Author Ольга Кияница
Extrasystolic tachycardia is an unidentified term most likely to be used in clinical practice. In the generally accepted International Classification of Diseases 10, another indication of rhythm disturbance, called extrasystole, is indicated.
Nearly 70% of extrasystoles are found, which are most often not associated with organic pathology of the heart. Therefore, such extrasystoles are called functional.
Extrasystoles often do not cause tangible inconvenience to the patient, but in some cases their frequency is very high.This provokes the development of tachycardia, which most likely formed the basis of such a clinical designation as extrasystolic tachycardia. What is it and how dangerous it is if we try to describe this state in more detail.
Description of extrasystolic tachycardia
Extrasystole, without symptoms of tachycardia, is an extraordinary contraction associated with untimely depolarization.May have a different localization: in the atria, ventricles, atrioventricular node.
The mechanism of development of extrasystoles is associated with the appearance in a region of the heart of a section with increased excitability, which sends stronger impulses than the sinus node. As a result, the normal rhythm is disturbed and the more such extraordinary contractions, the worse the clinical picture.
Some states contribute to the overvoltage of one or another part of the heart. This in turn can cause a special kind of extrasystole, which is called dynamic.
Symptoms of extrasystolic tachycardia
Subjective sensations of the patient are expressed in the perception of a strong push in the region of the heart, after which comes the feeling of fading. In some cases, after the shock, there is pain. Particularly unpleasant symptoms are associated with group extrasystoles, which significantly worsens the overall well-being.
On the background of tachycardia, extrasystole rarely manifests itself. Often it goes asymptomatic. This is due to the fact that during the rapid heartbeat, insufficient ventricular filling occurs with blood, resulting in no tangible shocks in the cardiac region.
What is the risk of extrasystolic tachycardia ? With frequent salivation of extrasystoles, it may develop atrial fibrillation or ventricles, complications of cryopulmonary arrhythmia, provocation of seizures of atrial fibrillation / ventricles. Numerous studies have confirmed that ventricular extrasystoles, even without concomitant tachycardia, can increase the likelihood of cardiac arrest.
Causes of extrasystolic tachycardia
Divided into functional and organic. The first ones include those extrasystoles that are associated with neurogenic disorders. With this pathology, there is no organic damage to the heart, but due to a disturbance of the nerve regulation, changes in the activity of the sympathetic or parasympathetic nervous system, extraordinary contractions of the heart organs arise.
Especially often, extrasystole in combination with tachycardia is noted in the following pathological conditions:
- cervical osteochondrosis;
- arterial hypertension;
- gastrointestinal diseases;
- infectious processes.
Organic heart disease can be expressed by myocardial infarction, ischemia, myocarditis, cardiomyopathy, cardiac muscle dystrophy. In some cases, minor heart damage to the patient might not be known, but the extrasystole appeared as a marker of an asymptomatic disease.
Types / photos of extrasystolic tachycardia
There are different categories of extraordinary contractions, but in clinical practice, the most commonly used division of ventricular extrasystoles by Laun and Wolf, according to which emit:
- The first class - single extrasystoles, the number of which at one hour is not more than 30.
- The second class - single extrasystoles, the amount of which at one time is 30 times or more.
- The third class is polymorphic extrasystoles, which can be dangerous when determined in large quantities.
- The fourth class - is divided into two subgroups: a) pair extrasystoles, which are located on the ECG two consecutive;b) volleyball extrasystoles located on the ECG for 3-5 consecutive.
- Fifth grade - early extrasystoles.
The most unfavorable are extrasystoles 3-5 classes, which most often trigger tachycardia, often ventricular. Also, if they are present, there is an increased risk of ventricular fibrillation, and such extrasystoles, especially in combination with tachycardia, require special treatment.
Diagnosis of extrasystolic tachycardia
It starts with electrocardiography, with the help of which almost always you can diagnose any kind of extrasystole, with and without tachycardia.
- Ventricular extrasystoles - the QRS complex is expanded, the pre-existent ischemic contraction does not determine the tooth P, with the T-tongues discordant.
- Atrial Extrasystoles - Extraordinary cardiac complexes are noticeable on the ECG, the tooth P may merge with the teeth of T. Changes in the ventricular complex are not observed.
With asymptomatic course of the disease or with a rare occurrence of extrasystoles, Holter monitoring can be prescribed, which allows for the fixation of individual extrasystoles.
Treatment and prevention of extrasystolic tachycardia
When an extrasystole occurs in the background of another cardiac disease, its treatment is first and foremost. It is also important to exclude possible predisposing factors that can cause attacks of extrasystoles and tachycardia. This may be smoking, alcohol and strong alcohol abuse, frequent stressful situations, physical activity.
Extrasystoles of the first two classes, asymptomatic, do not require specific treatment. Patients with similar forms of a pathology only periodically pass the examination at the cardiologist.
Specific treatment of extrasystole, as well as tachycardia, is prescribed in a pronounced clinical picture, a high risk of developing complications in the form of cardiac arrest. Initially, sedative medications and beta-blockers are used. They remove symptoms and in most cases turn out to be effective. In an unfavorable course antiarrhythmic means are used for IA, IB, or 1C classes.
Specific prevention of so-called extrasystolic tachycardia does not exist. To prevent reoccurrence, it is often recommended that the rules of general regime, nutrition, and therapeutic physical education common to all cardiac patients are recommended.