What is ventricular extrasystole and methods of its treatment?
Author Ольга Кияница
Ventricular extrasystoles (JE) are premature contractions that are formed from a pathological excitation wave that does not come from the sinus node, as is normal, but from the right or left ventricle. If there is a disturbance in the rhythm, there are heart abnormalities, weakness, lack of air, discomfort in the heart area.
The occurrence of ventricular extrasystoles is observed in different age groups. Among all forms of extraordinary contractions, EE occurs most often, in approximately 62% of cases.
For the diagnosis of ventricular extrasystole, electrocardiography, holter monitoring is used, auscultation of the heart is necessarily performed at the doctor's appointment. If there are indications, the treatment of ventricular extrasystole is performed, for which various combinations of medications are used.
Video Ventricular extrasystole. Symptoms, causes and methods of treatment
Ventricular extrasystole - principles of drug treatment
How to treat a ventricular extrasystole is best known to cardiologists. To prescribe medications you need to have indications in the form of progressive or group extrasystoles, a pronounced clinic, an unfavorable prognosis. Especially often patients have a subjective intolerance to an arrhythmia attack, which can be expressed by a feeling of stopping or fading of the heart.
At ventricular extrasystoles, antiarrhythmic drugs are primarily prescribed. Especially in those cases when there are concomitant diseases of the cardiovascular system (myocarditis, ischemic heart disease, cardiomyopathy, cardiac malformations).
Extrasystoles are mainly treated by trial and error. The first drug from complex therapy is prescribed for 3-4 days, after which its action is evaluated and if the following remedy is needed.
Antiarrhythmic drugs used in the treatment of frequent ventricular extrasystole, combined with organic heart lesions:
Sotalol - is also known as sotalex and sotahexal. It is taken in tablet form, produced in 150 mg. The average daily dose is up to 320 mg. The initial dose is about 80 mg, but more specifically the doctor prescribes. The drug may give a complication in the form of ventricular tachycardia, so it is recommended for admission in a hospital. If the electrocardiogram shows an increase in the QT interval, then the dose of the drug decreases or it is completely canceled.
Amiodarone - is more commonly known under the original name kordaronom. is considered the best for today antiarrhythmic drug, although against the background of its reception often there are various extracardiac complications. In particular, visual, nervous and endocrine system disorders, liver function can be observed. If long-term use of the drug and in large doses (about 400 mg / day), then amiodarone lung injury may develop.
Etatsizin - well-known drug since the Soviet Union. It is often used in ventricular extrasystoles, not complicated by organic heart lesions. Proved the effectiveness of the drug for nocturnal rhythm disturbances, while the need for cancellation occurs in 4% of cases. In the first week of admission, dizziness, visual impairment, and numbness of the tongue often occur. In the future, unpleasant symptoms become less pronounced or disappear altogether.
Propaphenone - is better known as propranolorm, rhythm monm. In pharmacies is sold in ampoules and tablets. The maximum dose can reach 1200 mg / day, although usually prescribed an average of 250 mg. It helps to eliminate the rhythm disturbance due to the slowing down of the impulses. After taking the drug in the mouth may appear metallic taste, as well as dizziness and the inability to fix eyes.
Quinidine - is widely used as kynidine durules in tablets of 0.2 g. Use the drug can not more than 1.5 grams per day, because there may be serious adverse complications in the form of disruption of the gastrointestinal tract, autonomic disorders and orthostatic hypotension. In small doses, it is normal, therefore 600-800 mg / day is most often used.
Allapinin - a well-known domestic drug, used in cardiology since 1986. A day can take no more than 300 mg, but begin with 25 mg three times a day. It is quite effective in the treatment of ventricular tachycardias and extrasystoles. In some cases, it can worsen the patient's health by the appearance of dizziness, visual impairment, and headaches. As a rule, in 6% of patients there is an absolute intolerance of the drug, because of what it is canceled.
Beta-blockers - today the most popular anti-arrhythmic drugs, which when properly applied help to eliminate a variety of forms of arrhythmia. Their special effectiveness in rhythm disturbances that occur against the background of physical exertion or emotional excitement is noted. Beta-adrenoblockers are often included in complex therapy and can enhance the effectiveness of arrhythmics from other classes. Most often used for tachyarrhythmias and extrasystoles, but some drugs from this group, such as pindolol, are prescribed for brady-dependent rhythm disturbances.
Treatment of extrasystole with ventricular folk remedies
With severe subjective intolerance of seizures, but the absence of organic pathologies of the heart, you can use the prescriptions of traditional medicine to strengthen the cardiovascular system.
Plants used to treat ventricular extrasystole:
- Berries of hawthorn.
- The root of valerian.
- Flowers of calendula.
- Grass horsetail field.
- Flowers of a cornflower.
Valerian is used as a sedative. It is especially useful at psychoemotional stresses, against which often there are ventricular extrasystoles. From the plant prepare infusions, which take a third of a glass three times a day.
Cornflower is useful in severe pain. With ventricular extrasystole, this is often found, so preparing the infusion and taking it on a third of the glass three times a day can ease the condition.
Calendula is able to restore the normal rhythm of the heart. With ventricular ekstrasistolii there may be interruptions in cardiac activity, with them help to cure infusion of dried flowers of calendula.
The horsetail helps to improve the activity of the heart muscle by strengthening it by the useful ingredients that make up the plant. From the dried grass prepare infusion, which is kept for three hours in a tightly closed container. Use the decoction on a tablespoon six times a day.
Hawthorn is the most famous tonic. Under the influence of the infusion obtained from berries, the heart muscle begins to contract more rhythmically. An alcoholic tincture can also be used, which is added to ordinary water in an amount of 10-20 drops.
Honey can be consumed alone (on a tablespoon before bedtime) or cooked with a radish, which is finely chopped. As a result, the heart activity stabilizes, blood supply in the myocardium improves, the work of the nervous system normalizes.
To prepare this for all recipes, you need to take a glass of boiled water, which is poured into a tablespoon of the cooked plant. Infuse can be from a few hours to 12 hours. As a rule, the longer the infusion is carried out, the stronger the infusion will be.
Ventricular extrasystoles and surgical treatment
In a number of cases, medical treatment, and even more unconventional, is ineffective and the disease takes an unfavorable course. This often happens with the development of ventricular extrasystole against a background of severe heart damage. It can be heart failure in the stage of decompensation, myocarditis or myocardial infarction.
The main surgical options for ventricular extrasystole:
- Radiofrequency catheter ablation is a minimally invasive operation, during which ectopic foci are excised. For this, a catheter with an electrode is used, which is brought to the heart through large vessels. The modified site is cauterized, after which in most cases repeated attacks of arrhythmia do not occur.
- The operation on the open heart is rarely performed today, because it is an unsafe and time-consuming method of surgical intervention. Such a tactic can be used in the case when, in addition to ventricular extrasystole, another serious organic pathology of the heart is determined in the patient. Often excision of the pathological site is combined with prosthetic valve.
Finally, let us remind you that ventricular extrasystole is not a life-threatening disease, unless the patient determines the organic pathology of the heart. In such cases, to prevent a negative prognosis, antiarrhythmic drugs are immediately prescribed, and if they are ineffective, radiofrequency ablation is performed.
It is important to diagnose a variety of arrhythmias, which leads to untimely reduction of ventricles. The signal for extraordinary depolarization comes from an additional (ectopic) focal point of excitation. To prevent the development of serious complications, it is necessary to conduct timely treatment of ventricular extrasystoles.
During pregnancy, various disorders of the rhythm, including ventricular extrasystoles, can be determined. The disease can represent a danger to fetal development and for the health of the mother. With the help of modern methods of research, the pathology is determined both at the planning stage, however, at the early stages of pregnancy, which allows timely carrying out the necessary therapeutic measures.
Rhythm disturbances are often associated with various diseases of the gastrointestinal tract, which in such cases act as a primary disease. Research in this direction has been going on for many years and today there is a clear link between GI disorders like GERD and cardiovascular system.