Under the influence of a pulse arising in ventriculonector barrel, its legs, feet or ramifications of the Purkinje fibers, there is a reduction of the myocardium from the ventricles, and then the second ventricle without prior reduction atria. This explains the main electrocardiographic signs of PVCs: premature expanded and deformed ventricular complexes and the absence of a normal P wave preceding it, indicating a reduction in atria.
What it is?
Ventricular premature beats - this is one of the types of arrhythmias, which are premature, arising out of the lineup, ventricular contraction. For the ventricular arrhythmia is characterized by a sense of disorders of the heart in the form of failure, weakness, circling the head, anginal pain and lack of air character.
This type of arrhythmia is set after listening to the heart, ECG monitoring and Holter. And for the treatment of ventricular extraordinary use drugs sedation, beta-blockers, and antiarrhythmics.
Causes
Reasons for ventricular arrhythmias occur in diseases of the heart:
- inflammatory (myocarditis, endocarditis, toxic);
- myocardial ischemia (Cardiosclerosis foci, acute infarction);
- exchange-dystrophic changes in muscle and conductive system (disturbance ratio electrolytes potassium sodium in myocytes and intercellular space);
- sharp energy depletion of cells caused by eating disorders, lack of oxygen in acute and chronic congestive heart failure, decompensated defects.
PVCs can occur in people with a healthy cardiovascular system due to:
- vagus stimulation (with overeating, insomnia, mental work);
- increased tone of the sympathetic nerve (smoking, physical work, stress, stressful job).
If the heart has two source pulses education, the main thing is the one that is capable of greater frequency. Therefore, most normal sinus rhythm is maintained. But the beats may occur against the background of atrial fibrillation.
Classification
There is a classification of ventricular arrhythmia Lown and Wolf are not all experts. It offers five degrees of arrhythmia in myocardial infarction risk-the risk of developing atrial fibrillation:
- Grade 1 - monomorphic recorded extraordinary reduction (not more than 30 per hour observation);
- degree 2 - more frequently, from one hearth (over 30 per hour);
- grade 3 - polytopic extrasystole;
- Grade 4 - is divided depending on the ECG rhythm pattern ( "a" - paired and "b" - salvo);
- degree of 5 - registered in the most dangerous type of prognostic sense «R on T», means that extrasystole "climbed up" the previous normal reduction and can disrupt the rhythm.
In addition, it highlighted the "zero" level for patients without arrhythmia.
Proposals M. Ryan on graduation (class) completed the classification B.Lown - M.Wolf for patients without myocardial infarction. They "gradation 1," "2 gradation" and "grade 3" coincide with launovskoy interpretation.
Others changed:
- "Gradation 4" - is considered as a paired extrasystoles to monomorphic and polymorphic variants;
- in the "gradation 5" included ventricular tachycardia.
symptoms
Isolated ventricular premature contractions recorded in half of healthy young adults during the monitoring for 24 hours (Holter ECG). They do not have to feel. The symptoms of ventricular arrhythmias occur when premature contractions are beginning to have a tangible impact on the normal rhythm of the heart.
Ventricular premature beats without concomitant heart disease patients tolerated very bad. This condition usually develops in the background of bradycardia (rare heart rate), and characterized by the following clinical signs for him:
- sensation of cardiac arrest, followed by a whole series of blows;
- from time to time felt some heavy blows in the chest;
- beats can also occur after a meal;
- feeling arrhythmia occurs in a peaceful position (at rest, sleep, or after the emotional outburst);
- violations during physical activity almost does not occur.
PVCs on a background of organic heart disease, usually are multiple, but the patient asymptomatic. They develop on exertion and tested in the supine position. Usually this type of arrhythmia develops on the background tachycardia.
Many women during pregnancy faced with tachycardia and pain in the left side of the chest. VES development expectant mother - not uncommon. This is due to the fact that the circulatory system and the heart is a double burden. In addition, should take into account the physiological hormonal reorganization that affects the rhythm of the pulse. This arrythmia is not of a malignant character and after childbirth is easily treatable.
methods of diagnosis
Diagnosis of the disease is carried out by two main methods, which include the daily ECG and Holter ECG monitoring.
- Electrocardiogram records all unplanned reduction ventricle, allowing to identify the frequency and sequence of heart rate.
- veloergometry method makes it possible to determine the dependence of manifestations zhelochkovyh ekstrasistoly from getting load, as well as to classify the disease, which greatly facilitates the preparation of its program treatment.
- As diagnostic methods can also be applied polikardografiya, CHPEKG, sphygmography and other methods.
Beats may not always be detected on an electrocardiogram. This is due to the fact that the study is conducted fairly quickly (about 5 minutes), and single beats can simply not get on film. In this case, use other types of diagnostics. One technique is Holter monitoring. It is held during the day, in the usual motor activity of the patient, after which the doctor determines whether there had been during this time any abnormal heart rhythm and how they are dangerous to the life of the patient.
Treatment of ventricular arrhythmia
In benign ventikulyarnoy arrythmia, which is well tolerated by patients, medical treatment is not carried out. Recommend avoiding harmful habits, risk factor modification, can receive korvalola.
With frequent PVCs expressed clinic malignant course appointed by antiarrhythmic drugs:
- Propafenone - antiarrhythmics class I used in benign course. Contraindicated in left ventricular aneurysm, severe heart failure.
- Bisoprolol - blocker, prevents the occurrence of ventricular fibrillation, a heart rhythm uryazhaetsya. Is contraindicated in patients with bronchial asthma.
- Cordarone - the drug of choice for malignant and prognostically unfavorable PVCs. It reduces cardiac mortality indicators.
Surgical treatment is carried out at frequent ventricular arrhythmias, which are difficult to drug treatment. Produce electrophysiological study to determine the exact location of the source and its radiofrequency ablation.
Lifestyle with ventricular premature beats
When ventricular arrhythmia, especially caused by other heart conditions, need more rest, more often remain in the fresh air, to observe the regime of work and rest, eat right, to exclude the use of coffee, alcohol, reduce or eliminate smoking.
Patients with benign type of ventricular arrhythmia is no need to limit physical activity. In malignant type should be limited to significant stress and psycho-emotional situation that could lead to an attack.
Traditional methods
If the beats are not life-threatening and is not accompanied by hemodynamic compromise, you can try to beat the disease on their own. For example, when receiving diuretic drugs from the patient derived potassium and magnesium. In this case it is recommended to take foods containing these minerals (but only in the absence of kidney disease), - apricots, raisins, potato, banana, pumpkin, chocolate.
Also, for the treatment of arrhythmia, you can use an infusion of medicinal herbs. He has cardiotonic, antiarrhythmic, soothing and gentle sedative effect. It should take one tablespoon 3-4 times a day. To do this you need the flowers of hawthorn, lemon balm, motherwort, ling and hop cones. They need to mix in the following proportions:
- 5 parts of lemon balm and motherwort;
- 4 parts heather;
- 3 parts hawthorn;
- 2 parts of hops.
Important! Before starting the treatment of folk remedies, you should consult with your doctor, because many herbs can cause allergic reactions.
Effects
Ventricular premature beats type 1 classification, the above article, do not pose a threat to life and usually does not cause any complications. When ventricular arrhythmia type 2 may develop complications, but the risk is relatively low.
If a patient has polymorphic beats, beats paired, unstable paroxysmal tachycardia or beats early group, a high risk of life-threatening consequences:
- A stable ventricular tachycardia is characterized by prolonged (more than half a minute) attacks group PVCs. She, in turn, provokes effects listed later in this table.
- Ventricular flutter ventricular contractions at a frequency of 220 to 300 beats per minute.
- Fibrillation (flicker) ventricles Chaotic ventricular contraction, the frequency of which comes to 450 beats per minute. Shimmering ventricles are not able to pump blood, so the patient usually loses consciousness from lack of oxygen in the brain. Such a state in the absence of medical care can cause death.
- Asystole (cardiac arrest) may occur on the background of the attack ventricular arrhythmias or sudden. Often asystole inevitably leads to death, because not always the doctors can conduct CPR for several minutes after cardiac arrest.
To avoid life-threatening consequences, do not delay the initiation of treatment, if you have identified a ventricular arrhythmia.
Forecast
In benign and absence of the basic cardiological disease prognosis.
When potentially malignant type and in the presence of organic lesions of the heart relatively unfavorable prognosis and is not determined only by the characteristics of ventricular extrasystoles ECG monitoring (frequent, medium, steam, group), but also the nature of the underlying disease and the stage of heart failure, in the later stages where no prediction favorable. When malignant course of an unfavorable prognosis due to the very high risk of sudden cardiac death.
Improve the prognosis allows antiarrhythmic drugs in combination with beta - blockers as the combination is These drugs not only improves the quality of life, but also significantly reduces the risk of complications and death.
Prevention of illness
As preventive typically include a recommendation:
- conduct a more active and mobile lifestyle;
- avoiding harmful habits, including smoking, excessive alcohol consumption and strong coffee;
- regular medical check-ups.
Detection of the disease can occur even with the planned routine inspection, for this reason, check the state of health in a medical facility is a must event for everyone.
