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• general characteristics
• Causes
• Symptoms and diagnosis

Supraventricular extrasystole is an extraordinary contraction of the atria. Ventricular extrasystole is an extraordinary contraction of the ventricles.

general characteristics

The human heart is equipped with a conduction system. These are isolated myocardial cells capable of conducting electrical current that excites the entire myocardium. Contraction occurs, the heart releases blood into the arterial bed. The cells of the conduction system are practically incapable of contracting.

The conduction system of the heart consists of several nodes and bundles. The main ones are:

1. Sinoatrial node.
2. Supraventricular node.
3. Atrioventricular node.
4. Branches of the His bundle.
5. Purkinje fibers.

All nodes and bundles go from the atria to the ventricles in the order indicated above.

The conducting system is completely autonomous. This is the so-called automatism of the heart. It is not affected by the activity of the human nervous system (brain and spinal cord). Otherwise, a person, through an effort of will, could stop the work of the heart (as happens with breathing), which is unacceptable. The body must be supplied with blood and oxygen every second, and the heart must beat constantly. A person is only able to slow down the heart with the help of special exercises (meditation, yoga), which, by the way, is very useful in stressful situations.

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Causes

Atrial extrasystoles can arise from the supraventricular node or pathological focus located in the atria. In this case, the pathological focus is not part of the conduction system of the heart, but is capable of generating a signal. If an extraordinary impulse occurs in the atrioventricular node, it can cause an extraordinary contraction of the ventricles, since it is located below the atria. And the electrical impulse in the conduction system of the heart can only propagate from top to bottom.

Supraventricular extrasystole occurs with smoking, abuse of alcohol, caffeine, drugs, and energy drinks. It often occurs in physically overloaded athletes and even in healthy individuals. Extrasystole is provoked by myocardial ischemia (CHD). Often the cause is constant stress. Extrasystoles accompany endocrine diseases, as well as arterial hypertension and organic myocardial damage.

With extrasystole, the atria contract “idle”. The whole purpose of the atria is to deliver blood to the ventricles. This process can occur by itself, under the influence of gravity. The atria only “push” the blood. Therefore, extraordinary contraction of the atria does not entail such serious consequences as occurs with extraordinary contractions of the ventricles, when serious hemodynamic disturbances occur. The atria and ventricles can contract even independently of each other and often without significant disturbances in blood flow.

In prognostic terms, supraventricular extrasystole is less dangerous.

Frequent ventricular extrasystole can indicate, firstly, serious damage to the myocardium, and secondly, cause a sharp deterioration in blood flow and even death.

Based on the frequency of occurrence, the following are distinguished:

• single;
• frequent supraventricular extrasystole.

By number of outbreaks:

• monotopic (one source);
• polytopic extrasystoles (many foci).

There are also ordered (bigeminy, trigeminy) and unordered.

Single, rare - up to 5 extrasystoles per minute, multiple - more than 5 per minute.

Monotopic ones can arise both from a focus that is part of the conduction system of the heart (supraventricular node), and from a pathological focus resulting from myocardial ischemia or another pathological process. If such an impulse comes from two or more foci simultaneously, polytopic extrasystoles are declared.

Ordered ones are observed when a normal complex is followed by an extrasystole - bigeminy, and two normal complexes are followed by an extrasystole - trigeminy. If the extrasystoles are disordered, then all this happens chaotically.

Then, if you look at the ECG, one P wave (reflecting atrial contraction) will be normal, and the other will be deformed, altered or negative.

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Symptoms and diagnosis

Extrasystole may not appear outwardly in any way. The person feels absolutely healthy and, if we are talking only about atrial extrasystoles, can perform normal, everyday work.

Sometimes there are symptoms of “stopping” the heart, “interruptions” in its work, “freezing”, and then a sharp jolt in the chest. This most often occurs with multiple, group extrasystoles. Weakness and dizziness are rare.

Supraventricular extrasystole is detected using an ECG or.

Let us briefly recall that the entire complex of cardiac contraction recorded using an ECG appears in the form of teeth. This is the P wave - contraction of the atria, QRS - contraction of the ventricles, T - the repolarization phase - a kind of “recharging” of the conduction system of the heart.

On the film, signs of extrasystole are an unchanged or deformed P wave, superimposed on the remaining teeth of the cardiac contraction complex. A shortened R-R interval is required. This interval indicates the time that passed between the first contraction of the atrium and the next one. From this interval, the heart rate is also calculated. If several intervals are of the same length, and one is shortened, then there is an extrasystole. Sometimes the P wave, superimposed on the other teeth, can mislead the doctor. He may suspect a more serious pathology than extrasystole.

Then, in addition to the ECG, 24-hour monitoring (Holter) will be a good help in diagnosis. It allows you to accurately determine how many extrasystoles there were per day. Modern devices allow you to transfer data to a computer and perform analysis. The patient will be given a conclusion, which indicates the number of normal complexes and extrasystoles as a percentage.

It is necessary to differentiate atrial (supraventricular) extrasystoles from a disease when the atria and ventricles contract “on their own”, in their own rhythm.

Single extrasystoles are not treated.

Multiple extrasystoles are subject to treatment when they cause discomfort, discomfort or reduce the volume of circulating blood (this is rare for atrial extrasystoles).

Supraventricular extrasystoles, as a rule, do not cause the need for urgent hospitalization or calling an ambulance.

However, until all the circumstances of their occurrence are identified (especially if multiple extrasystoles occurred suddenly, against the background of complete health), beta-blockers are indicated: atenolol, bisoprolol, metaprolol. It has been proven that they significantly improve the prognosis of life during extrasystole. An alternative is calcium antagonists, such as verapamil.

It is necessary to limit the consumption of coffee, cigarettes, alcohol, and avoid stress. If we are talking about overloaded athletes, refrain from playing sports for a while. That is, it is necessary to exclude all those factors that provoke extrasystole.

The need for surgical treatment may arise in the case of proven polytopic extrasystole. It is necessary to identify the pathological focus and inactivate it. This is achieved by ablation (cauterization). In practice, it is rarely performed, since in most cases supraventricular extrasystoles do not pose a health hazard.

Supraventricular extrasystoles also occur in children. Moreover, this is not at all uncommon. Drug treatment, as a rule, is not required, only observation and regular examination, and an ECG once every six months are needed.

Normally, the human heart contracts rhythmically, after systole (contraction) comes diastole (relaxation).

Any disturbance of the heart rhythm (its rhythm, the duration of pauses between systole and diastole, additional contractions, etc.) is called arrhythmia.

The appearance of additional defective heart contractions - extrasystoles - is a pathology of the heart rhythm and can disrupt the functioning of the heart.

Supraventricular extrasystole - what is it, is it dangerous and why, what consequences can rare single or frequent attacks lead to?

Extrasystole occurs due to the appearance of an ectopic (abnormal) focus of trigger activity in the myocardium (heart lining) or its parts. Depending on the site of excitation, supraventricular (supraventricular - atrial and from the atrioventricular septum) and ventricular extrasystoles are distinguished.

The term “supraventricular” means that additional contraction occurs in the upper - supraventricular - part of the heart, that is, in the atrium or the septum between the atria and ventricles (antiventricular septum).

Who has it?

Supraventricular extrasystole (SE) occurs in 60-70% of people. Normally, it can also occur in clinically healthy patients.

The presence of supraventricular extrasystole (SVES) is also does not mean that a person is sick.

SE more often registered in adults and older children, since young children are not yet able to describe their sensations and do not really understand what is happening to them.

In newborns and small children, supraventricular extrasystole is detected during an ECG during medical examination, general examination or in connection with an alleged disturbance in the functioning of the heart (congenital defects, a sharp deterioration in the child’s condition in the absence of external factors).

Causes and risk factors

Supraventricular extrasystole can be idiopathic, that is, it occurs for no apparent reason. It occurs in practically healthy people of any age.

In middle-aged people, the main cause of SE is functional:

• stress;
• tobacco and alcohol;
• abuse of tonic drinks, especially tea and coffee.

In the elderly An organic cause of SE is more common due to an increase in cases of ischemic heart disease, cardiosclerosis and other heart diseases with age. In such patients, there are profound changes in the heart muscle: areas of ischemia, dystrophy or necrosis, sclerotic areas, due to which electrical heterogeneity is formed in the heart muscle.

Organic causes can be divided into 5 groups:

In young children, supraventricular extrasystole often develops due to congenital heart defects and endocrine diseases. In adolescence, stress, poisoning from tobacco, drugs and alcohol are added to them.

Classification and types

Supraventricular extrasystoles differ in several ways.

According to the location of the source of excitation:

• atrial – located in the atria, i.e. upper parts of the heart;
• antrioventricular - in the atrioventricular septum between the atria and ventricles.

According to the frequency of extrasystoles in 1 minute:

• single (up to 5 additional contractions);
• multiple (more than 5 per minute);
• group (several extrasystoles one after another);
• doubles (2 in a row).

By the number of foci of excitation:

• monotopic (1 lesion);
• polytopic (more than one focus).

By appearance:

• early (occur at the time of atrium contraction);
• medium (between contraction of the atria and ventricles);
• late (at the moment of contraction of the ventricles or with complete relaxation of the heart).

By order:

• ordered (alternating full contractions with extrasystoles);
• disordered (lack of pattern).

Symptoms and signs

Often supraventricular extrasystole is asymptomatic, especially if its origin is due to organic reasons.

Patients may complain of strong tremors and beatings of the heart, a feeling of constriction in the chest, and a feeling that the heart has stopped.

Extrasystoles of functional origin are characterized by neuroses and autonomic disorders: feeling of lack of air, anxiety, sweating, fear, pale skin, dizziness, weakness.

In children supraventricular extrasystole often occurs without symptoms. Older children complain of fatigue, dizziness, irritability, and a feeling of “upheavals” of the heart.

In patients with an organic cause of SE arrhythmias appear less in a supine position (the patient feels better) and more strongly in a standing position.

Patients whose cause of SE is functional, feel better when standing, and worse when lying down.

Diagnostics and first aid

The mere presence of SE does not indicate the presence of any heart disease.

The diagnosis is made based on:

• patient complaints;
• general examination with auscultation and measurement (heart rate);
• data on the patient’s lifestyle, bad habits, past illnesses and surgical interventions, heredity;
• laboratory blood test (thyroid and adrenal hormones).

If necessary, stress tests with ECG recording before and after exercise.

Differential diagnosis of SE is carried out using an ECG and electrophysiological study of the heart (EPS), which record intracardiac potentials.

First aid for SE: calm the person down, take off outer clothing (if the attack did not happen outside during the cold season) or unbutton the collar, give him a drink of water, and sit him in a cool, quiet place.

Treatment tactics

If the patient has no complaints, hemodynamic disorders (decreased cerebral, coronary and renal blood flow) and there are no organic lesions of the heart, specific treatment for supraventricular extrasystole is not carried out. Single extrasystoles are not dangerous They do not require any health or treatment.

With frequent manifestations of symptoms of supraventricular extrasystole and their poor tolerance You can prescribe sedatives.

Antiarrhythmic drugs are prescribed by a doctor in exceptional cases due to the large number of side effects. Rare SE (several tens or hundreds of additional contractions per day) does not require such serious therapy.

Thus, if there are no clinical manifestations, blood flow disturbances or heart disease, it is enough to reassure the patient and recommend:

• Establish proper nutrition, if possible, exclude fatty, salty, and hot foods from the diet. Consume more fiber, vegetables and fruits.
• Avoid tobacco, alcohol and energy drinks.
• Spend more time outdoors.
• Avoid stress and heavy physical activity.
• Ensure adequate sleep.

In the presence of a pronounced decrease in blood flow, heart disease and SE against their background, it is prescribed conservative treatment antiarrhythmic drugs and glycosides. Medicines are selected only by the attending physician individually for each patient.

In the treatment of underlying heart disease SE symptoms weaken or disappear completely.

In extreme cases, if medications do not bring relief and the patient has difficulty with extrasystole, surgical intervention may be performed.

Currently, there are two options for surgical treatment of SE:

• Open heart surgery, during which ectopic areas are removed. Typically, such an operation is indicated in cases of intervention in connection with heart valve replacement.
• Radiofrequency ablation ectopic foci - a catheter is inserted into a large blood vessel, an electrode is inserted through it, which is used to cauterize the areas where pathological impulses occur.

Rehabilitation

No specific rehabilitation is required for supraventricular extrasystole.

• peace, no stress;
• minimal physical activity: walking, no heavy lifting;
• dietary food;
• restful, long sleep;
• completely eliminate smoking, alcohol, energy drinks;
• do not overheat (do not go out in the heat, do not visit the bathhouse or sauna, dress according to the season).

Prognosis, complications and consequences

According to some experts, frequent supraventricular extrasystole after a few years can lead to the development of heart failure, atrial fibrillation and cause a change in the configuration of the atria.

The prognosis for SE is favorable. This disease does not lead to, unlike ventricular extrasystole in combination with organic heart damage.

In rare cases, supraventricular tachycardia may develop.

Relapse prevention and prevention measures

Specific prevention for supraventricular extrasystole is not required. Doctors advise establishing a healthy lifestyle and diet:

• sleep in a cool room at least 7-8 hours a day;
• reduce salty, fried, hot foods in the diet to a minimum;
• smoke and drink alcohol as little as possible, it is better to eliminate energy drinks completely;
• walk in the fresh air for at least an hour a day, preferably 2 hours;
• moderate physical activity: swimming in the pool, taking the stairs instead of the elevator, skiing or jogging in the park. This is especially true for people with sedentary jobs.

Supraventricular (supraventricular) extrasystole occurs in people of any age. Mild cases do not require treatment. More serious ones may be accompanied by heart and other diseases and require drug therapy, and in extreme cases, surgical treatment. The main thing with this disease is to remain calm and lead a healthy lifestyle.

Extrasystole is premature excitation of the entire heart or any part of the heart in relation to the main rhythm.

Depending on the site of origin, ES is divided into supraventricular (occurs above the bifurcation of the His bundle) and ventricular (occurs below the bifurcation of the His bundle).

If there is extrasystole, I definitely evaluate:

1- coupling interval - the distance from the sinus complex preceding the extrasystole to the ecstasitole

2- compensatory pause - the distance between the extrasystole and the sinus complex following it

Supraventricular extrasystoles usually have a narrow QRS and an incomplete compensatory pause (the sum of the pre-extrasytolic and post-extrasytolic intervals Not equals 2 R-R). SVEs can be rare (up to 5 per minute), moderate in frequency (from 6 to 15 per minute) and frequent (more than 15 per minute). In addition, they can be single or paired, as well as sporadic or regular. An obvious regularity in the appearance of SVE is also possible: bigeminy (SVE after each main complex) or trigeminy (SVE after every two main complexes). All this data must be indicated in the diagnosis, since these types of NJES have different clinical significance.

In healthy people when monitoring ECG, SVE is found in 43-63% of cases. In this case, SVE is most often rare (less than 30 per hour) and occurs during a decrease in sinus rhythm.

In various diseases of the cardiovascular system, SVE is more often of medium frequency and frequent; it can appear against the background of sinus tachycardia; allometry is characteristic. Sporadic SVE is possible, appearing during attacks of angina pectoris and hypertensive crises.

The clinical significance of SVE is that it provokes more severe NRS: atrial fibrillation and flutter, supraventricular reentrant tachycardia, etc. In addition, SVE is often subjectively poorly tolerated by patients.

Examples of diagnoses for SVE:

Stage II hypertension, stage 2 hypertension, risk 3. Frequent regular supraventricular extrasystole. CHF I-1 f.k.

Treatment of patients with SVE:

Patients with VES, which are subjectively difficult to tolerate by patients, or VES, provoking paroxysms of tachycardia, are subject to specific therapy. The most commonly used are beta blockers and calcium antagonists (verapamil and diltiazem group). However, if it is proven that SVE causes paroxysms of one or another tachycardia, then an antiarrhythmic drug (AAP) selected to prevent attacks of tachycardia is used for treatment.

At ventricular extrasystole QRS complexes are widened and deformed, there is a complete compensatory pause (the sum of the pre-extrasystolic and post-extrasystolic intervals is equal to 2 R-R).

Right ventricular ES have the form of left bundle branch block, left ventricular ES have the form of right bundle branch block.

For prognostic assessment, a grading system for PVCs developed by V. Lown and M. Wolf (1971) is used.

Gradations of PVCs according to V. Lown (1971):

• 0 - absence of PVCs
• 1-30 or less per hour PVCs
• 2- more than 30 PVCs per hour
• 3- polymorphic PVCs
• 4(A) - paired PVCs
• 4(B) - three or more PVCs in a row
• 5- ZhE type R on T.

If PVCs are registered in practically healthy(especially a young) person and does not cause serious unpleasant subjective sensations, then there are no absolute indications for antiarrhythmic therapy (AAT) in such a patient. If PVCs are frequent and poorly tolerated, then certain treatment may be possible.

If the patient has a tendency towards sympathicotonia. PVCs occur during the daytime, during stress, and during physical activity, he is recommended to be treated with beta-blockers in combination with mild sedative therapy. It is advisable to limit coffee, tea, alcoholic drinks, and smoking. It is possible to consult a psychotherapist and provide adequate treatment for depressive and anxiety states.

If the patient has a tendency to parasympathicotonia. PVCs occur at night, at rest, against the background of bradycardia, and reflexively in diseases of the gastrointestinal tract. Such patients are recommended to receive adequate treatment for gastrointestinal diseases, possibly using sedatives, tranquilizers (Grandaxin), and drugs that slightly increase heart rate.

In organic diseases of the CVS, the clinical significance of PVCs is determined by their ability to provoke attacks of VT and ventricular fibrillation.

The risk of sudden death (SD) in this group of patients is highly variable and very difficult to estimate. It can be assessed according to 3 main risk factors: MI, EF less than 40%, PV (more than 10 per hour). In the presence of 1 risk factor (MI or EF less than 40%), the risk of VS per year is 5%, when combining each of these risk factors with PVCs the risk of VS is 10%, with a combination of 3 risk factors - 15%.

When treating patients with PVCs, a number of rules must be followed:

1. The most important direction in the management of such patients is active therapy of the underlying heart disease.
2. Do not prescribe VS to patients with RF for continuous use of class I AAP.
3. In patients with a history of MI, EF less than 40% and PVCs IV in the gradation, endocardial EPS is indicated. If VT is provoked during EPS, implantation of a cardioverter-defibrillator (CV-DF) is indicated in a patient resistant to AAP.
4. If EPS does not provoke AAP-resistant VT, prophylactic therapy with amiodarone is possible.

Causes

Supraventricular extrasystole can be idiopathic, that is, it occurs without any apparent reason. It can be observed in practically healthy people at any age. In addition, there are different reasons for the development of supraventricular extrasystole:

• Heart diseases:
  • heart failure;
  • cardiac ischemia;
  • myocardial infarction;
  • heart defects, both congenital and acquired;
  • myocarditis (inflammatory processes in the heart muscle);
  • cardiomyopathy.
• Endocrine diseases:
  • diabetes;
  • hyperthyroidism, or thyrotoxicosis;
  • adrenal gland diseases.
• Exposure to toxins:
  • alcohol abuse;
  • smoking.
• Long-term use of certain heart medications, including:
  • antiarrhythmic drugs;
  • glycosides;
  • diuretics.
• Autonomic disorders.
• Electrolyte imbalance (disturbance in the body's metabolism of electrolytes - sodium, potassium, magnesium).
• Oxygen starvation for bronchitis, sleep apnea, anemia.

Classification and causes of supraventricular extrasystole

The disease is characterized by extraordinary premature excitation of the heart

Supraventricular extrasystole is a special condition directly related to heart rhythm disturbances. The disease is expressed in an extraordinary contraction of either the entire heart or its individual sections.

Supraventricular extrasystole is also called supraventricular extrasystole, and it is characterized by premature impulses that occur in ectopic foci located in the atria.

As a result of this action, defective contraction of the heart occurs. There are cases when heart contractions in the atria can cause atrial fibrillation and supraventricular tachycardia.

Classification of the disease

In medicine, it is customary to classify supraventricular extrasystole according to several characteristic features:

According to the location of the outbreak:

• atrioventricular (occur in the septum between the atria and ventricles);
• atrial (occurs in the upper parts of the heart).

By frequency (per minute):

• group (several extrasystoles in a row are observed at once);
• single (up to five contractions are observed);
• multiple (from five extraordinary reductions);
• doubles (two in a row).

According to the number of emerging outbreaks:

• monotopic (there is one focus);
• polytopic (there are several foci).

By order:

• ordered extrasystoles (meaning the alternation of normal contractions with extrasystoles);
• disordered extrasystoles (implies the absence of any pattern in the alternation).

By time of appearance:

• early (appear during atrial contraction);
• medium (appears in the interval between contractions of the atria and ventricles);
• late (appear during contraction of the ventricles with complete relaxation of the heart).

Causes

There are several reasons that can lead to the development of supraventricular extrasystole:

1. Cardiac, that is, cardiac causes. These include the presence of diseases such as:

• Ischemic disease. In this case, this is due to insufficient blood supply and oxygen starvation;
• Myocardial infarction. The death of an entire section of the heart muscle occurs, which is subsequently replaced by scar tissue;
• Cardiomyopathy. In such cases, damage to the heart muscle occurs;
• Myocarditis. This is inflammation of the heart muscle;
• Congenital/acquired heart defects (implies a violation of the structure of the heart);
• Heart failure. Here we are talking about conditions when the heart is not able to fully perform its function of pumping blood.

1. Drug treatment. In this case, it is meant that the causes of the disease can be various drugs that were taken by the patient, either uncontrolled or over a long period of time. Among these medications are the following:

• drugs against arrhythmia (they can cause heart rhythm disturbances);
• cardiac glycosides, which are aimed at improving heart function while reducing the load on it;
• diuretics, which increase the production and excretion of urine.

1. Violations of the level of electrolytes, that is, a change in the existing proportions of the ratio of salt elements: potassium, magnesium, sodium.
2. Toxic effects on the body, namely, the effects of cigarettes and alcohol.
3. Disorders of the autonomic nervous system.
4. The presence of the following hormonal diseases:

• diabetes mellitus (the pancreas is affected, which leads to disturbances in glucose metabolism);
• adrenal gland diseases;
• thyrotoxicosis (the thyroid gland secretes an increased amount of hormones that have a destructive effect on the body).

1. Chronic oxygen starvation (hypoxia). This is possible if the patient has diseases such as sleep apnea (short-term stops in breathing during sleep), bronchitis, and anemia (anemia).
2. Idiopathic cause, that is, the case when the disease occurs without any reason.

Symptoms

The disease often has no obvious symptoms

Supraventricular extrasystoles are insidious in that they often do not have any pronounced symptoms.

Patients often do not have any complaints, and the disease proceeds unnoticed, but only for some time.

Supraventricular extrasystole may have the following symptoms:

1. Shortness of breath, feeling of suffocation.
2. Dizziness (this occurs due to decreased blood flow and oxygen starvation).
3. Weakness, increased sweating, discomfort.
4. Interruptions in the work of the heart (feeling of beats out of rhythm or even “reversals”).
5. “Hot flashes” that have no reason.

The most important and common sign of the disease is a feeling as if the heart stops for a while. Most often this causes panic, anxiety, paleness, etc. in people.

Generally speaking, supraventricular extrasystole accompanies a large number of heart diseases. Sometimes it is associated with the presence of vegetative or psycho-emotional disorders.

Diagnosis of the disease

Diagnosis of the disease is based on the following points:

• Analysis of patient complaints, which refers to a feeling of “interruptions” in the heart, general weakness and shortness of breath. The doctor will definitely ask how long ago all these symptoms appeared, what treatment was carried out previously, if any, and how the signs of the disease changed during this time;
• Analysis of anamnesis. The cardiologist must find out what operations and diseases the patient has had previously, what kind of lifestyle he leads, what bad habits he has, if any. Heredity is also important, namely, the presence of heart disease in close relatives;
• General inspection. The doctor feels the pulse, listens and taps the heart in order to identify any changes in the boundaries of the organ;
• Taking a biochemical analysis of blood, urine, analysis of hormone levels;
• ECG data. It is this moment that makes it possible to identify changes characteristic of the disease;
• Holter monitoring indicators. This diagnostic procedure involves the patient wearing a machine that performs an ECG throughout the day. In this case, a special diary is kept where absolutely all the patient’s actions are recorded. The ECG and diary data are subsequently compared, which makes it possible to identify unknown heart rhythm disturbances;
• Echocardiography data. The procedure allows us to identify the fundamental causes of the disease, if any.

Consultation with a therapist and cardiac surgeon is also important, so if you have the above symptoms, it is better to contact them along with a visit to a cardiologist.

Treatment

Treatment of supraventricular extrasystole has two types:

• conservative;
• surgical.

Conservative treatment involves prescribing several drugs against arrhythmia from different groups of drugs. This allows you to normalize your heart rate and improve heart function.

The choice of medication depends on the type of extrasystole and the presence/absence of contraindications to the drug.

Commonly prescribed medications include the following:

• etacizin;
• anaprilin;
• obzidan;
• allapinin;
• arrhythmil;
• verapamil;
• amiodarone.

Treatment can only be prescribed by an experienced doctor

Also, the doctor, at his discretion, can prescribe cardiac glycosides to the patient, which are designed to improve heart function while reducing the load on it. It is also possible to prescribe medications that lower blood pressure.

Surgical intervention is used only in the case of a complete lack of improvement after taking medications from different groups. The operation is most often recommended for young patients.

The following types of intervention are possible:

• Radiofrequency catheter ablation. A catheter is inserted through a large blood vessel into the atrium cavity, through which, in turn, an electrode is passed that cauterizes the altered area of ​​the patient’s heart;
• Open heart surgery, which involves excision of ectopic foci (those areas of the heart where an additional impulse occurs).

Possible complications

How dangerous is the disease? It can cause the following complications:

• Ischemic disease. In this case, the heart ceases to perform its function correctly;
• Change the structure of the atria;
• Create atrial fibrillation (that is, defective heart contractions).

Preventive measures and forecasts

• Maintain a rest regime, control the duration of sleep;
• Eat right, exclude spicy foods, fried, salty, canned foods from your diet. Doctors recommend eating more greens, fruits, and vegetables;
• Any medication intake should be carried out under the supervision of a specialist;
• Quitting smoking, alcohol;
• Contact a cardiologist at the first manifestation of symptoms of the disease.

In conclusion, I would like to note that if you consult a doctor in a timely manner and follow all norms and recommendations, patients are given a good prognosis.

Supraventricular extrasystole is one of the types of arrhythmia. In this case, an extraordinary excitation of any part of the heart occurs, caused by the occurrence of a premature impulse in the upper parts of the heart or in the antiventricular node.

Etiology and types of supraventricular extrasystoles

The causes of supraventricular extrasystole are varied. Extrasystoles are functional and organic.

Functional

Functional ones can occur in people with a healthy heart, in particular in children and tall young men. This is a rare single supraventricular extrasystole with the number of contractions less than 30 per hour.

Extrasystoles of the following origin are usually classified as functional:

• neurogenic;
• diselectrolyte;
• dishormonal;
• toxic;
• medicinal.

Enlargement of the thyroid gland and its increased function can often be the cause of supraventricular extrasystole

Neurogenic, in turn, are divided into hypoadrenergic, hyperadrenergic and vagal.

Hyperadergic extrasystoles are associated with increased physical and mental work, emotional arousal, drinking alcohol, smoking, and eating spicy foods.

Hypoadergic are difficult to recognize. Their existence is confirmed by experimental data and clinical observations.

At vagal extrasystole Interruptions in heart contraction occur after eating and during sleep, that is, in a horizontal position.

Organic

Organic supraventricular extrasystoles are caused by heart diseases, including:

• cardiac ischemia;
• heart defects;
• cardiomyopathy;
• myocarditis;
• tricuspid valve prolapse;
• mitral valve prolapse with blood returning to the left atrium;
• minor atrial septal defect;
• expansion of the pulmonary artery trunk;
• atrial dilatation in obesity, diabetes mellitus, chronic alcohol intoxication.

Sinus extrasystole is most often caused by chronic ischemic heart disease. We can talk about the organic nature of supraventricular extrasystole if it develops:

• with sinus tachycardia;
• comes from several foci (polytopic);
• associated with angina pectoris;
• extrasystoles more than 30 per hour during ECG monitor recording and more than 5 per minute during examination by a doctor.

In addition, supraventricular extrasystole is classified as follows:

1. According to the number of ectopic foci: monotopic (one foci), polytopic (several foci).
2. By localization: atrial with the source of excitability in the atria and antiventricular - in the septum between the upper and lower parts of the heart.
3. By frequency: paired (two extrasystoles in a row), single (less than 5 per minute), multiple (more than 5 per minute), group (several premature contractions in a row).

Signs

Often people with supraventricular premature beats have no symptoms. The most characteristic signs:

1. Dizziness, feeling of weakness.
2. Shortness of breath, lack of air.
3. Fear, anxiety, panic, fear of death.
4. Interruptions in the work of the heart, a feeling of its revolutions.
5. Feeling of heart stopping or freezing.
6. After freezing, a push to the chest.

Diagnostics

Diagnosis of extrasystole is based on an analysis of the patient’s complaints and medical history. That is, the doctor finds out how long ago the signs appeared, what they are associated with, in the patient’s opinion, and how they change over time.

ECG is one of the most accessible methods for diagnosing extrasystoles

The doctor examines the life history. This includes bad habits, heredity, lifestyle, working and rest conditions, past illnesses and surgical interventions.

During the examination, the patient's pulse is measured and the heart is listened to. Blood and urine tests (general and biochemical), as well as an analysis of hormone levels, are prescribed.

Hardware methods include ECG, ultrasound, Holter monitoring, and recording of an electrocardiogram during and after physical activity.

Treatment

If supraventricular extrasystole is benign, then treatment is most often absent. If there are no endocrine or heart diseases, the patient is recommended to fulfill certain requirements:

1. Maintaining a daily routine, proper rest and sleep.
2. Exercise moderation when exercising, try to protect yourself from stress, and do not take everything to heart.
3. Spend more time outside and breathe fresh air.
4. Stick to a healthy diet. The diet should contain more greens, vegetables, and fruits. Spicy, fried, canned foods should be excluded. It is also undesirable to eat hot food.

Treatment of supraventricular extrasystole is necessary in the following cases:

• Poor tolerance of symptoms, which cannot be ignored, as it makes patients neurotic.
• The risk of atrial fibrillation in patients with heart defects, as well as with progressive organic pathologies of the atria.
• Frequent extrasystoles - about 1000 per day or more.

Treatment is aimed at relieving the symptoms of supraventricular extrasystole.

Drug therapy consists of choosing an antiarrhythmic drug. It depends on the etiology and frequency of extrasystoles. Beta-blockers, class I antiarrhythmic drugs, and calcium antagonists are prescribed. Efficacy is determined clinically and using Holter monitoring. In addition, depending on the indications, infections are treated with anti-inflammatory, antiviral agents, and glucocorticoids. Vegetotropic and psychotropic drugs are prescribed.

Non-drug treatment includes psychotherapeutic methods and elimination of non-cardiac causes of extrasystole. You should limit the consumption of alcohol, strong tea, coffee, and completely stop smoking.

Surgical intervention is indicated for frequent, usually monotopic extrasystole, if drug treatment does not have an effect. Radiofrequency ablation is performed.

In case of supraventricular extrasystole, consultation with a psychiatrist, surgeon, endocrinologist, or cardiac surgeon may be required. This is associated with such concomitant diseases as psychovegetative disorders, hyperthyroidism, reflex supraventricular extrasystole.

Folk remedies

Treatment with folk remedies is always very popular. For supraventricular extrasystole, the following tinctures are widely used:

• Pour vodka over hawthorn (10 g of dried fruits) and leave for 10 days. After this, strain, dilute with water and drink 10 drops a day three times.
• Pour valerian roots (3 teaspoons) with boiled water (100 ml). Cook for a quarter of an hour over low heat. After this, cool and filter. Drink one spoon one hour before meals in the morning, at lunch and in the evening.

Forecast

As a rule, there is no convincing evidence that supraventricular extrasystole is life-threatening. However, it can provoke the development of other types of arrhythmias, and its symptoms may be poorly tolerated by patients. In this case, it is necessary to be observed by a cardiologist.

The prognosis depends on the frequency of extrasystoles and the severity of the primary disease. There is a risk of developing atrial fibrillation.

Etiology and types of disease

During an arrhythmia called supraventricular extrasystole, premature impulses occur, which provoke extraordinary activity mainly in the upper parts of the heart.

Supraventricular extrasystole in children can occur against the background of tachycardia and cardiovascular diseases. There are cases where the disease occurs in children with a completely healthy heart.

It is important to note that in some cases you can do without any treatment, since the nature of the disease is benign. If possible, it is necessary to eliminate the factor that provokes supraventricular extrasystole and carry out antiarrhythmic therapy. Indications for this procedure are as follows:

1. Intolerance to supraventricular extrasystole.
2. There is a high risk of developing complications, as a rule, this is observed in patients with heart defects and other diseases of the cardiovascular system.
3. Too frequent supraventricular extrasystole.

Characteristic symptoms

In addition to the fact that the characteristic symptoms of the disease appear, the emotional and psychological state of the patient also changes. This is how anxiety and an unconscious feeling of fear arises. Often, completely unreasonably, the patient is in panic, afraid of dying.

Causes of extrasystole

The main causes of the disease can be divided into several types.

1. Initially, pathologies of the cardiovascular system lead to the occurrence of supraventricular extrasystole. This includes ischemic disease and myocardial infarction. Pathology of the heart muscle due to congenital or acquired heart defects.
2. Cardiac disturbances can be caused by drugs taken without a doctor’s prescription or by chaotic and uncontrolled use of drugs, when the dose is often exceeded.
3. The use of anti-arrhythmic drugs, as well as the use of diuretics.
4. Abuse of tobacco and alcohol leads to toxic poisoning of the body and provokes the occurrence of extrasystole.
5. Disturbances in the functioning of the thyroid gland and hormonal imbalance can also become another cause of the disease.

The causes of the disease are often the result of both the patient’s poor lifestyle, various operations he has undergone during his life, and serious illnesses.

Treatment of supraventricular extrasystole

Treatment of supraventricular extrasystole can only be prescribed by a specialist, after a thorough diagnosis. This disease is divided into several types, based on which the doctor will decide on the use of one or another treatment method.

In general, both non-surgical treatment methods and surgery can be used.

After a thorough diagnosis, when the diagnosis is accurately established and the cause that triggered the onset of the disease is identified, appropriate treatment will be prescribed.

With the medicinal method, a specialist prescribes antiarrhythmic drugs that normalize the heart rhythm. Moreover, the doctor can prescribe several drugs or just one. It all depends only on what type of supraventricular extrasystole is detected and what the immediate disturbances in the rhythm are.

It should be noted that drugs in this group have many contraindications and side effects, which, of course, any specialist must take into account when prescribing.

Sometimes a specialist may prescribe cardiac glycosides. They help reduce the load on the heart muscle and improve heart function. It is possible to prescribe drugs from a group that normalizes blood pressure.

If the medications prescribed by a specialist do not bring a beneficial result and their use is ineffective, the doctor considers the possibility of performing a surgical operation if the patient does not tolerate the resulting extrasystole. Because there are cases where patients live with such a disease and do not complain of symptoms or discomfort.

The surgical method is preferable to use at a young age. During the operation, a catheter is inserted into the area of ​​the atria, which facilitates the conduction of an electrode, which, when exposed, cauterizes the modified area of ​​the heart.

The open method of surgery is performed when there is an urgent need to replace the valve. In such operations, ectopic areas are excised.

Types of supraventricular extrasystole

Supraventricular extrasystole is the general name for some types of extrasystole. It is advisable to consider each of them separately, since they have different symptoms and arise in different areas of the heart.

Ventricular and supraventricular extrasystole lead to changes in the myocardium. But supraventricular extrasystole, as a rule, occurs in the rarest cases. Its effect on the heart is almost passive, since it does not cause obvious signs in the blood circulation of the organ. The severity is also small and often resembles normal contractions of the heart muscle. The impulse spreads its effect to the ventricles, but the speed of propagation is low, so this type of arrhythmia practically does not pose a danger to the functioning of the cardiovascular system.

But ventricular extrasystole acts in counterbalance, spreading its effect to the ventricles, it completely changes their work schedule. This can be clearly seen when performing an ecg. As a result of such exposure, a disruption occurs in the normal functioning of the heart muscle. It either becomes immune to new impulses that should force it to contract, or, on the contrary, reacts even to extraordinary impulses caused by arrhythmia; as a rule, during these periods a person either feels an increased heart rate, or, on the contrary, feels that it seems to freeze and stop .

A single supraventricular extrasystole also causes characteristic symptoms felt by the patient, such as disruptions in the functioning of the heart. They can also occur in a completely healthy person, since they are a consequence of impaired circulation of the heart muscle in completely small areas.

In addition to single ones, there is also a paired supraventricular extrasystole, which is also clearly visible during an ECG. It is characterized by two extrasystoles that slip between normal contractions of the heart muscle.

Bigeminy

Panventricular and supraventricular extrasystole are often combined under the same term bigeminy. Normally, in a healthy person, the number of extrasystoles is 9, contractions of the heart muscle or myocardium should be 30-60 per hour. During the electrocardiogram, you can clearly see alternating normal contractions and arrhythmic ones, which can be quite frequent.

Bigeminy may not be permanent. It can manifest itself as a single supraventricular extrasystole and disappear during the day, therefore, in order to determine the significance of the arrhythmia, it must be recorded using an ECG recording performed during the day.

And only based on the results of the ECG obtained, it will be possible to draw conclusions. An arrhythmia that manifested itself within just 10 minutes over the course of a whole day is not dangerous, but an arrhythmia that was constant and lasted for several hours is considered a pathology.

Being a term characterizing arrhythmias. It manifests itself similarly. To treat or not to treat will depend only on individual tolerance or, conversely, complete intolerance of bigeminy by the patient.

Treatment of extrasystole with folk remedies

Of course, in folk medicine there are recipes that are intended to treat this disease. It should be emphasized that treatment of arrhythmia with folk remedies should only be of a course nature.

A one-time dose of any drug, even a medicinal one, will have absolutely no effect on the manifested arrhythmia, the same applies to folk remedies.

Arrhythmia is a disturbance in the normal functioning of the heart muscle caused by certain reasons. Therefore, during treatment you should exercise maximum attention and caution, and be sure to first consult with a specialist.

Currently, the following traditional medicine recipes are most in demand and are quite popular.

Treatment with valerian

It's no secret what a calming effect valerian has. A tincture of it is often taken for stress, nervous excitement, and overexertion.

By the way, there is an interesting fact: it is believed that arrhythmia in some cases occurs in patients against the background of a disturbed psycho-emotional state or stress, but this issue is very controversial. Therefore, if arrhythmia was caused by stress, then ordinary valerian is the best remedy.

To prepare the infusion, 1 tbsp is enough. Brew a spoonful of plant roots with a glass of hot, just boiled water. Let it brew for 10 hours, strain and take 1 tbsp. l. 3 times a day.

Cornflower will help avoid acute attacks

Severe attacks accompanied by unpleasant sensations caused by polytopic pancreatic extrasystole can be stopped by using an infusion of cornflower.

For cooking you need 1 tbsp. l. Pour 1 cup boiling water over the plants and let it brew. Take before meals, 3 times a day. It is advisable to take the decoction only when severe attacks occur.

Calendula will eliminate heart rhythm disturbances

Traditional medicine is very effective against extrasystole, since this disease causes disturbances in the normal functioning of the heart rhythm; medicinal plants help normalize the rhythm.

It will take 2 hours to prepare the infusion. l. dry plant, which are poured with boiling water, in the amount of two glasses. You need to leave for an hour, then strain and drink about 4 times a day, half a glass.

Horsetail will eliminate heart weakness

Often, arrhythmia occurs due to weakness of the heart muscle itself (myocardium); at first, this manifests itself as a rare pancreatic extrasystole. To train the muscle and, accordingly, eliminate the symptoms of arrhythmia, use an infusion of ordinary horsetail.

To prepare 1 tbsp. l. The plants are poured with boiling water in the amount of three glasses and left for 3 hours in a sealed container. Take the resulting tincture 6 times a day, only 1 tbsp. l.

Hawthorn tincture with alcohol

A very effective product, sold everywhere in pharmacies. But if you are intolerant to ethyl alcohol, then you should not take it. It lowers blood pressure well, soothes, improves heart rate, and improves blood circulation.

Honey against arrhythmia

Radish juice should be mixed with honey in equal proportions, stirred and stored in a cool, dark place. The resulting mixture is taken 1 tbsp. l. three times a day. The mixture improves and normalizes heart rate.

Conclusion

Supraventricular extrasystole can be identified based on the patient’s complaints, after listening to which the specialist usually prescribes an electrocardiogram. Frequent pancreatic extrasystole of the ECG, in which it is necessary to carry out, is clearly visible, manifested by jumps between the normal contraction of the heart muscle. But even such results will not help establish an accurate diagnosis and identify the type of arrhythmia. Therefore, it is advisable to prepare for both a comprehensive examination and complex treatment. Always try to be positive, as this helps to cope with any manifestations of arrhythmia, which can often be a consequence of severe stress or depression.

Supraventricular extrasystole

Supraventricular extrasystole- this is a certain type of heart contraction in which an ectopic focus of automatism is formed in the atrial myocardium or in the atrioventricular junction. Supraventricular extrasystole can be detected in people who do not have cardiac pathologies and, vice versa. The causes of this condition may be an increased concentration of catecholamines that participate in the circulation, various pathologies of the pericardium and the effects of cor pulmonale.

Sometimes the heart contractions of the atria can trigger atrial fibrillation and tachycardia in the area above the ventricles. In addition, when impulses develop in only one area of ​​the atria, monomorphic P waves with the same shape are formed, and when impulses occur in different areas, polymorphic or polyfocal ectopic P waves with different shapes are formed. But the ectopic impulse, which is conducted through the atrioventricular connection, is characterized by a certain slowdown, that is, an extended P-R interval complex is formed.

On the electrocardiogram, supraventricular extrasystole represents a premature deformed P wave with subsequent changes in the QRST complex. And after a heartbeat, an incomplete pause of a compensatory nature is formed, which is slightly longer than the R-R interval. In some cases, atrial extrasystole is blocked. The supraventricular form of arrhythmia from the atrioventricular node is characterized by extraordinary complexes that have negative P-waves in certain leads, recorded before and after the QRS complex, or when it is layered. Heart contractions of the atria are characterized by deformations of this complex due to blockade of the conduction system.

In case of existing heart diseases, the condition of patients is constantly monitored in order to promptly identify a permanent form of heart rate disturbance. In this case, antiarrhythmic drugs of the first, second and fourth classes, as well as cardiac glycosides, are used. And in the absence of pathological heart diseases, it is advisable to stop drinking coffee, tea, alcoholic beverages and smoking.

Causes of supraventricular extrasystole

Today, a variety of causes of supraventricular extrasystole have been identified. In general, supraventricular heart contraction disorders can be divided into extrasystoles of a functional and organic nature. Some authors consider only arrhythmias of neurogenic origin that occur in people who have a healthy heart to be functional atrial contractions. Indeed, in this category of people, an ECG study reveals this arrhythmia in 60% of cases. And they mainly appear when the sinus node slows down. However, in addition to neurogenic causes, diselectrolyte, toxic, dishormonal, medicinal, etiological factors are distinguished, that is, those that are caused by mild forms of dystrophic disorders in the myocardium and disappear when metabolic processes are restored.

Neurogenic atrial contractions include hyperadrenergic, vagal and hypoadrenergic cardiac contractions. In the first case, supraventricular extrasystole occurs during emotional excitement, intense physical and mental work of a person, when consuming alcohol, nicotine, spicy food, etc. Very often, heart contractions develop in patients suffering from neuroses and VSD. diencephalic disorders. But hypoadrenergic extrasystoles are quite problematic to detect. The lack of norepinephrine in the heart muscle is characterized by a pathogenetic factor in the presence of myocardial dystrophy of alcohol-toxic origin. Also, many athletes with existing myocardial dystrophy against the background of chronic physical overstrain may develop supraventricular extrasystole.

Increased vagal stimulation also affects the formation of this arrhythmia. But if interruptions in heart contractions appear during sleep, eating, or in a horizontal position, then it can be argued that the cause of the formation of these heart contractions is considered to be too great an effect on the heart of the vagus nerve. Very often, these reflexes emerge from a sliding hernia, gastric bladder, or esophageal diverticulum. Other sources of cardiac irritation include: intestines, gallbladder, abdominal tumors, prostate cancer and uterine fibroids, etc.

The functional form of supraventricular extrasystole includes atrial arrhythmias of practically healthy children and tall young people. Some of them have changes in the chest, Marfan syndrome. mid-located heart. These features very often occur in combination with VSD, which becomes the cause of the development of supraventricular extrasystole.

The arrhythmogenic effects of hypokalemia in combination with iron deficiency and anemia, hyperkalemia, hypoproteinemia, sodium and water ion retention, as well as hypertension are also well known. In addition, thyrotoxic dystrophy plays an important role in the formation of supraventricular extrasystole. But the tonsillogenic form of cardiac muscle dystrophy is manifested only by single extrasystoles and the cause of their occurrence may be unclear for a long time.

The organic nature of the development of supraventricular extrasystole includes heart rhythm disturbances against the background of coronary artery disease. myocarditis, cardiomyopathies, heart defects, especially with mitral valve stenosis. The second subgroup of this arrhythmia includes patients with triscupid valve prolapse, a slight defect of the septum between the atria, idiopathic dilatation of the pulmonary trunk and atrium due to diabetes mellitus. obesity and chronic alcohol poisoning.

Supraventricular extrasystole symptoms

This is a certain form of arrhythmia, in which the process of excitation of the heart is noted as a result of an impulse that occurs out of turn and emanates from the atrioventricular junction or atrium.

The main mechanism for the development of atrial heart contractions is based on the process of reentry in certain areas of the heart muscle or conduction system, which have conductivity of different shapes and a blockade of the conduction of this impulse in one direction.

Another mechanism for the development of supraventricular extrasystole is considered to be pathological automatism of the cardiac conduction system, increased activity of myocardial membranes in early diastole or late systole. In clinical practice, one of the most common causes of supraventricular extrasystoles is considered to be disturbances in autonomic balance, where sympathotonia predominates. These disorders are caused by meteorological, emotional factors and the influence of nicotine, alcohol and coffee on the body of patients. As a rule, supraventricular extrasystole can occur in healthy people up to thirty times a day.

The symptomatic picture mainly consists of subjective sensations, which are not always expressed during cardiac contractions of the atria. It is quite difficult for patients diagnosed with VSD, but with organic cardiac lesions this type of arrhythmia is tolerated somewhat more easily.

Basically, supraventricular extrasystole is manifested by a beat, a push of the heart in the chest area from the inside as a result of an energetic contraction of the heart after a pause of a compensatory nature. Sometimes the heart turns over or somersaults, a malfunction in its work in the form of freezing is felt. The functional form of extrasystole is characterized by hot flashes, discomfort, weakness, anxiety, sweating and lack of air.

Frequent supraventricular extrasystoles help reduce cardiac output, and this in turn reduces blood circulation in the coronary vessels, kidneys and brain. And with ischemic heart disease, an attack of angina develops; with signs of atherosclerotic lesions of cerebral vessels, patients complain of dizziness, fainting, paresis and aphasia.

On the electrocardiogram with atrial extrasystole, the P wave and QRS complex appear prematurely; the polarity of this tooth is deformed and changes; an incomplete compensatory pause is determined; there is a slightly changed extrasystolic QRS complex; the shape of the P wave varies from complex to complex.

Single supraventricular extrasystole

This form of supraventricular extrasystole is called premature electrical activation of the heart as a result of impulses that are located in the atria, vena cava or pulmonary veins, as well as in the atrioventricular junction. A single supraventricular extrasystole is considered safe and can appear in absolutely healthy people. This type of arrhythmia is more common than other forms.

Single supraventricular extrasystole can develop due to various diseases of the S.S.S. endocrine pathologies and other diseases that are accompanied by cardiac symptoms. In healthy people, this arrhythmia is provoked by stressful situations, physical activity, intoxication and iatrogenic factors.

Single supraventricular extrasystole is of two types - atrial and from the atrioventricular node. The atrial form is characterized by the formation of an ectopic focus of excitation in the atria, which is transmitted up to the sinus node and down to the ventricles. This type of arrhythmia is caused by organic cardiac lesions and is observed when the patient is in a horizontal position.

Supraventricular extrasystole from the AV junction is characterized by two types of heart contractions. In the first case, the atria are excited, and then the ventricles. And according to their clinical characteristics, they resemble atrial extrasystole. In the second case, both the atria and ventricles are simultaneously excited.

The symptoms of a single supraventricular extrasystole consist of too strong cardiac impulses and beats. Patients complain of a malfunction of the heart when it freezes and stops. At the moment of a pause of a compensatory nature, the head may feel dizzy, weakness appears throughout the body, the patient cannot breathe, a squeezing feeling occurs behind the chest and pain in the heart.

This type of arrhythmia can be detected by cardiac listening, as well as by ECG.

Supraventricular extrasystole treatment

Sometimes this arrhythmia can be benign and does not require treatment. If possible, they try to eliminate the cause of supraventricular extrasystole.

Indications for the use of antiarrhythmic drug therapy are that this form of arrhythmia is poorly tolerated, a high risk of ventricular fibrillation and frequent heart contractions, more than a thousand per day. Antiarrhythmic therapy is not used if the arrhythmia is idiopathic, there are no symptoms, the heart rate is borderline, and there is drug intolerance.

The main goal of treatment is the need to suppress supraventricular extrasystole and alleviate symptoms, as well as reduce the risk of developing atrial fibrillation.

Indications for hospitalization are acutely occurring frequent heart contractions in the presence of organic lesions of the atria.

Non-drug therapy for supraventricular extrasystole involves excluding causative factors and psychotherapeutic influence.

But when choosing antiarrhythmic drugs, attention is paid to the etiology, quantity and prognostic value of supraventricular extrasystole. Treatment generally begins with beta-blockers (Propranol, Atenolol, Metoprolol, Bisoprolol, Betaxolol, Nebivolol). Then Verapamil and Diltiazem (calcium antagonists) are prescribed. These two groups of drugs are especially effective in the trigger form of arrhythmia. And only then do they begin to use antiarrhythmic drugs, taking into account all contraindications (Disopyramide, Allapinine, Quinidine, Propafenone, Etatsizin).

Holter monitoring is used to evaluate the effectiveness of these drugs. In addition, foci of chronic infection are simultaneously sanitized with Chloroquine or Hydroxychloroquine in combination with NSAIDs and small doses of glucocorticoids. They also prescribe sedatives and benzodiazepines with vegetotropic or antiarrhythmic effects.

Surgical treatment is used for frequent and drug-sensitive arrhythmias in the form of radiofrequency ablation.

Supraventricular extrasystole is not dangerous for patients, but sometimes it can be difficult for them to tolerate and can also cause other arrhythmias.

The prognosis of supraventricular extrasystole is directly dependent on the severity of the underlying cardiac pathology, heart rate and the risk of flutter or atrial fibrillation.

Functional

Functional ones can occur in people with a healthy heart, in particular in children and tall young men. This is a rare single supraventricular extrasystole with the number of contractions less than 30 per hour.

Extrasystoles of the following origin are usually classified as functional:

• neurogenic;
• diselectrolyte;
• dishormonal;
• toxic;
• medicinal.

Enlargement of the thyroid gland and its increased function can often be the cause of supraventricular extrasystole

Neurogenic, in turn, are divided into hypoadrenergic, hyperadrenergic and vagal.

Hyperadergic extrasystoles are associated with increased physical and mental work, emotional arousal, drinking alcohol, smoking, and eating spicy foods.

Hypoadergic ones are difficult to recognize. Their existence is confirmed by experimental data and clinical observations.

With vagal extrasystole, interruptions in heart contraction occur after eating and during sleep, that is, in a horizontal position.

Organic

Organic supraventricular extrasystoles are caused by heart diseases, including:

• cardiac ischemia;
• heart defects;
• cardiomyopathy;
• myocarditis;
• tricuspid valve prolapse;
• mitral valve prolapse with blood returning to the left atrium;
• minor atrial septal defect;
• expansion of the pulmonary artery trunk;
• atrial dilatation in obesity, diabetes mellitus, chronic alcohol intoxication.

Sinus extrasystole is most often caused by chronic ischemic heart disease. We can talk about the organic nature of supraventricular extrasystole if it develops:

• with sinus tachycardia;
• comes from several foci (polytopic);
• associated with angina pectoris;
• extrasystoles more than 30 per hour during ECG monitor recording and more than 5 per minute during examination by a doctor.

In addition, supraventricular extrasystole is classified as follows:

1. According to the number of ectopic foci: monotopic (one foci), polytopic (several foci).
2. By localization: atrial with the source of excitability in the atria and antiventricular - in the septum between the upper and lower parts of the heart.
3. By frequency: paired (two extrasystoles in a row), single (less than 5 per minute), multiple (more than 5 per minute), group (several premature contractions in a row).

Signs

Often people with supraventricular premature beats have no symptoms. The most characteristic signs:

1. Dizziness, feeling of weakness.
2. Shortness of breath, lack of air.
3. Fear, anxiety, panic, fear of death.
4. Interruptions in the work of the heart, a feeling of its revolutions.
5. Feeling of heart stopping or freezing.
6. After freezing, a push to the chest.

Diagnostics

Diagnosis of extrasystole is based on an analysis of the patient’s complaints and medical history. That is, the doctor finds out how long ago the signs appeared, what they are associated with, in the patient’s opinion, and how they change over time.

ECG is one of the most accessible methods for diagnosing extrasystoles

The doctor examines the life history. This includes bad habits, heredity, lifestyle, working and rest conditions, past illnesses and surgical interventions.

During the examination, the patient's pulse is measured and the heart is listened to. Blood and urine tests (general and biochemical), as well as an analysis of hormone levels, are prescribed.

Hardware methods include ECG, ultrasound, Holter monitoring, and recording of an electrocardiogram during and after physical activity.

Treatment

If supraventricular extrasystole is benign, then treatment is most often absent. If there are no endocrine or heart diseases, the patient is recommended to fulfill certain requirements:

1. Maintaining a daily routine, proper rest and sleep.
2. Exercise moderation when exercising, try to protect yourself from stress, and do not take everything to heart.
3. Spend more time outside and breathe fresh air.
4. Stick to a healthy diet. The diet should contain more greens, vegetables, and fruits. Spicy, fried, canned foods should be excluded. It is also undesirable to eat hot food.

Treatment of supraventricular extrasystole is necessary in the following cases:

• Poor tolerance of symptoms, which cannot be ignored, as it makes patients neurotic.
• The risk of atrial fibrillation in patients with heart defects, as well as with progressive organic pathologies of the atria.
• Frequent extrasystoles - about 1000 per day or more.

Treatment is aimed at relieving the symptoms of supraventricular extrasystole.

Drug therapy consists of choosing an antiarrhythmic drug. It depends on the etiology and frequency of extrasystoles. Beta-blockers, class I antiarrhythmic drugs, and calcium antagonists are prescribed. Efficacy is determined clinically and using Holter monitoring. In addition, depending on the indications, infections are treated with anti-inflammatory, antiviral agents, and glucocorticoids. Vegetotropic and psychotropic drugs are prescribed.

Non-drug treatment includes psychotherapeutic methods and elimination of non-cardiac causes of extrasystole. You should limit the consumption of alcohol, strong tea, coffee, and completely stop smoking.

Surgical intervention is indicated for frequent, usually monotopic extrasystole, if drug treatment does not have an effect. Radiofrequency ablation is performed.

In case of supraventricular extrasystole, consultation with a psychiatrist, surgeon, endocrinologist, or cardiac surgeon may be required. This is associated with such concomitant diseases as psychovegetative disorders, hyperthyroidism, reflex supraventricular extrasystole.

Folk remedies

Treatment with folk remedies is always very popular. For supraventricular extrasystole, the following tinctures are widely used:

• Pour vodka over hawthorn (10 g of dried fruits) and leave for 10 days. After this, strain, dilute with water and drink 10 drops a day three times.
• Pour valerian roots (3 teaspoons) with boiled water (100 ml). Cook for a quarter of an hour over low heat. After this, cool and filter. Drink one spoon one hour before meals in the morning, at lunch and in the evening.

Forecast

As a rule, there is no convincing evidence that supraventricular extrasystole is life-threatening. However, it can provoke the development of other types of arrhythmias, and its symptoms may be poorly tolerated by patients. In this case, it is necessary to be observed by a cardiologist.

The prognosis depends on the frequency of extrasystoles and the severity of the primary disease. There is a risk of developing atrial fibrillation.