Premature beats are the most common cardiac arrhythmia, in which the normal pendulum-like heartbeat becomes abnormal and the normal heart rhythm is disturbed. Although there are premature beats originating from different parts of the heart (e.g., atria, atrioventricular junction zone, ventricles), they often have similar symptoms, such as panic, sudden cardiac arrest, or a feeling of tightness in the chest, which can often be confirmed by an electrocardiogram or an ambulatory electrocardiogram.
Premature beats can be a manifestation of various heart conditions or can occur in physiological conditions without heart disease, such as strenuous exercise, heavy consumption of strong tea or coffee, electrolyte abnormalities after diarrhea and vomiting, etc. Once premature beats have caused significant discomfort, they are usually treated with medication. In addition to the cause-specific treatment for various causes of heart disease, the important point in drug therapy is to relieve the symptoms of arrhythmia, i.e. anti-arrhythmic treatment.
At present, there are many drugs for the treatment of premature beats, such as cardioplegia, ketorolone (amiodarone), sotolol, morethizine, etc., which can be used for all kinds of premature beats, and slow heart rhythm, lidocaine, which is mainly used for ventricular premature beats, and isoprodine, which is mainly used for atrial premature beats. Of course, the doctor’s opinion should be consulted for the application of specific drugs. The point here is that even if the right drug is chosen for the treatment of premature beats, it is important to be aware of the possible arrhythmogenic effects during the treatment.
The so-called arrhythmogenic effect of anti-arrhythmic drugs means that these drugs can effectively treat arrhythmias, but at the same time may worsen the original arrhythmia or induce new arrhythmias, i.e. the drugs used to treat arrhythmias lead to arrhythmias, which makes the patient’s premature beats not only untreated but also add new problems.
As early as 1785, British doctors discovered that digitalis drugs could cause premature beats and other problems when treating arrhythmias, and in the 1960s Slzer and other doctors confirmed that a drug called quinidine for premature beats could cause patients to faint, essentially inducing a new arrhythmia called ventricular tachycardia. Modern studies have even confirmed this, and some anti-arrhythmic drugs even increase mortality.
Although arrhythmias caused by drugs used to treat premature beats can manifest themselves in various ways, they can be broadly classified into 2 main groups. One type is the slow arrhythmia, which is characterized by a slow heartbeat, mostly between 30-60 beats per minute, or even complete arrest, with the patient experiencing dizziness, bouts of blindness, or fainting and cramping.
The mechanism is that the heart’s own excitation point is excessively inhibited, or the electrical conduction within the heart is inhibited and then conduction is blocked, just like a poor contact or complete break in the electric light wiring, and a slow heartbeat occurs. The other type of arrhythmia is tachycardia, which is characterized by more frequent premature beats, increased panic and chest tightness, tachycardia (up to 150 beats per minute or more), and sometimes a rapid heartbeat of 200 beats per minute or more, with pale faces, cold sweats, undetectable blood pressure, and even fainting and cramping.
Because arrhythmias such as premature beats can themselves cause these symptoms, it is sometimes difficult to clinically diagnose an arrhythmogenic effect of anti-premature drugs based on symptoms alone. In any case, if a person’s symptoms do not improve while taking the medication, but worsen or if the above symptoms occur, it is important to be aware of the possibility of arrhythmogenic effects.
This is the time to see a doctor immediately. Doctors can determine the problem by using an electrocardiogram, 24-hour ambulatory electrocardiogram, electrocardiogram exercise test, or electrophysiological examination of the heart. The medical diagnosis of arrhythmogenic effects has appropriate diagnostic criteria, and these highly specialized issues will not be discussed here. It is important to note that the likelihood of arrhythmogenic effects is significantly increased if the following susceptibility factors are present during the course of drug administration.
They are.
1. self-increased doses of drugs for premature beats, or accidental overdose of drugs.
Unreasonable combination of medications, taking several drugs with combined pharmacological effects, such as cardioplegia + cortisone, isoptin + betaloc, etc. (of course, if the doctor considers it necessary to combine these drugs in special cases, it is a different matter).
3, their own condition is not good, there are easy to form the arrhythmogenic effect of conditions. Such as serious liver and kidney function abnormalities, chronic hepatitis or uremia, affecting the normal metabolism and excretion of drugs, resulting in drug accumulation poisoning; long-term eating less, or vomiting, diarrhea, resulting in the body electrolyte metabolism disorders, hypokalemia and hypomagnesemia, which can easily cause arrhythmogenic effects. ④ Poor control of underlying diseases and severely impaired myocardial metabolism, such as acute myocarditis, severe cardiomyopathy, left ventricular enlargement, severe myocardial ischemia, severe hyperthyroidism, etc. The functional status of cardiac muscle cells is poor and prone to problems.
When we know the above knowledge, we may try to avoid the arrhythmogenic effect of anti-premature drugs during the treatment. The first thing is to be cautious in treating premature beats and not to take anti-arrhythmic drugs easily, let alone indiscriminately; medical research has proved that some premature beats do not need treatment at all and it has no adverse effect on the patient’s life expectancy.
The second is to avoid susceptibility factors.
1. Choose drugs according to medical advice. After discovering premature beats, you should first go to the hospital and ask your doctor to determine if you need to take medication and which kind of medication to take. If you are sure about the drug you are taking, you must take it according to the doctor’s prescription, because everyone has different sensitivity to different anti-arrhythmic drugs, and the same kind of premature beats may not be effective for others.
2, do not arbitrarily increase or decrease the amount of medication and change the drug. Some people think that they can stop treatment or start to reduce the amount of medication after taking the medication, but it is important to know that the treatment of premature beats with antiarrhythmic drugs is mostly a “cure”, that is, to control premature beats, so short-term discontinuation of medication often leads to recurrence of the disease, and irregular medication also increases the risk of drug side effects. In addition, antiarrhythmic drugs are often used to treat premature beats.
In addition, most of the antiarrhythmic drugs have a specific “dose-effect relationship”, that is, at a certain dose, the drugs really play a therapeutic role, and below this dose, there is no role in the treatment of premature beats; on the contrary, blindly increasing the drug dose or unreasonable combination of drugs, “arrhythmogenic” effect will be On the contrary, if the dosage of drugs is increased blindly or the combination of drugs is unreasonable, the “arrhythmogenic” effect will come out and the phenomenon of more and more premature beats will appear.
The first thing you need to do is to take care of yourself during the medication, especially when your situation is not good. During the period of taking medication for premature beats, you can often take your own pulse to notice any improvement in your symptoms and detect abnormalities early. This is especially important in the elderly. This is because older people are less tolerant of medications and are prone to side effects. Be concerned about whether symptoms have worsened? Is there any blackness in front of the eyes, dizziness, chest tightness, nausea? Is there an increase in premature beats? Is there an increase in premature beats? Is there any significant slowing of pulse rate than before? If so, it is important to consult a doctor promptly.
If you have premature beats, in addition to medication, the following points may be helpful to your treatment.
1, correct treatment, open-minded: premature beats patients should be open-minded and establish confidence to overcome the disease. Don’t be worried because you have premature beats. Generally, patients with premature beats can live, study and work like healthy people.
2. Actively treat the primary disease and take medication on time.
Regular daily life plays an important role in the recovery of arrhythmia patients, so it is important to arrange rest and activities reasonably and ensure sufficient sleep.
4.Adjust life and living with the seasons and climate change: take measures to prevent colds and flu when the climate is changing and the seasons are alternating, so as not to aggravate the disease.
5, pay attention to the arrangement of a reasonable diet, should not be too full; must quit smoking, quit drinking.
6, develop good bowel habits, do not have accidents because of constipation.
7, regular check-ups at the hospital, review the relevant items, reasonable adjustment of medication.