Treatment of ventricular extrasystoles
Author Ольга Кияница
The group of extrasystoles is a violation of the heart rhythm, in which extraordinary contractions of the myocardium arise. They may feel sick as a push in the region of the heart or as a "fading". Rare extrasystoles are practically imperceptible, whereas frequent and polymorphic are expressed in a hardly flowing clinic, which can be complicated by tachycardia or fibrillation.
Ventricular extrasystoles are found more often in other forms of extraordinary contractions. Of the total number of patients, 62-65% are determined.
For diagnostics of ventricular extrasystoles it is better to use Holter monitoring, which determines the pathology of half of the subjects. One-time ECG recording allows you to detect a 5% rhythm impairment. Therefore timely diagnostics allows to timely appoint medicines and preparations for treatment of extrasystolic arrhythmia. In turn, this effect gives positive results in the effectiveness of the therapy.
Video Ventricular Extrasystole. Symptoms, causes and methods of treatment
Suitable for those patients with asymptomatic extrasystoles diagnosed, even if an organic cardiac failure is determined.First of all, you need to realize that extrasystole is benign, so it is not able to cause a significant violation of hemodynamics. In addition, the following tips should be followed:
- The food should be saturated with potassium salts, which in large quantities are contained in dried fruits, baked potatoes, watermelons, apples and the like.
- It is necessary to exclude provocative factors which are smoking, drinking alcohol and strong coffee, frequent nervous and physical overvoltages.
- Physical activity should be at a sufficient level to ensure normal oxygen saturation of the heart muscle.
Similar recommendations are relevant also for patients with clinically expressed ventricular extrasystoles, passing into the reception of drugs with their poor effect on the course of the disease.
Medicinal treatment of ventricular extrasystoles
The main purpose of medication treatment is as follows:
- Improve the outlook for the disease.
- Reduce the severity of the symptoms
Treatment begins with sedatives and beta-blockers. The majority of patients with their help improves their well-being, both by reducing the number of extraordinary contractions, and as a result of providing sedative effects on the nervous system.
The main preparations of the group of beta-blockers are obidin, propranolol, anaprilin. The course of treatment begins with minimal doses - 15-20 mg three times a day. If you need to increase the dose, then it is done under the control of the frequency of heart rate.
Ventricular extrasystoles may be accompanied by bradycardia. Such is often observed in young people who have an activity of the parasympathetic nervous system. In such cases, it is advisable to appoint arrhythmias with a cholinolytic action. First of all, itropium and preparations for beauty (bellayida).
Persistent forms of ventricular extrasystoles, which are not corrected by sedative treatment, need to be prescribed antiarrhythmic drugs with a more pronounced effect. The following classes of tablet membrane stabilizing drugs are used:
- IA - effective in 70% of cases (chinidine in retard form, novocainamide);
- IB - act in 50% of cases (Mexilletin);
- IC - the efficacy is less than 50% (flekainid, propafenone).
The presented preparations are not desirable, since their reception is complicated by various side effects (nausea, dizziness, inflammation of the mucous membrane of the stomach). In addition, the favorable effect of all arrhythmias, with the exception of beta-blockers, on the course of the disease in patients with FE has not been proven.
Accepting antiarrhythmic drugs without a medical recommendation is unacceptable, because in case of improper selection of the dose and without proper diagnosis, it is possible to cause a cardiac arrest. Therefore, all arrhythmias are used only after the appointment of a doctor. In addition, a repeated ECG is performed over time to adjust dosage if necessary.
Instrumental methods of treatment of ventricular extrasystoles
This includes implantation of a defibrillator cardioverter or an artificial rhythm driver (pacemaker).
With the help of the first device, it is possible to prevent the development of a cardiac arrest, with the root cause it does not eliminate, and therefore does not affect the course of the disease. Therefore, practicing the use of antiarrhythmic drugs after implantation of CD. It is worth knowing that with a frequent operation of a defibrillator cardioverter, the quality of life of the patient decreases. In addition, the device is quickly discharged, which requires replacement of the battery, therefore this variant of the instrumental treatment is suitable only in extreme cases, that is, patients with a pronounced threat of cardiac arrest.
Implantation of the pacemaker is performed with pronounced bradycardia, which does not allow you to correctly select the dose of antiarrhythmic drugs. Also, an indication of the use of COP is a pause in the ventricles for more than 3 seconds.
Surgical treatment of ventricular extrasystoles
The most commonly used methods are revascularization and radiofrequency ablation (RFA).
Burning of ectopic foci is shown in frequent monomorphic ventricular extrasystoles. With this operational method of treatment, you can improve the efficiency of the left ventricle, which will affect the quality of life of the patient. Particularly relevant in the past is the execution of RFA with arrhythmogenic dysplasia of the right ventricle, since in almost 80% of patients, along with stopping the rhythm disturbance, further development of fatty replacement of the myocardium is prevented.
Video Treatment of ventricular extrasystoles
Thus, modern medicine offers various ways of treating ventricular extrasystoles, each of which is assigned to specific indications. The most commonly used antiarrhythmic drugs have proven their effectiveness in a large number of patients. In some cases, especially in the asymptomatic course, general recommendations and treatment of ventricular extrasystoles are shown by folk remedies. A minor part of patients is prescribed surgical therapy.