Scientific editor: Strokina OA, therapist, doctor of functional diagnostics. Practical experience since 2015.
November, 2018.
Beats - is the formation of early contractions of the heart (or the individual cameras) do not fit into the overall heart rate. This is the most common disorder of heart rhythm.
When the manifestation of pathological premature beats may appear uncomfortable symptoms, blood circulation, as well as the brain and heart blood flow.
Causes
Beats can be functional (when there are no irregularities in the structure of the heart), and organic origin, when the heart is affected by pathological processes.
Functional ektrasistoly can be at:
- cervical osteochondrosis,
- with nervousness,
- at neuro dystonia,
- under stress,
- while taking medicines, some food products (coffee, tea), alcohol, smoking,
- for no apparent reason in healthy people. Especially in athletes.
Organic ekstrasitoliya occurs on the background:
- cardiosclerosis,
- myocardial infarction,
- coronary heart disease,
- cardiomyopathy,
- myocardial hypertrophy (thickening of the walls)
- infiltrative diseases of the heart.
- with the defeat of heart inflammation,
- heart defects,
- in some systemic diseases with heart failure.
There may also be dystrophic (if insufficient power) arrythmia, toxic, metabolic (due to ion metabolism disorders).
Kinds
Depending on the place of occurrence of extrasystoles release:
- ventricular arrhythmia,
- atrio-ventricular arrhythmia,
- atrial arrhythmia.
parasystole phenomenon also stands out - the simultaneous operation of the normal pacemaker and extrasystolic.
By the time of occurrence of stands:
- bigemeniya - one normal and one extraordinary reduction,
- trigemeniya - two normal contraction and one premature beat,
- kvadrigemeniya - three normal and one abnormal contraction.
Further, extrasystole can be different in form, especially ventricular. This directly affects the choice of tactics of patient treatment and prognosis of the disease.
Groups of 3 or more extrasystoles is called paroxysmal tachycardia, which is already a formidable manifestation of heart disease than single beats.
symptoms of arrhythmias
Very often beats by the patient is not felt, especially if it is functional and rare.
When organic and usually more frequent complaints arise extrasystoles in feeling or jolt or shock to the heart within the chest, this occurs because the excessively active ventricular contraction. There may be complaints of heart intermissions, squeezing feeling in chest or somersaults, discomfort and hot flushes, fever or sweating, anxiety, fear and lack of air.
With frequent occurrence of premature beats can be a manifestation of dizziness, fainting, seizures angina pain behind the breastbone.
Diagnostics
Suspected arrhythmia is possible on the basis of complaints, probing pulse and listening to the heart, but an accurate diagnosis can be established by removing the 12-lead ECG. Transparencies will be clearly seen very occurrence of extrasystoles, their appearance - atrial or ventricular or atrioventricular, as well as their number.
Complementing the study ECG monitoring (Holter), in which the computer will analyze the data and give an opinion on the degree of violation.
Additionally can be assigned veloergometry or treadmill test as exercise test. It can also be carried out cardiac ultrasound (echocardiography) and, if necessary, MRI.
Differential diagnosis is needed with other arrhythmias, as well as to distinguish between different types of an arrhythmia.
From laboratory diagnosis may need blood chemistry electrolytes (this may vary potassium or magnesium).
arrythmia treatment
Diagnosis and treatment of arrhythmia involved physicians, general practitioners, cardiologists and cardiac surgeons sometimes.
Individual functional beats require no treatment, and the treatment of those that are caused by other diseases, are beginning to eliminate the influence factor.
Extrasystole can cause some drugs:
- aminophylline,
- ephedrine,
- caffeine,
- diuretics,
- glucocorticosteroids,
- antidepressants,
- overdose of digoxin.
In this case, you need to remove the drug (if possible, after consultation with the doctor).
With increased psycho-emotional excitability is enough use of sedatives (Valerian preparations, motherwort, Percy, neo-pass) or tranquilizers (afobazol, phenazepam, Grandaxinum).
When electrolyte imbalance effective drugs potassium and magnesium (Pananginum).
Treatment administered at an amount of extrasystoles per day more than 25% of the reductions from the Holter electrocardiogram or the presence of serious complaints and disorders of the heart. Treatment may be medicated, i.e. with reception of drugs and surgery.
In the first option the choice of drug depends on the type of premature beats and heart disease, which they could cause. If supraventricular arrhythmias may be effective
- verapamil,
- Beta-blockers (eg, Concor, bisoprolol, metoprolol, nebivolol)
- etatsizin,
- propafenone,
- amiodarone.
When ventricular arrhythmia apply
- amiodarone,
- sotalol
- etatsizin,
- propafenone.
Besides the above pharmaceuticals, there are several others with similar effect. Which drug to take, say, only the physician, who carefully analyzed the complaint and all survey data.
Beats, as well as any arrhythmia - it is a serious pathology, so you should consult your doctor for further examination and addressing the need for treatment.
To consult a physician was the most informative, You need to observe his condition for some time,
- analyze whether there is any pattern in the appearance of faults in the heart (perhaps after physical exertion, emotional stress, taking any medications, coffee, etc.)
- remember how long ago concerned a complaint that preceded it,
- it is useful to keep a diary and blood pressure pulse (recorded morning and evening measurements) at least for a week, so that the doctor can correctly prescribe treatment.
Surgical treatment is given only if drug therapy fails. Radiofrequency ablation - a burning source of additional pulses to the heart. The method is used for both atrial and ventricular arrhythmias for.
In special cases, when the beats grew into paroxysmal ventricular tachycardia and caused cardiac arrest, it is recommended setting intrathoracic defibrillator. In the case of this type of arrhythmia device gives the charge and restores normal heart rhythm to a person and prevent further cardiac arrest.
Complications and prognosis
Arrhythmia may become severe cardiac arrhythmias - paroxysmal tachycardia and atrial flutter.
Atrial fibrillation can be formed, circulatory failure, sudden death syndrome.
The prognosis depends on the cause of arrhythmia and its severity.
When functional ekstrasistoliyah it is favorable, when the organic and malignant - questionable may need lifelong treatment.
sources:
- Society of Emergency Cardiology. Ventricular arrhythmias in adults. - Federal clinical guidelines 2016.
- Russian Scientific Society for Clinical Electrophysiology, arrhythmology and electrostimulation. Society of Emergency Cardiology. Supraventricular cardiac arrhythmias in adults. - Federal clinical guidelines 2016.
