Ventricular extrasystole
Last reviewed: 23.04.2024
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Ventricular extrasystole (VES) - single ventricular impulses resulting from re-entry involving ventricles or abnormal automatism of ventricular cells. Ventricular extrasystole is often found in healthy people and in patients with cardiac disease. Ventricular extrasystole may be asymptomatic or cause a heartbeat. The diagnosis is made according to ECG data. In treatment, there is often no need.
Causes of ventricular extrasystole
Ventricular extrasystoles (VES), also called premature ventricular contractions (PZH), can appear suddenly or at regular intervals (for example, every third contraction is a triagism, and the second is a bigowy). The frequency of ventricular extrasystoles may increase with stimulation (eg, anxiety, stress, alcohol intake, caffeine, sympathomimetic drugs), hypoxia or electrolyte imbalance.
[Symptoms of ventricular extrasystole
Ventricular extrasystoles patients can characterize as missed or "pop-up" contractions. Feels not the ventricular extrasystole itself, but the subsequent sinus contraction behind it. If the ventricular extrasystoles are very frequent, especially if they appear instead of every second contraction, mild hemodynamic symptoms are possible, since the sinus rhythm is severely affected. Existing ejection noise can be amplified, as there is an increase in the filling of the ventricles and the degree of contraction after the compensatory pause.
The diagnosis is made according to ECG data: a wide complex without a preceding P wave appears, usually accompanied by a full compensatory pause.
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Prognosis and treatment of ventricular extrasystole
Ventricular extrasystole is not considered significant in patients without heart disease, and there is no need for special treatment, with the exception of a pathology potentially capable of provoking the occurrence of ventricular extrasystole. If the patient does not tolerate symptoms, b-blockers are prescribed. Other antiarrhythmic drugs that suppress ventricular extrasystole may lead to more severe arrhythmias.
In patients with organic heart disease (for example, aortic stenosis or after a heart attack), the choice of the treatment method is a controversial issue, even if the frequent ventricular extrasystole (more than 10 per hour) correlates with an increase in mortality, as no studies have shown, that pharmacological suppression of ventricular extrasystoles reduces mortality. In patients after myocardial infarction, class I of antiarrhythmic drugs causes an increase in mortality in comparison with placebo. This fact, perhaps, reflects the side effects of antiarrhythmic drugs. B-Adrenoblockers are effective in heart failure, accompanied by clinical symptoms, and after myocardial infarction. If the number of ventricular extrasystoles increases with physical exertion in patients with IHD, percutaneous intraarterial coronary angioplasty or coronary artery bypass grafting may be necessary.
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