Treatment of extrasystole. Causes, symptoms, prevention, prognosis

Causes, symptoms and treatment of extrasystole

Extrasystole is a variant of cardiac rhythm failure in which out-of-order contractions of the heart or its individual sections occur. Unscheduled electrical impulses are called extrasystoles.

Classification

According to the localization of the sources of excitation, the pathology is:

ventricular extrasystole;
atrial-ventricular;
atrial;
combined.

Very rarely, extrasystoles appear in the sinus-atrial node.

Often the normal (sinus) rhythm is superimposed on the extrasystolic one - the so-called parasystoles occur.

Extrasystoles that develop one after the other are called paired, more than two - group (as well as volley). It can be supraventricular extrasystole and others.

According to the time of formation in diastole (relaxation period), extrasystoles are:

wounds;
medium;
late.

According to the frequency of formation, extrasystoles are divided into:

infrequent - observed less often than 5 times in 1 minute;
average - 6-15 for 1 minute;
frequent - more than 15 per 1 minute.

By the number of foci of excitation, the following types of extrasystoles are distinguished:

monotopic - at the same time, 1 cell of electrical excitation is detected in the heart muscle;
polytopic - several foci of excitation develop in the myocardium.

Depending on the reasons, the following violations occur:

functional (this is a fairly frequent extrasystole) - when examining the patient outside of extrasystoles, no heart muscle disorders are observed;
organic;
toxic.

Causes of extrasystole

Extrasystoles can appear without any abnormalities in healthy people. As a rule, extrasystole occurs in 70-80% of patients over 50 years of age.

Functional extrasystoles are based on failures of a neuro- or psychogenic nature. Their reasons:

food factors;
taking alcohol;
smoking (not necessarily frequent);
use of drugs;
toxic factors.

The causes of extrasystole of the functional type can be the following disorders and conditions:

neurocirculatory dystonia;
neuroses;
osteochondrosis of the cervical spine;
menstrual.

The organic nature of extrasystoles is recorded in the following pathologies:

ischemic heart disease;
cardiosclerosis;
myocardial infarction;
myocarditis;
cardiomyopathy of various types;
heart defects and others.

The causes of extrasystoles of a toxic nature are:

fever of various origins;
thyrotoxicosis;
some medicines.

Symptoms of extrasystole

The clinical picture does not always appear. If complaints arise, patients most often tell the doctor about such feelings:

beat or jolt of the heart in the chest;
sensation of "overturning" of the heart;
interruptions in his work.

Symptoms of functional extrasystole:

hot flushes;
inexplicable discomfort;
annoying weakness;
increased sweating;
lack of air.

When cerebral circulation suffers, fainting and paresis (impaired sensitivity) are observed.

The cause of such sensations may be supraventricular extrasystole or other varieties of this pathology.

Diagnostics

Diagnosis is made on the basis of complaints, anamnesis and the results of additional examination methods.

From the anamnesis, the following are important:

visible causes of extrasystole;
frequency of occurrence;
effectiveness of treatment.

When auscultating the heart (listening), the phenomenon of premature tones is noted.

Of the additional methods, electrocardiography (ECG) is the most informative. It will help determine whether atrial extrasystole or other types of disease occur. At the same time, daily ECG monitoring is important.

In order to detect extrasystole, which is not manifested in a state of rest, bicycle ergometry is performed - a load on an apparatus that resembles a bicycle, followed by detection of heart rhythm disturbances.

CT, MRI, ultrasound of the heart and other methods will reveal heart diseases that can lead to extrasystole.

Treatment

Treatment of extrasystole is not necessary for single extrasystoles.

If extrasystole is of neurogenic origin, sedative drugs are prescribed. More effective drugs are prescribed if there are more than 200 extrasystoles per day. Apply:

procainamide;
lidocaine;
quinidine;
amiodoron and others.

At the same time, pathologies that caused extrasystole are treated. If a malignant form of ventricular extrasystole has developed, antiarrhythmic drugs are prescribed for life.

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Prevention and prognosis

Treatment of extrasystole is more difficult than its prevention. Therefore, great attention should be paid to preventive measures. Prevention of any heart diseases is the primary prevention of extrasystole. Also important are: