Causes | Extrasystoles (tripping of the heart)

Causes

As already described, extrasystoles can occur without any disease value. Mostly they are triggered in healthy people by arousal or by stimulants such as coffee, alcohol or nicotine. However, an extrasystole can also be an indication of heart disease.

Sick heart cells tend to produce false potentials. If there is underlying heart disease such as coronary artery disease (CHD), myocarditis or a heart attack, extrasystoles can also trigger dangerous persistent rhythm disturbances at the atrial and ventricular level, such as a persistently fast heartbeat (tachycardia; see below). Metabolic disorders such as hyperthyroidism can also lead to extrasystoles.

Diagnosis

For the diagnosis of supraventricular extrasystoles the long-term and exercise ECG are used. The origin of the extrasystoles can only be clarified by an ECG. The long-term ECG can show whether persistent tachycardia is present in addition to individual extrasystoles.

Usually, the patient is asked to record during the long-term ECG when he/she feels symptoms.Thus it can be determined whether the complaints and the extrasystoles occur simultaneously and thus a causal connection can be assumed or whether further searches for causes of the symptoms are necessary. The exercise ECG can be used to determine whether the extrasystoles occur more frequently during physical exertion. However, this diagnostic method is not used in all cases.

Only if the extrasystoles: In the ECG, extrasystoles can usually be detected as narrow (i.e. normally shaped) QRS complexes that occur earlier in the cycle. The preceding P-wave may be larger than a normal P-wave. In supraventricular extrasystole, a so-called non-compensatory pause occurs after the additional QRS complex, i.e. the beat of the sinus rhythm is shifted.

• Frequent (e.g. over 30 times per hour)
• Leading to symptoms
• Or a heart disease is present.

Therapy

Supraventricular extrasystoles that occur in healthy individuals do not require therapy. In the presence of a heart disease, the therapy of this disease is the first priority. If the SVES triggers tachycardia or other cardiac arrhythmias, treatment is always necessary. Usually beta-blockers or potassium–magnesium preparations are used for this purpose.