The normal heartbeat is regular and each interval is the same. Premature ventricular contraction is a very common clinical arrhythmia caused by the early electrical activity of the ventricles in addition to the normal contraction, which means that another heartbeat is added in advance.
How far away are ventricular premature beats from us?
How far away are premature ventricular contractions?
The detection rate of ventricular premature beats in healthy people with normal resting electrocardiograms is 5%, while the detection rate of ventricular premature beats with 24-hour ambulatory monitoring is 50%. In other words, premature ventricular contractions are not far from every one of us. We do not need to be afraid of ventricular premature, but should face it correctly.
How to diagnose premature ventricular contractions? What tests should be done?
The examination of ventricular premature beats is mainly aimed at the presence of structural heart disease and the determination of premature beat load. The non-invasive diagnostic methods include the following.
1. Medical history review.
(1) Symptoms of premature ventricular contractions: whether there is any relationship with body position, some premature ventricular contractions are obvious when lying on the left side, or related to mood changes, agitation, exercise, etc.
(2) medication history: whether or not certain drugs are being used, such as the use of alpha, beta, dopamine receptor antagonists, etc.
(3) Medical or surgical history: coronary artery disease, myocardial infarction, chronic heart failure, heart valve disease, congenital heart disease, hereditary disease, cardiomyopathy, Q_T interval abnormalities, ion channel disease, pulmonary hypertension, obstructive sleep ventilation disorder, endocrine diseases such as abnormal thyroid function, abnormal sex hormones, abnormal adrenal function, etc.
(4) Family history: sudden sudden cardiac death in first-degree relatives, hereditary cardiac abnormalities, or history of premature coronary heart disease, etc.
(2) ECG or ECG monitoring: ECG monitoring, usually for 24-48 hours, can determine the number of premature ventricular contractions and detect ventricular tachycardia, as well as detect supraventricular arrhythmias and bradycardia. However, there are limitations; many patients have transient ventricular premature beats occurring over a period of days or weeks that cannot be detected with a single ECG or 24-48 hours of monitoring.
A 30-day ambulatory cardiac event monitoring system, a wearable recording device, can record continuously for 6 weeks.
3.Transthoracic ultrasound: Also called cardiac fan scan, it can determine the size of the heart chambers, the thickness of the ventricular walls, the function of the heart, etc., and detect valvular heart disease.
4.Exercise test: It is indicated when premature beats occur during exercise, or to assess whether there is combined coronary artery disease. Exercise test can be used in combination with ultrasound or myocardial nuclear imaging to evaluate myocardial ischemia.
5. CT, MRI, etc.: for congenital cardiac anomalies, atopic cardiomyopathy and arrhythmogenic right ventricular dysplasia, etc.
How to treat premature ventricular contractions?
The goals of treatment for ventricular premature beats include relief of symptoms, maintenance of cardiac function, prevention of progression to tachycardia cardiomyopathy, and reduction of references to coffee, stimulation, and stress.
1. Premature ventricular contractions that do not require treatment.
Without structural heart disease, ventricular premature beats are evaluated by ECG monitoring as low to moderate load (ventricular premature beats account for less than 15% of the total number of beats).
2. Ventricular prematureness requiring treatment.
Ventricular premature beats evaluated by cardiac monitoring are highly loaded (ventricular premature beats account for >
15-20%), or those that exhibit ventricular tachycardia at risk of tachyarrhythmic cardiomyopathy or heart failure need treatment even if they are asymptomatic.
Treatment of ventricular premature beats includes.
β-blockers, calcium antagonists, other antiarrhythmic drugs, and catheter ablation therapy: catheter ablation is radical, but is usually used in patients with resistant ventricular tachycardia, or if drug therapy has failed.