Extrasystole after sport

In many cases, the exact temporal correlation of the occurrence of an extrasystole can already help to narrow down its possible causes. For example, a pronounced lack of sleep, or severe overtiredness, can lead to the development of an extrasystole even in an actually completely healthy person. Another particularly frequent cause of an extrasystole in a healthy person is increased activity of the vagus nerve.

This nerve is responsible for the innervation of the heart muscle and can lead to an extrasystole during and after sports. The vagus nerve is considered the largest nerve of the so-called parasympathetic nervous system (resting system) and can therefore have a particularly strong effect on the heart rate during and after sports. This phenomenon is caused by an excessive increase in the impulses leading from the nerve to the heart.

After sport, the body tries to switch from the activated state (sympathetic system) to the resting mode (parasympathetic system). The main nerve of the resting system is therefore increasingly activated. Persons who tend to experience extrasystoles after sport can be recommended to allow the physical activity to slowly cease.

In this way, the change from sympathetic to parasympathetic nervous system can be much more orderly and the risk of developing an extrasystole is reduced. Physical, psychological or social stress can all contribute to the development of extrasystole. Stress is an alarm reaction of the body to certain situations.

The body often responds with increased activity of the autonomic nervous system and also increased activity of the endocrine organs. This also affects the body’s electrolyte and hormone balance, which is why negative feelings such as anxiety, depression and suppressed aggression lead to increased extrasystoles. But also positive stress (eustress), for example before the birth of a child, can cause extrasystoles due to the increased excitation of the body.

In general, it can be summarized that any kind of stress, be it positive stress (eustress) or negative stress (dysstress) can lead to extrasystoles due to various mechanisms.Particularly patients with heart neuroses often have problems with extrasystoles, since they pay particular attention to their own heartbeat and are therefore more likely to notice extrasystoles than non-neurotic patients, but on the other hand are constantly under stress due to the neurosis, which can cause further extrasystoles. Especially during pregnancy, an increased occurrence of extrasystoles can occur. These can cause an unpleasant feeling, but are usually harmless, especially if they do not cause symptoms such as dizziness.

As mentioned above, extrasystoles can be triggered by various things such as little sleep, stress or hormonal fluctuations. All of these factors can occur during pregnancy and they all favour the occurrence of extrasystoles. Especially at the beginning and end of pregnancy, extrasystoles are relatively common.

Nevertheless, even in the case of extrasystoles during pregnancy, it is often not possible to find a clear cause. If the extrasystoles should last longer or if an unpleasant feeling is associated with them, thyroid and electrolyte levels can be determined and an ECG can be written to identify electrolyte derailment or hyperthyroidism as the cause of the extrasystoles and to rule out an organic cause. These could then be treated with medication.

However, the therapeutic window during pregnancy is narrow, so any new prescription of medication should be carefully considered. If several extrasystoles occur directly one after the other, an ECG should be written by the family doctor as a precaution. Extrasystoles often disappear again after pregnancy, but can also remain present, but then they are often attenuated and less frequent.

Besides other stimulants such as caffeine or nicotine, increased consumption of alcohol can also lead to extrasystoles. If there is a suspicion that the extrasystoles are particularly caused by increased consumption of alcohol, alcohol should be avoided for some time. In addition to excessive alcohol consumption, alcohol withdrawal can also trigger extrasystoles in addicts due to stress.

In this case, any extrasystoles that occur should be examined in the withdrawal clinic to rule out an organic cause. In the case of both supraventricular and ventricular extrasystoles, the aim should be to avoid substances that can trigger these extrasystoles. If the development of the extrasystoles is associated with the consumption of caffeine, nicotine, alcohol or drugs, these stimulants should be avoided.

Situations that have been identified as causes for extrasystoles after appropriate self-observation should also be avoided. 1st Therapy Supraventricular extrasystoles (SVES) Supraventricular extrasystoles do not require treatment as long as the patient is healthy and does not complain of any further complaints. If heart disease can be identified as the cause of the supraventricular extrasystoles, the aim should be to treat the heart disease causally so that the extrasystoles also disappear.

In addition, the potassium balance should be checked, since deviations from the norm can also trigger supraventricular extrasystoles (SVES). Drugs that act on the heart, such as digitalis preparations, should also be adjusted if the patient complains of extrasystoles. In rare cases, supraventricular extrasystoles can also trigger palpitations (tachycardia) or atrial fibrillation.

If this is the case, treatment with verpamil or beta blockers is necessary. 2 Ventricular extrasystoles Ventricular extrasystoles in healthy persons also do not require treatment. One form of ventricular extrasystole in particular, which disappears again with increased stress (overdrive suppression), is classified as particularly harmless and therefore does not require treatment.

However, if the patient complains about a restriction of the pumping function of the heart by the extrasystoles despite the lack of an organic cause, or feels subjectively impaired by them, drug therapy is indicated. However, if the ventricular extrasystoles are caused by organic heart disease, a causal therapy of the underlying disease is required.After a heart attack, for example, a quick revascularization measure should be taken, for example by a quick intervention in the heart catheterization laboratory, so that no permanent damage with scar tissue remains on the heart muscle, which could trigger ventricular extrasystoles. Similar to supraventricular extrasystoles, ventricular extrasystoles can also be caused by magnesium and potassium imbalances.

If this is identified as the cause, the magnesium and potassium levels should be set to a highly normal serum level, i.e. a level that is at the upper limit of the norm. In addition to this, medication must also be excluded as the cause of the ventricular extrasystoles that act on the heart. Particularly during therapy with digitalis preparations, overdosage often occurs in previously damaged hearts, which can then trigger extrasystoles again.

It should be remembered that the more damaged a heart is, the less it can tolerate digitalis preparations. Therefore, it can help to reduce the digital dose so that the ventricular extrasystoles disappear. Therapy with antiarrhythmics is only indicated if the patient has an increased risk of sudden cardiac death.

This can happen if the patient suffers from ventricular fibrillation. The drug group of choice here are beta blockers. In addition, a defribillator (ICD) can be implanted to reduce the risk of ventricular fibrillation or sudden cardiac death. As a rule, however, the implantation of a pacemaker is only necessary in cases of very severe rhythm disturbances, which usually do not include ventricular extrasystoles.