An extrasystole (ES) – colloquially called a cardiac arrest or. Stumbling heart – (synonyms: atrial SVES; AV-junctional SVES; exercise-induced extrasystole; ectopic systole; extrasystole; extrasystolic arrhythmia; nodal SVES; permature ventricular contractions; supraventricular extrasystoles (SVES); supraventricular extrasystole; SVES [supraventricular extrasystole]; ventricular extrasystoles (VES); ICD-10-GM I49. 4: Other and unspecified extrasystole) is a heartbeat that occurs outside the physiological heart rhythm.
Extrasystoles (ES) are a cardiac arrhythmia that belongs to the group of impulse formation disorders. Extrasystoles present as supraventricular extrasystoles (SVES; atrial extrasystole) or ventricular extrasystoles (VES).
Ventricular extrasystoles occur in either the right or left ventricle. There is an association with increased sympathetic tone.
Ventricular extrasystoles (VES) may occur with some regularity or have some relationship to sinus rhythm:
| History | Description | |
| Couplet | N ES ES | 2 VES occur in direct succession ECG: deformed, widened QRS complex. |
| Triplet | N ES ES | 3 VES occurring directly one after the other |
| Salvo | ES ES ES … | > 3 consecutive VES (= ventricular tachycardia, if lasting longer than 30 seconds). |
| Bigeminal | N ES N | each normal stroke is followed by 1 VES |
| Trigeminal | N ES N | each normal stroke is followed by 2 VES |
| 2: 1 extrasystole | N ES | 2 normal strokes and 1 VES |
| 3: 1 extrasystole | N N ES | 3 normal strokes and 1 VES |
Frequency Peak: Supraventricular extrasystoles (SVES) increase in frequency with advancing age.
The prevalence (disease incidence) for ventricular extrasystoles (VES) in healthy individuals is 0.8%. Only about 30% of people notice an extrasystole as a “heart palpitation” or “dropout”.
Course and prognosis: If ventricular extrasystoles (VES) occur in otherwise healthy individuals, they are considered harmless. Treatment should only be started if the affected person feels ill. Note: Even in high numbers, VES can remain asymptomatic for the patient. However, if syncope (brief loss of consciousness) or presyncope occurs in the context of VES, this represents a relevant symptomatology that requires further diagnosis. If extrasystoles occur as a consequence of a disease (e.g. hyperthyroidism), the treatment of the causative disease is of primary importance. For example, if the patient has had a myocardial infarction (heart attack), the increased occurrence of ventricular extrasystoles should be interpreted as an alarm signal for ventricular fibrillation.