Violation of the heart rhythm according to the type of ventricular extrasystole is a pathology that is characterized by premature, extraordinary contractions of the ventricles. It is a fairly common type of arrhythmia.
What causes this pathology? What are the prerequisites? What symptoms indicate its presence? How is diagnosis and treatment performed? This and much more will now be discussed.
Pathogenesis and classification
Violation of the heart rhythm according to the type of ventricular extrasystole depending on localization is divided into the following types:
- Atrial It is characterized by premature contraction of the entire muscle from impulses coming from the atria.
- Sinus Also called nodal. Untimely impulses of the sinus rhythm are observed.
- Superventicular. It is characterized by extraordinary excitations of the atria, accompanied by a discharge of the sinus node. This type of pathology combines sinus and atrial extrasystoles of the atrioventricular connection.
- Purely ventricular. It arises from premature excitations emanating from a conducting system.
Rhythm disturbances can be frequent and rare, group and single, and also salvo (alternating normal heartbeat with several extrasystoles in a row).
Also, attention should be paid to such a concept as allorhythmia. This is the name of the form of arrhythmia, which is characterized by the occurrence of a violation for each first, second or third normal ventricular complex.
Extrasystoles can also be multiple (polytropic) and single (monotropic).
One cannot but mention the classification of Laun and Wolf. It includes 6 types of cardiac arrhythmias according to the type of ventricular extrasystole. What is the defining feature? The number of extrasystoles that occurred within one hour. So, here are 6 of these types:
- Up to 30 extrasystoles in 1 hour.
- Over 30.
- Polymorphic extrasystole.
- One steam room.
- Group that lead to tachycardia.
- Early extrasystole type R on T.
The last three of these are violations of high gradation, and therefore life-threatening. They can provoke ventricular fibrillation or tachycardia, which can lead to cardiac arrest.
Etiology
According to this criterion, heart rhythm disturbances by the type of ventricular extrasystole are of the following types:
- Organic The most difficult view. Trophic myocardial changes, heart defects, coronary artery disease, cardiosclerosis and coronary insufficiency lead to it.
- Toxic. The prerequisites in this case are the pathological changes occurring in the tissues, as well as metabolic disorders directly in the heart muscle. This leads to the abuse of certain groups of medicines, coffee, alcohol, and also narcotic and toxic agents.
- Vegetative (functional). They are formed due to vegetovascular dysfunction, neurogenic disorders, neurosis and psychoemotional disorders. Also, pathologies of the gastrointestinal tract, hormonal disruptions and osteochondrosis often become prerequisites.
- Ideopathic. The most controversial type of heart rhythm disturbance. Because there is an extrasystole of this form in an absolutely healthy person, when there is no objective reason for that.
It is important to make a reservation that not all types of disorders are manifested by specific symptoms, but each of them is quite realistic to diagnose using echocardiography.
Symptoms
The types of cardiac arrhythmias were discussed in detail above. Now the symptoms should be discussed.
In fact, subjective complaints with this pathology for a long time may be completely absent. This is a problem, because when a person turns to a cardiologist, it turns out that the disease is in an advanced stage.
If any signs appear, then usually it is a feeling of "freezing" of the heart, as well as "tremors" and "interruptions" arising from increased post-extrasystolic contraction.
Often, the pathology proceeds against the background of vegetovascular dystonia. In this case, the following symptoms are observed:
- Recurrent headache.
- Irritability.
- Dizziness.
- Fatigue.
If extrasystoles occur against a background of organic diseases, then a person is faced with a feeling of lack of air, anginal pain and weakness. Fainting may even occur.
Many symptoms are often combined with fear, fear, anxiety. Dyspnoea (even at rest) may occur due to changing hemodynamics. Frequent pain type of angina pectoris, arrhythmia of the pulse. Sometimes pulsating veins are noticed.
Diagnostics
Violation of the heart rhythm by the type of supraventricular extrasystole is usually detected during a preventive medical examination - everything is visible on the ECG.
However, in those cases when the symptoms are very pronounced and greatly disturb the person, he himself turns to the cardiologist with complaints. In order to accurately establish the diagnosis, and also determine the primary disease that triggered the extrasystole, you need to go through several procedures.
First, the doctor interrogates the patient, finds out how often disturbing sensations arise. It also measures heart rate, blood pressure. Even at this stage, the specialist may notice irregular muscle contractions. However, the patient is sent to the ECG in any case. This is the main diagnostic method. Although they still resort to Holter monitoring.
It is through the electrocardiogram that it is possible to register the following phenomena:
- Premature occurrence of an altered ventricular complex QRS.
- Absence of a tooth of R. before extrasystole.
- Full compensatory pause after the violation.
- Expansion of the extrasystolic complex, etc.
Often, a treadmill test or bicycle ergometry can be prescribed to determine heart rhythm disturbances by the type of supraventricular extrasystole. One of these methods can identify the relationship of pathology with loads. So, for example, idiopathic extrasystole is usually suppressed by stress. But their occurrence in response to the load is an occasion to think about the organic causes of rhythm disturbances.
Additionally, echocardiography, CPECG, polycardiography and rhythmocardiography may be necessary.
Principles of Therapy
It should immediately be noted that people who have a cardiac arrhythmias such as supraventricular extrasystole proceed without any symptoms do not prescribe treatment. It is important for them only to adhere to such recommendations:
- Follow a diet, enrich the diet with potassium salts.
- Increase physical activity with physical inactivity.
- Refuse strong coffee, alcohol and smoking.
In all other cases, in addition to this, treatment is prescribed aimed at eliminating the symptoms and preventing life-threatening arrhythmias.
Therapy begins with sedatives and ß-blockers. Usually with their help it is possible to achieve an excellent symptomatic effect - the amount of extrasystoles decreases, as does the strength of post-extrasystolic contractions.
If a person still has bradycardia, then for the relief of pathology, medications of anticholinergic action can be prescribed. This is ergotoxin, combined with belladonna extract, phenobarbital with alkaloids of the same plant, etc.
If a rhythm disturbance of the type of ventricular extrasystole leads to poor health, and sedatives and ß-blockers do not help, then the doctor may prescribe antiarrhythmic drugs. These include sotalol, amiodarone, flecainide, mexiletine and procainamide. Their specialist selects under the control of Holter monitoring and ECG.
Medicines
Once again, it should be noted that for the treatment of cardiac arrhythmias by the type of ventricular extrasystole, drugs are prescribed only by a cardiologist. But as an example, some medications used for therapeutic purposes should be listed.
Bisoprolol is very popular. It is a beta blocker that suppresses the sensitivity of the corresponding cardiac myocardial receptors. Actually, the main advantage lies in the selective action. And it can even be taken by people with asthma and diabetes.
Take "Bisoprolol" once a day. It not only inhibits arrhythmia - the drug also prevents angina attacks, and also slows the pulse.
A good remedy is Sotalol. Its use also helps to cope with cardiac arrhythmias such as atrial fibrillation and ventricular extrasystole.
Also, the doctor may prescribe "Cordaron." This is a powerful tool, prescribed in cases where any others are powerless. To achieve the effect, it is enough to take the medication for one week. Then, as a rule, they take a break for 14 days.
Widely used are also preparations based on potassium and magnesium. These are Concor, Propafenone and Amiodarone. If the disease is accompanied by atrial fibrillation, then “Verapamil” and “Etatsizin” are prescribed.
Membrane stabilizers have a good effect on cardiac arrhythmias such as bigeminia. They are usually administered intravenously. They quickly stop attacks. Such medicines as Ritmonorm, Lidocaine, Etatsizin and Novocainomide have proven themselves best.
In addition to the above, patients are prescribed calcium channel antagonists. The best are Verapamil and Diltiazem. They are prescribed without fear even to those people who have a slow heartbeat.
Often, therapy involves taking sodium channel blockers. They reduce intraventricular conduction, but do not affect myocardial contractility or pressure. The most famous representative of this group is Allapinin.
Potassium channel blockers also help in the treatment of cardiac arrhythmias such as AF-paroxysm (fibrillation) and extrasystole. Taking these drugs can increase the level of thyroid hormones. This is their big plus, but people who have problems with the endocrine system, they may be banned.
If there are big problems with sleep and anxiety, to which part the rhythm disturbance leads to the type of atrial fibrillation and ventricular extrasystole, Diazepam and Sibazon can be prescribed. These tranquilizers fix the problem.
Vitamins and Minerals
If a person has revealed any type of heart rhythm disturbance, then he needs to start actively taking certain elements that can improve muscle function.
The most important substance is selenium. People experiencing a lack of this element have a 6-fold lower cardiac index, and are also more at risk for heart problems.
Omega-3 is an unsaturated fatty acid vital for the human body. It protects the vascular walls from negative influences, strengthens the immune system, minimizes the risk of blood clots, ensures the normal functioning of cell membranes and improves the functioning of the cardiovascular system.
It is very important to eat ginkgo biloba. The chemical compounds that it contains help to normalize blood pressure, improve the condition of blood clots and blood vessels. The most valuable element in its composition is quercetin.
And, of course, you can’t do without potassium. He, like sodium. The body needs. Potassium regulates blood pressure, normalizes heart rate, does not allow the deposition of sodium salts, fights atherosclerosis, supports vascular tone. Often it is a lack of potassium that leads to arrhythmia. Therefore, it is necessary to monitor its level not only in the presence of heart problems. It is important to ensure the intake of potassium in the body and healthy people, and also not to forget about it during periods of prevention.
Radiofrequency catheter ablation
This is the name of the surgical technique with which you can eliminate the problem of rhythm disturbance by the type of ventricular extrasystole. Of course, the method is radical. But effective. It has another name, colloquial - the method of "cauterization of the heart."
The bottom line is to eliminate a small area of tissue, due to which too frequent muscle stimulation occurs. It is possible to achieve this result by acting on a selected area with radio frequency signals, which cause damage.
What is the result? An additional path for conducting pulses is interrupted. However, the normal paths remain intact. The heart continues to contract at a normal rhythm, with the usual frequency.
Of course, there are contraindications. This operation is unacceptable if a person has one of the following conditions:
- Acute stroke.
- Myocardial infarction.
- Acute infectious diseases.
- Fever.
- Exacerbation of chronic diseases (ulcer, asthma, diabetes mellitus in the stage of decompensation, etc.).
- Severe hepatic and renal failure.
- Anemia.
Before the appointment of an operation to eliminate heart rhythm disturbances by the type of extrasystole, you will have to go through many examinations. Among them:
- General urine and blood tests.
- Echocardioscopy.
- Analysis of the blood coagulation system.
- ECG and monitoring.
- Transesophageal electrophysiological examination.
- Coronaroangiography.
- Consultation of an ENT doctor and dentist.
- A blood test for syphilis, hepatitis and HIV.
Hospitalize the patient 2-3 days before surgery. The day before the intervention, you must stop taking antiarrhythmic and other drugs, as well as from food (only a light dinner is allowed).
Diet
If the heart rhythm is disturbed, such as a paroxysmal form (and any other too), it is very important to adhere to a certain diet. It is highly recommended to diversify it with such products:
- Vegetables: broccoli, tomatoes, pumpkin, bell pepper, cabbage, cucumbers, potatoes, turnips, corn, radish, beets.
- Fruits: peach, pear, grapefruit, plum, avocado, apricot, apples, melon.
- Berries: blackberries, raspberries, grapes, currants.
- Dried fruits: dried apricots, prunes, raisins, dates.
- Greens: celery, parsley, rosemary, garlic.
- Oil: olive, pumpkin, wheat, linseed.
- Useful drinks: green tea, freshly squeezed juices, infusions of lemon balm and linden flowers, raspberries and currants.
- Nuts.
- Legumes and cereals.
- Dairy products.
- Honey, bee honeycombs.
- Fish.
The most useful foods for the heart are olives, oatmeal, avocados, red fish, nuts, berries, garlic and pomegranate. Refuse, of course, will have to fatty, harmful, smoked and highly cholesterol foods. And also from everything that harms the work of the heart (alcohol, energy drinks, coffee, etc.).
Folk remedies
Many people use them to eliminate rhythm disturbances by the type of extrasystole. Here are some natural phytocomponents that have proven themselves in alternative medicine:
- Valerian root. It has a calming effect, normalizes heart rate. The recipe is simple: 1 tbsp. l pour 1 cup boiling water, stand for 1 hour. Then take 1 tbsp. l thrice a day.
- Calendula. Enzymes of this plant normalize the functioning of the heart muscle. You just need to take 2 tsp. calendula and brew boiling water (enough 500 ml). Insist for 4 hours. Then strain and drink half a cup a day.
- Black radish and honey. The crushed root vegetable must be mixed with the bee product in equal proportions. Take the resulting mixture three times a day for 1 tbsp. l
- Hawthorn. From it you need to make a tincture: pour 20 grams of berries with alcohol (200 ml) and let it brew for 10 days. Then take - 10 drops before meals three times a day (it is recommended to dilute in a small amount of water).
- Rosehip. Its fruits can be simply brewed, and then drink the resulting composition as regular tea.
- Garlic and lemon. It is necessary to take two citrus fruits and 5-6 cloves. Grind all the components and put in a 3-liter glass jar. Pour water completely. Insist for a day. Then take - half a glass 1 time per day.
In addition, during the day you can use infusion of chamomile and lemon balm. It is better for them to replace green or black tea. It also has a pleasant taste, and also perfectly quenches thirst.