Extrasystoles: Diagnostic Tests

Obligatory medical device diagnostics.

  • Electrocardiogram (ECG; recording of the electrical activity of the heart muscle)-indicates the conduction of excitation in the heart (subsequent abbreviations: see resting ECG below)
    • Supraventricular extrasystole (SVES); origin: atrial myocardium/atrial muscles; typical characteristics:
      • Extrasystole occurs earlier than the QRS complex that should actually be expected
      • P wave deformed or absent
      • PQ time shortened
      • Ventricular complex (QRS) configured normally
      • No compensatory pause
    • Ventricular extrasystole (VES); origin: ventricular myocardium; typical characteristics:
      • Widespread QRS complex with change in positional type; random or fixed pattern (e.g., bigeminal (each normal beat followed by 1 VES), trigeminal (each normal beat followed by 2 VES), couplets (2 VES following each other), volley (> 3 VES occurring in succession (= ventricular tachycardia if lasting longer than 30 seconds)).
      • monomorphic VES
        • Each VES looks the same (identical origin in the ventricle/cardiac chamber).
      • polymorphic VES
        • VES look different (different sites of origin in the ventricle).
      • Right ventricular extrasystoles look left bundle branch block-like (see below “Intraventricular block”)
      • Left ventricular extrasystoles look right bundle branch block-like (see “Intraventricular block” below)

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and mandatory medical device diagnostics – for differential diagnostic clarification.