Extrasystole

Extrasystole

Extrasystole, also known as premature contraction, is a medical condition characterized by an extra heartbeat that occurs outside the normal rhythm. These extra beats are often perceived as palpitations or a "skipped beat" and can originate from the atria, ventricles, or the junction between them. While extrasystoles are common and often benign, they can sometimes indicate underlying heart conditions.

Pathophysiology

Extrasystoles occur due to premature depolarization of the heart muscle. This can be caused by various factors, including electrolyte imbalances, ischemia, or increased sympathetic activity. The premature beat interrupts the normal cardiac cycle, leading to a compensatory pause before the next normal beat.

Types of Extrasystoles

• Atrial Extrasystole (Atrial Premature Contraction): Originates in the atria. These are often benign and can be triggered by stress, caffeine, or alcohol.
• Ventricular Extrasystole (Ventricular Premature Contraction): Originates in the ventricles. These can be more serious, especially if they occur frequently or in patterns such as bigeminy or trigeminy.
• Junctional Extrasystole: Originates in the atrioventricular node or the junction between the atria and ventricles.

Clinical Presentation

Patients with extrasystoles may experience palpitations, a sensation of a "skipped beat," or no symptoms at all. In some cases, frequent extrasystoles can lead to dizziness or fatigue due to decreased cardiac output.

Diagnosis

Extrasystoles are typically diagnosed using an electrocardiogram (ECG), which can capture the premature beats. Holter monitoring or event recorders may be used for patients with intermittent symptoms.

Management

Management of extrasystoles depends on the frequency and underlying cause. In many cases, no treatment is necessary. Lifestyle modifications, such as reducing caffeine and alcohol intake, can be beneficial. In symptomatic cases, beta-blockers or antiarrhythmic medications may be prescribed.

Prognosis

The prognosis for patients with extrasystoles is generally good, especially if there is no underlying heart disease. However, frequent ventricular extrasystoles may require further evaluation to rule out structural heart disease.

Also see

• Arrhythmia
• Atrial Fibrillation
• Ventricular Tachycardia
• Electrocardiogram

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