat. But in order to improve well-being and prevent unexpected extrasystoles, it is advisable to eat right, give up bad habits, and take sedatives in stressful situations (preferably homeopathic remedies or herbs).

Folk methods for the treatment of extrasystole are only preventive in nature, and in no case can they replace the appointment of a doctor. To maintain treatment, you can apply the following recipes:

• add 2 teaspoons of hawthorn tincture to green tea;
• make a decoction of lemon balm, common heather, hops, hawthorn, motherwort (all in equal parts). In a glass of boiling water, a tablespoon of a dry mixture of herbs. Take 1/3 cup three times a day;
• a teaspoon of cornflower tincture is brewed in 200 g of boiling water, you need to drink only on the day of an attack, 50 g each.

If attacks of frequent extrasystoles are disturbing, in this case it is important to do the following:

• take a prone position;
• stop any kind of load;
• ensure an uninterrupted supply of fresh air;
• drink a sedative;
• perform breathing exercises with your eyes closed - take a very deep breath - hold your breath for a few seconds - exhale completely.

The appointment of treatment for extrasystole and the selection of the dosage of drugs occurs exclusively in conjunction with the attending physician. It is important to remember that extrasystoles are of a different nature, so it may be necessary to additionally consult a neurologist, endocrinologist and gastroenterologist.

The best treatment is prevention

Doctors have noticed that in the fight against relapses of extrasystoles, it is necessary to eat enough foods rich in potassium and magnesium. They are found in bananas, potatoes, dried apricots, pumpkins, and beans. It is also important to avoid frequent use of alcohol, coffee and strong tea.

• preventive gymnastics;
• the use of sedative and anti-inflammatory drugs;
• take food in small portions, do not eat up at night;
• avoid physical and emotional exhaustion;
• replenish vitamins and minerals.

With the appearance of extrasystole or an increase in discomfort in the region of the heart, you should immediately contact a specialized doctor. Self-medication can cause serious complications and delay the healing process.

Important to remember

Now, knowing the problem, and having analyzed it by its constituent elements, the question does not arise: extrasystoles in the heart - is this a dangerous disease? But like any change in the body, this problem requires proper attention, prevention and, if necessary, timely treatment.

Heart rate is one of the most important indicators of the state of the entire human body. According to statistics, rhythm disturbances occur in approximately 85% of patients, regardless of age, gender, social status, lifestyle and other significant factors.

Why this happens, it is impossible to say in advance. There are many reasons, both natural and pathological.

Extrasystole is the occurrence of single or group contractions of the heart in one or more structures: the ventricles or throughout the entire myocardium. Depending on the type of process, it can pose a danger to health and life, or be relatively harmless.

It is impossible to figure it out on your own, it is a waste of time, in this case precious. With group extrasystole, there is a high probability of sudden cardiac arrest.

The possibility of developing a problem is from 12 to 25% for threatening forms and about 85-90% for single types. The second variety is not dangerous, often people simply do not notice it. Over time, there is a risk of transformation from one form to another.

Extrasystole of the heart is the occurrence of pathological excitation and automatic contraction. In fact, we are talking about a milder version of atrial fibrillation.

To understand what distinguishes the considered deviation, it is necessary to consider the anatomical and physiological features of the body.

The heart functions autonomously. Cardiomyocytes are the only cells in the body capable of spontaneous excitation. Hence the conclusion - the muscular organ is located for independent, autonomous activity without external stimuli.

To some extent, the frequency of contractions is corrected by the brain, also by hormonal substances.

The main generator of the electrical impulse is the sinus node, a special accumulation of cells. Further, through special beams, the signal is conducted to other structures of the myocardium, causing a full contraction.

In the case of the process under consideration, a pathological phenomenon occurs, in which the electrical signal is created by other cardiac structures: the ventricles, etc.

Single extrasystoles in the heart - occur spontaneously, are not characterized by regularity and persistence. The multiple group option differs in duration, carries the risk of a rapid stop of the organ's work. Without medical attention in the long run of a few years or less leads to death.

Unlike, extrasystole is not characterized by chaotic contractions of the heart muscle. They are ordered, but wrong and redundant.

You can't call it a full hit. Detection of pathological flutter will come out only on an electrocardiogram (ECG).

Phenomenon classification

The process can be typified in two ways.

Depending on the origin of the problem, there are:

• neurogenic variety. It is characterized by activation and pathological work of the parasympathetic system. Inhibition is disturbed, the heart begins to function differently. As a rule, such an origin is characterized by single extrasystoles, they are not dangerous, although they can lead to a threat to life and health in the future.
• organic type. Caused by problems with the heart itself. Usually we are talking about unnoticed defects, congenital and acquired. The patient himself can understand that a process is taking place, persistent extrasystoles occur, which are felt as skipping heart beats or slowing down his work.

Another basis for classification is the frequency of changes, the nature of deviations.

Then allocate:

• Single extrasystole. The most common type of process. It occurs in 85% of cases or more, as already noted. It is not felt by the patient, therefore there are no symptoms at all. A problem is discovered by chance, in the process of diagnosis for other pathologies or a preventive examination.
• Multiple extrasystoles. Occurs less frequently. Carries a high risk of mortality. The heart does not work normally, this is a constant phenomenon. The beats are out of place, the electrical signal is generated in the ventricles or other structures, up to the entire myocardium. Stopping the work of a muscular organ is the most likely consequence of such a problem. An urgent diagnosis is needed to verify the disease and an equally rapid treatment. Better in stationary conditions.

Extrasystoles are extraordinary contractions of the heart that do not correspond to the adequate functioning of the organ. The considered classifications play an important clinical role.

There are other types as well. They matter less. However, they are worth considering.

Depending on the moment of occurrence of the reduction:

• Early.
• Medium.
• Late.

According to the number of sources:

• Single.
• Multiple (occur in the atria, ventricles).

Reasons for the development of the process

Diverse, as are the forms of the phenomenon. Among them are:

• Pronounced allergic reactions. As a rule, these are urgent conditions, such as Quincke's edema or anaphylactic shock. Formed rapidly, cause an increase in the work of the heart. Accordingly, in response to a threatening situation, extrasystoles may occur. It's a kind of defense mechanism that doesn't fit the occasion.
• autoimmune processes. They have a similar origin, since they are provoked by inflammatory mediators, including histamine. But they are longer in nature. We are talking about rheumatism, arthritis, sarcoidosis and other syndromes.
• The use of invasive or functional methods in the study of the heart muscle. Electrocardiography using a special probe and others. Cause artificial stimulation of muscle fibers. Extrasystole in this case is a temporary phenomenon and does not pose a danger. But to be sure, it is recommended to stay within the walls of the hospital for a certain period, until the general condition stabilizes.
• Weak sinus node. It develops on its own or as a secondary pathological phenomenon. It is characterized by insufficient intensity of the produced electrical impulse. Hence the violation of myocardial contractility. The body seeks to restore the normal activity of cardiac structures. There are third-party sources of signal generation, but they cannot cover the need for contraction force. The mechanism is flawed from the start.

• Chest injury. Bruises, fractures, other injuries. Cause disturbances in the work of the heart. Which character - depends on the factor. Correction of the underlying condition, normalization of cardiac activity in stationary conditions is required. The problem is life threatening.
• Increase in body temperature. It is provoked by infectious and inflammatory phenomena and other reasons. It can be a simple cold, tuberculosis, cancer. Therapy is to lower the thermometer. Normalization of cardiac activity is carried out as part of symptomatic treatment.
• Problems of the musculoskeletal system at the level of the cervical spine. From banal osteochondrosis to tumors and other phenomena of a destructive kind. It causes a violation of blood circulation in the brain. Hence the pathological signals to the heart. Therefore, all diseases of the spinal column should be treated in the early stages.

• Prolonged cough. It provokes reflex excitation of cardiac structures. As a rule, these are single extrasystoles. Treatment is not required. However, cases of stopping the work of the body are known.
• neurovegetative problems. Associated with a violation of the process of inhibition of the central nervous system. Hence the overstimulation of the heart. Treatment under the supervision of a neurologist, but this is not a guarantee of success, since the phenomenon has a complex mechanism and requires a complex effect of a whole group of drugs.
• Uncontrolled or illiterate use of drugs, such as glycosides, antihypertensive drugs, antiarrhythmics. The fault can be both the patient and the doctor who is not competent to prescribe a course of therapy.
• Respiratory failure. A consequence of chronic obstructive pulmonary disease or bronchial asthma, less often other problems of a similar type. Correction of the condition is carried out under the control of a pulmonologist. Treatment is long and difficult. Usually the root cause of all problems is smoking or working in a hazardous occupation for an extended period of time.
• Pathologies of the hematopoietic and hemodynamic profile: anemia in the first place.
• Metabolic disorders. This is not about endocrine processes. The cause of extrasystole in this case is a deficiency or excess of potassium, calcium, magnesium, excessive consumption of alcoholic beverages, caffeine, and harmful substances contained in tobacco products.
• Hormonal abnormalities. Diabetes mellitus of any type or hyperthyroidism (excessive amounts of T3, T4, TSH, specific substances of the thyroid gland).

Causes of Cardiac Profile

Actually, heart disease is somewhat more common:

• Increased pressure in the pulmonary artery. Occurs with a long course of the hypertensive process, etc.
• Malformations of the muscular organ, both congenital and acquired.
• Inflammatory diseases, the leading one is myocarditis. Leads to the destruction of cardiac structures in the short term.
• Operations on the heart.
• Tumors of a malignant and benign nature.
• IHD (ischemic heart disease).
• Cardiomyopathy.
• Postponed myocardial infarction and the next after it. The process is determined by acute tissue necrosis of muscle structures and their replacement by cicatricial, non-functional ones.

Against the background of non-cardiac causes, single pathological contractions often develop. With cardiac factors - group extrasystoles. Treatment is differentiated, depending on the type of process.

Toxic extrasystole

In a small number of cases, the so-called toxic varieties are formed:

• Overdose of drugs to eliminate heart pathologies.
• Poisoning with salts of heavy metals and hazardous compounds: mercury, antimony, alkaline earth elements, etc.
• Bust with oral contraceptives.

Typical Symptoms

Extrasystole of the heart is a dangerous phenomenon: even against the background of frequent contractions of a pathological kind manifestations may not be at all.

Hence the need for urgent diagnosis and regular preventive examinations by a cardiologist or, at least, a therapist.

In other situations, there are such signs:

• Violation of the heart. It is felt. Patients describe their symptoms as: uneven pulse, the organ skips beats, speeds up or slows down. Without the use of drugs, stabilization of the condition almost never occurs. Vagus techniques are also ineffective.
• Shortness of breath even with minimal or no physical activity (in severe cases).
• Headache. It is relatively rare, indicating an increasing violation of the trophism of cerebral structures.
• Vertigo. Lack of orientation in space. It also demonstrates the impossibility of a normal supply of nutrients to the brain.
• Physical intolerance. Heart beats, sweating increases.
• Cyanosis of the nasolabial triangle.
• Paleness of the skin.

These are manifestations of extrasystoles that require a visit to a doctor. Do not delay visiting a medical facility.

Signs requiring an ambulance call

• Sharp headache for no apparent reason. Bales, shoots in the back of the head and crown.
• Speech, vision, hearing disorders, problems with neurological functions.
• Paralysis, paresis, a feeling of goosebumps running through the body.
• Distortions of the face, disobedience of muscle structures, limbs.
• It is possible to develop a stroke or heart attack against the background of the problem under consideration. More frequent phenomena are cardiogenic shock or a stop in the work of a muscular organ.

Symptoms of extrasystole neurological and cardiac, can lead to dangerous consequences.

Diagnostics

Identification presents certain difficulties, since manifestations in the early stages are completely absent.

All responsibility lies with the treating specialist. The profile doctor is a cardiologist.

If we are talking about a large settlement with developed medicine, you can contact an arrhythmologist. As necessary, they turn to other doctors working in related fields.

An approximate list of diagnostic measures:

• Fixing patient complaints about health. It is necessary for further analysis of the subjective sensations of the patient. It can be carried out using a special questionnaire-questionnaire.
• Collection of anamnesis. Lifestyle, the presence or absence of bad habits, family history and other points. Also other factors that could play a role in identifying the problem.
• Measurement of blood pressure, also heart rate. Objectification of functional indicators is necessary to identify the possible etiology of the process
• Daily monitoring using a Holter, automatic programmable tonometer. shown in all cases. It is better to carry out on an outpatient basis so that the patient is in a natural, familiar environment. Physical activity in this case plays a significant role. In the hospital, it is minimal, when a person is at home - it is common. The dynamics of changes in levels is required to identify the origin of the process
• Listening to the heart sound. Against the background of extrasystole, there is deafness of tones, increased volume, but correctness, randomness does not occur.
• Electrocardiography. An objective method for assessing the functional activity of cardiac structures. It is considered the gold standard for early diagnosis, as it allows you to catch single changes, such as extrasystoles. Frequent are determined by a cursory review of the results, even by inexperienced doctors, since the process is running.
• Echocardiography. Ultrasound technique aimed at visual assessment of cardiac structures. Demonstrates pathological changes of an organic nature.
• Angiography.
• CT or MRI.

Other techniques may also be used. They are appointed by other specialists as needed.

Signs of extrasystole on the ECG

Among the characteristic features:

• Early appearance of the P wave, deformity of the same structure.
• Wide QRS complex.
• Paired occurrence of peaks.

There are at least 10-15 less specific objective indicators of extrasystoles on the ECG. Only a doctor can detect them. Deciphering requires considerable skill, without proper skill it is easy to miss an important point.

Therapeutic impact

Treatment of extrasystole is complex, surgical and medical, depending on the severity, etiology and nature of the process.

Among the funds:

• calcium antagonists. Like Diltiazem and Verapamil.
• Beta blockers. Anaprilin, Metoprolol, Carvedilol and similar.
• ACE inhibitors. Perineva, Prestarium.

used in the system. The complexity of the impact provides an impact on all aspects of the pathological process.

Surgical therapy is prescribed in extreme cases. It may be necessary to implant a pacemaker (artificial pacemaker) or a defibrillator. Heart defects are eliminated by surgery. Possible methods of prosthetics in the destruction of cardiac structures.

Folk recipes are not effective and, moreover, dangerous. Lifestyle changes can be a good help, but by no means the main method of therapy. In addition, the reasons are deeper, it will not work out in such simple ways.

Forecast

Single extrasystoles are cured in 100% of cases, often therapy is not required at all. Multiple and group are characterized by high mortality. The probability of cardiac arrest without treatment is 65%, with the appointment of a competent course - 20%.

Prevention

Specific has not been developed. It is enough to follow simple rules:

• Quit smoking, alcohol and especially drugs.
• Proper nutrition (more vitamins, less harmful foods).
• Full sleep 8 hours per night or more.
• Walking 2 hours a day.
• Salt no more than 7 grams.
• Optimal drinking regimen (2 liters per day).

Extrasystoles in the heart is the occurrence of extraordinary pathological contractions of the organ. The reason is the appearance of electrical impulses in structures other than the sinus node.

Diagnosis and treatment are urgent, under the supervision of a cardiologist. As needed - other specialists. In the absence of help, lethal complications are possible.

- this is a variant of heart rhythm disturbance, characterized by extraordinary contractions of the whole heart or its individual parts (extrasystoles). It is manifested by a feeling of a strong cardiac impulse, a feeling of sinking heart, anxiety, lack of air. Diagnosed by the results of ECG, Holter monitoring, stress cardiotests. Treatment includes elimination of the root cause, medical correction of the heart rhythm; in some forms of extrasystole, radiofrequency ablation of arrhythmogenic zones is indicated.

ICD-10

I49.1 I49.2 I49.3

General information

Extrasystole - premature depolarization of the atria, ventricles, or atrioventricular junction, leading to premature contraction of the heart. Single episodic extrasystoles can occur even in practically healthy people. According to the electrocardiographic study, extrasystole is recorded in 70-80% of patients older than 50 years. A decrease in cardiac output during extrasystoles leads to a decrease in coronary and cerebral blood flow and can lead to the development of angina pectoris and transient cerebrovascular accidents (fainting, paresis, etc.). Extrasystole increases the risk of developing atrial fibrillation and sudden cardiac death.

Causes of extrasystole

Functional extrasystole, which develops in practically healthy people for no apparent reason, is considered idiopathic. Functional extrasystoles include:

• rhythm disturbances of neurogenic (psychogenic) origin associated with food (drinking strong tea and coffee), chemical factors, stress, alcohol intake, smoking, drug use, etc .;
• extrasystole in patients with autonomic dystonia, neuroses, osteochondrosis of the cervical spine, etc.;
• arrhythmia in healthy, well-trained athletes;
• extrasystole during menstruation in women.

Extrasystole of an organic nature occurs in case of myocardial damage with:

• IHD, cardiosclerosis, myocardial infarction,
• pericarditis, myocarditis,
• chronic circulatory failure, cor pulmonale,
• sarcoidosis, amyloidosis, hemochromatosis,
• cardiac operations,
• in some athletes, the cause of extrasystole may be myocardial dystrophy caused by physical overstrain (the so-called "athlete's heart").

Toxic extrasystoles develop with:

• feverish conditions,
• proarrhythmic side effect of certain drugs (aminophylline, caffeine, novodrine, ephedrine, tricyclic antidepressants, glucocorticoids, neostigmine, sympatholytics, diuretics, digitalis preparations, etc.).

The development of extrasystole is due to a violation of the ratio of sodium, potassium, magnesium and calcium ions in myocardial cells, which negatively affects the conduction system of the heart. Physical activity can provoke extrasystoles associated with metabolic and cardiac disorders, and suppress extrasystoles caused by autonomic dysregulation.

Pathogenesis

The occurrence of extrasystole is explained by the appearance of ectopic foci of increased activity, localized outside the sinus node (in the atria, atrioventricular node or ventricles). The extraordinary impulses arising in them propagate through the heart muscle, causing premature contractions of the heart in the diastolic phase. Ectopic complexes can form in any part of the conduction system.

The volume of extrasystolic blood ejection is below normal, so frequent (more than 6-8 per minute) extrasystoles can lead to a marked decrease in the minute volume of blood circulation. The earlier the extrasystole develops, the less blood volume accompanies the extrasystolic ejection. This, first of all, is reflected in the coronary blood flow and can significantly complicate the course of the existing cardiac pathology.

Different types of extrasystoles have different clinical significance and prognostic characteristics. The most dangerous are ventricular extrasystoles that develop against the background of organic heart damage.

Classification

According to the etiological factor, extrasystoles of functional, organic and toxic genesis are distinguished. According to the place of formation of ectopic foci of excitation, there are:

• atrioventricular (from the atrioventricular connection - 2%),
• atrial extrasystoles (25%) and various combinations of them (10.2%).
• in extremely rare cases, extraordinary impulses come from the physiological pacemaker - the sinoatrial node (0.2% of cases).

Sometimes there is a functioning of the focus of the ectopic rhythm, regardless of the main (sinus), while two rhythms are noted simultaneously - extrasystolic and sinus. This phenomenon is called parasystole. Extrasystoles, following two in a row, are called paired, more than two - group (or volley). Distinguish:

• bigeminy- rhythm with alternating normal systole and extrasystole,
• trigeminy- alternation of two normal systoles with extrasystole,
• quadrihymenia- following an extrasystole after every third normal contraction.

Regularly repeated bigeminy, trigeminy and quadrihymeny are called allorhythmy. According to the time of occurrence of an extraordinary impulse in diastole, early extrasystole is isolated, which is recorded on the ECG simultaneously with the T wave or no later than 0.05 seconds after the end of the previous cycle; middle - 0.45-0.50 s after the T wave; late extrasystole, which develops before the next P wave of the usual contraction.

According to the frequency of occurrence of extrasystoles, rare (less than 5 per minute), medium (6-15 per minute), and frequent (more often than 15 per minute) extrasystoles are distinguished. By the number of ectopic foci of excitation, extrasystoles are monotopic (with one focus) and polytopic (with several foci of excitation).

Symptoms of extrasystole

Subjective sensations with extrasystole are not always expressed. Tolerability of extrasystoles is more difficult in people suffering from vegetative-vascular dystonia; patients with organic heart disease, on the contrary, can tolerate extrasystole much easier. More often, patients feel extrasystole as a blow, a push of the heart into the chest from the inside, due to vigorous contraction of the ventricles after a compensatory pause.

There are also "somersaults or overturning" of the heart, interruptions and fading in its work. Functional extrasystole is accompanied by hot flashes, discomfort, weakness, anxiety, sweating, lack of air.

Frequent extrasystoles, which are early and group in nature, cause a decrease in cardiac output, and, consequently, a decrease in coronary, cerebral and renal circulation by 8-25%. In patients with signs of cerebral atherosclerosis, dizziness is noted, transient forms of cerebrovascular accident (fainting, aphasia, paresis) may develop; in patients with coronary artery disease - angina attacks.

Complications

Group extrasystoles can transform into more dangerous rhythm disturbances: atrial - into atrial flutter, ventricular - into paroxysmal tachycardia. In patients with atrial congestion or dilatation, extrasystole may progress to atrial fibrillation.

Frequent extrasystoles cause chronic insufficiency of the coronary, cerebral, renal circulation. The most dangerous are ventricular extrasystoles due to the possible development of ventricular fibrillation and sudden death.

Diagnostics

Anamnesis and physical examination

The main objective method for diagnosing extrasystole is an ECG study, however, it is possible to suspect the presence of this type of arrhythmia during a physical examination and analysis of the patient's complaints. When talking with the patient, the circumstances of the occurrence of arrhythmia (emotional or physical stress, in a calm state, during sleep, etc.), the frequency of episodes of extrasystole, the effect of taking medications are specified. Particular attention is paid to the history of past diseases that can lead to organic damage to the heart or their possible undiagnosed manifestations.

During the examination, it is necessary to find out the etiology of extrasystole, since extrasystoles with organic heart damage require a different treatment strategy than functional or toxic ones. On palpation of the pulse on the radial artery, the extrasystole is defined as a prematurely occurring pulse wave followed by a pause or as an episode of pulse loss, which indicates insufficient diastolic filling of the ventricles.

During auscultation of the heart during an extrasystole, premature I and II tones are heard above the apex of the heart, while the I tone is increased due to the small filling of the ventricles, and the II tone is weakened as a result of a small ejection of blood into the pulmonary artery and aorta.

Instrumental diagnostics

The diagnosis of extrasystole is confirmed after an ECG in standard leads and daily ECG monitoring. Often, using these methods, extrasystole is diagnosed in the absence of patient complaints. Electrocardiographic manifestations of extrasystole are:

• premature occurrence of the P wave or QRST complex; indicating a shortening of the preextrasystolic clutch interval: with atrial extrasystoles, the distance between the P wave of the main rhythm and the P wave of the extrasystole; with ventricular and atrioventricular extrasystoles - between the QRS complex of the main rhythm and the QRS complex of the extrasystole;
• significant deformation, expansion and high amplitude of the extrasystolic QRS complex with ventricular extrasystole;
• absence of P wave before ventricular extrasystole;
• following a complete compensatory pause after a ventricular extrasystole.

Holter ECG monitoring is a long-term (over 24-48 hours) ECG recording using a portable device attached to the patient's body. Registration of ECG indicators is accompanied by keeping a diary of the patient's activity, where he notes all his sensations and actions. Holter ECG monitoring is performed for all patients with cardiopathology, regardless of the presence of complaints indicating extrasystole and its detection in a standard ECG.

Forecast

The prognostic assessment of extrasystole depends on the presence of an organic lesion of the heart and the degree of ventricular dysfunction. The most serious concerns are caused by extrasystoles that have developed against the background of acute myocardial infarction, cardiomyopathy, and myocarditis. With pronounced morphological changes in the myocardium, extrasystoles can turn into atrial or ventricular fibrillation. In the absence of structural damage to the heart, extrasystole does not significantly affect the prognosis.

The malignant course of supraventricular extrasystoles can lead to the development of atrial fibrillation, ventricular extrasystoles - to persistent ventricular tachycardia, ventricular fibrillation and sudden death. The course of functional extrasystoles is usually benign.

Prevention

In a broad sense, the prevention of extrasystole provides for the prevention of pathological conditions and diseases underlying its development: coronary artery disease, cardiomyopathies, myocarditis, myocardial dystrophy, etc., as well as the prevention of their exacerbations. It is recommended to exclude drug, food, chemical intoxication that provoke extrasystole.

Patients with asymptomatic ventricular extrasystoles and no signs of cardiac pathology are recommended a diet enriched with magnesium and potassium salts, smoking cessation, drinking alcohol and strong coffee, and moderate physical activity.