VENTRICULAR ARRHYTHMIAS


Ventricular arrhythmias are most often due to ischemia (acute myocardial infarction, angina pectoris, chronic coronary insufficiency, myocardial aneurysm, vasospastic angina), at cardiomyopathy, myocarditis, prolonged QT interval, mitral valvular prolapse, physical load, and can occur without clinically visible disease.

Ventriculat extrasystoles (VES) – a premature contraction of venticlesis an additional heartbeat caused by the electric activation of the ventricle before a normal beating occurs. When they occur after each sinus impulse, it is a bigeminy, and after two impulses a trigeminy. Two VES in a row make a pair (couplet), and three or more ventricular tachycardia.

Ventricular extrasystoles occur frequently and do not pose a risk to people who are not suffering from heart diseases. However, if they are common in a person with heart failure or aortic stenosis, or have suffered a heart attack (myocardial infarction), they may be a prelude to more dangerous arrhythmias, such as ventricular fibrillation, possibly causing sudden death.

Symptoms:

  • Usually asymptomatic
  • Heart pounding, premature heartbeat

Diagnosis:

ECG, load test

Treatment:

Asymptomatic single VES without other clinical damage to the myocardium do not require treatment

Medication therapy (application of beta blockers and antiarrhythmics)

Treatment of the underlying disease

Ventricular tachycardia VT  is defined as a series of three or more ventricular extrasistols with a frequency between 100 and 250/min. It occurs due to the existence of an ectopic center at the level of the ventricles with a rapid pulse-generating frequency.

Symptoms:

Palpitations (heart pounding), weakness and unconsciousness

It can cause or worsen cardiac failure or cardiogenic shock (since it occurs in patients with significant myocardial damage).

Diagnosis:

ECG; It is presented by ventricular complexes that are bizarre with an extended QRS complex and a discordant final oscillation.

Treatment:

Medical (adrenaline, amiodarone, lidocaine intravenously)

Electroconvesion (DC shock)

Ventricular fibrillation VF is a chaotic activation of the myocardium of a ventricle caused by the existence of ectopic focus in the heart muscle of the ventricle. It is a heart rhythm disorder, in which heart beats are rapid and irregular, causing a useless flicker of the heart ventricles instead of pumping blood.

Symptoms:

light-headedness, loss of consciousness

leads to a fall in blood pressure, vital organs hyperfusion, myocardial infarction, death

Diagnosis

ECG; Many, irregular, sinusoidal waves of different apmlitude and duration are recorded.

Treatment is urgent:

Electroconversion (DC shock)

Massage of the heart and artificial respiration

Intravenous administration of adrenaline, amiodarone or lidocaine

Prevention:

In patients with increased risk for VT or VF occurence, special antiarrhythmic treatment is required, and an implantable cardioverter defibrillator (ICD) can be fitted.


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