Treatment of extrasystolic tachycardia
Author Ольга Кияница
Extrasystolic tachycardia is a clinical definition that is based on the definition of two different mechanisms of development of states - tachycardia and extrasystoles.Since both pathologies can be asymptomatic as with the development of a serious clinic, the approach to diagnosis of the disease is extremely serious.
Extrasystole is one of the most commonly occurring rhythm disturbances. Even in clinically healthy people, extrasystoles may be detected during the examination. In some cases, extraordinary contractions are perceived as a variant of the norm.
Diagnosis of the disease is carried out with the participation of electrocardiography, echocardiography, ultrasound examination of the heart, and, if necessary, transesophageal electrophysiological examination is performed. Diagnosis may require MRI and CT to be diagnosed as accurately as possible. After complex examination of the patient in an individual order, the treatment of extrasystolic tachycardia, often complex with the use of drugs from various pharmacological groups, is made.
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Not all extrasystoles require specific treatment. If cardiac violations are not determined, the patient is practically not disturbed by extraordinary attacks, then therapy is not prescribed. In other cases, after the diagnosis, the treatment tactics are chosen.
In determining the asymptomatic flow of extrasystole and tachycardia, does not mean that you can not pay attention to the state of health. Despite the lack of specific treatment, one should adhere to the recommendations given to all cardiac patients, including asymptomatic tachycardia and extrasystoles.
- The nutrition should be adjusted as a full-fledged and maximally saturated with foods useful for the heart.
- Physical activity should be present, but not excessive or, conversely, completely excluded from the daily regime.
- Harmful habits should be eliminated (smoking, drinking alcohol and strong coffee).
- It is important to observe emotional calm, as cardiovascular diseases are most often developed in the face of stress.
If, apart from extrasystolic tachycardia, other heart conditions are detected, then pharmacologists are prescribed by the doctor.
Medicinal treatment of extrasystolic tachycardia
In the process of examination of the patient, the reasons for which antiarrhythmic therapy should be performed are identified.
Indications for antiarrhythmic drugs.
- There is a subjective intolerance to attacks of tachycardia, which does not pass independently and is complicated by anxiety, anxiety.
- The course of extrasystolic tachycardia is unfavorable. There are frequent seizures, or in patients other than this rhythm disorder, there are other cardiovascular diseases.
- On the background of seizures develop half-abnormal or fainting conditions, as well as other life-threatening pathologies.
The choice of antiarrhythmic treatment is carried out taking into account the following factors: varieties of extrasystole and tachycardia, prognostic value, initial electrocardiographic parameters, availability of experience of previous therapy, concomitant pathologies.
Frequently used antiarrhythmic drugs:
- Calcium antagonists (verapamil, diltiazem) - are often effective in supraventricular extrasystoles and tachycardia.Less results are observed in idiopathic trigger forms of rhythm disturbance.
- Class I drugs (propafenone, ethaczine, flekainid) - are considered universal means, as effectively restore the rhythm of ventricular and supraventricular tachycardia.
- Preparations of IB class (lidocaine, diphenin, mexiletin) - are most often effective in ventricular extrasystoles and tachycardia.
- Class III preparations (amiodarone, sotalol) are used in various forms of rhythm disturbance, but only in cases where other agents are inactive.
The use of quinidine in ectopia with ventricular localization is not recommended .
The appointment of antiarrhythmic therapy in some cases is based more on the causative factor:
- With ischemic heart disease, hypertension, thyrotoxicosis, beta-blockers are most commonly used.
- Extrasystole, combined with paroxysmal tachycardia, is defined in the WPW syndrome. In such cases, it is impossible to use verapamil, whereas aimalin has the desired effect on the course of the disease.
- Ventricular extrasystole with ischemia is well suited for treatment with ettimin.
- Digitalital extrasystole is eliminated by effective and relatively safe diphenin.
- The combination of ventricular extrasystole and sinus tachycardia is treated with combination therapy of beta-blockers and antiarrhythmic drugs of grades I and III.
- Supraventricular extrasystole with tachycardia can be treated mainly with beta-blockers (bisoprolol, atenolol, betaxolol, propranolol, ethanolol.
Together with antiarrhythmic drugs, agents from other pharmacological groups are often used:
- Glucocorticoids (prednisolone), aminohinolines (delagil, plavquinol), nonsteroidal anti-inflammatory drugs (ibuprofen, butadiene) - are prescribed for one or two months with possible myocarditis.
- Benzodiazepines (clonazepam, phenazepam), tincture of honeysuckle and hawthorn - are prescribed for subjective intolerance to seizures.
- Statins, ACE inhibitors, aspirin - are used to prevent the development of sudden death.
Control over the effectiveness and safety of extrasystolic tachycardia
It is conducted using the following methods to evaluate the effectiveness of the therapy:
- empirical - is expressed in the observation of a patient who takes antiarrhythmic drugs;
- Holter monitoring.
Electrocardiography more helps to assess the safety of the therapy. At the same time, Holter monitoring contributes to the orientation of both safe and effective treatment.
Surgical treatment of extrasystolic tachycardia
It represents the final stage of therapy for the combination of extrasystoles and tachycardia. Often, they are resorted to with the ineffectiveness of the medication.
- Frequent extrasystoles and tachycardias are indications for ablation of pathological foci and EFI-study.
- Volumetric operations are mainly performed in complicated cases, when the myocardium is not able to cope with its functions. It can be a transplant of the whole heart, as well as local surrogate surgical interventions.
Basically, with the correct treatment, the patient gets better through time. Depending on the treatment, the efficacy can range from 40 to 90%.