Extrasystoles: Causes, Characteristics, Types, Complications, Diagnosis and Treatment

It is one of the most common varieties of arrhythmias, characterized by the appearance of an extraordinary shortening of the heart muscle.

The extrasystoles, whose symptoms arise not only in patients but also in healthy people, can be triggered by fatigue, psychological stress, and other external stimuli.


They can be caused even by the use of caffeine, alcohol, or tobacco; in addition to other factors in the form of overexertion and excessive fatigue, they are a relatively safe state for a person, their life, and their health.

Meanwhile, if it is about its appearance in individuals for whom cardiovascular diseases are present in one way or another, then, in this case, the extrasystole plays the role of an increased risk factor.


The appearance is explained by the formation of ectopic foci, characterized by more excellent activity and located outside the sinus node (that is, in the ventricles, the atria, or in the atrioventricular nodule).

The extraordinary pulses formed in these foci spread along with the cardiac muscle, causing premature cardiac contractions to the diastole phase.

The volume of blood ejection with extrasystole is below average; for this reason, frequent premature beats (significant contractions of the individual parts of the heart), which occur more often 6-8 times per minute, can lead to noticeable changes in the minute volume of blood circulation.


It should be noted that the earlier begins to develop extrasystole, the lower the amount of blood that accompanies the extrasystolic ejection, respectively.

In the first place, these characteristics are reflected in the coronary blood flow and can also substantially complicate the cardiac pathology that is already topical for the patient.

Depending on the particular type of extrasystole, its clinical importance and corresponding prognostic characteristics are determined.

The most dangerous extrasystoles are gastric. Its development is accompanied by organic damage to the heart, against which they arise.

Types of extrasistóles

Depending on the area in which ectopic foci of excitation are formed, ventricular, extrasystole, atrioventricular, and extrasystolic atrial extrasystole are determined. In addition to this, some variants of their combination also stand out.

Exceptional cases indicate that extraordinary impulses appear from the atrial sinus node, that is, from the physiological pacemaker.

In some cases, there are two simultaneous rhythms: sinus rhythm and extrasystolic, which is defined as parasystole.

It also distinguishes a rhythm in which normal systoles alternate with extrasystoles (i.e., Bimini). Two normal systoles alternate with extrasystole (trigeminal) and a rhythm in which the extrasystole follows each third normal contraction.

The regular repetition of Bigeminy, Trigeminy and Quadrigeminy determines these conditions as Alorritmia.

Depending on the frequency of formation of extrasystoles, they are detected:

  • Rare extrasystoles (up to 5 for 1 minute).
  • Average Extrasystoles (from 6 to 15 for 1 minute).
  • Frequent extrasystoles (more than 15 times per minute).

Depending on the number of emerging ectopic foci, the extrasystole is determined with a guide (monotopic) and the extrasystole with several priorities (polytopic).

Functional extrasystoles represent disturbances in the rhythm of psychogenic origin (neurogenic). They are related to chemical influence factors, including alcohol and drugs, smoking, etc.

Functional extrasystole is also recorded in patients diagnosed with autonomic dystonia, osteochondrosis, neurosis, and other conditions.

As an example of the variety considered extrasistólis, you can observe an arrhythmia in trained and completely healthy athletes.

The frequency of development of functional extrasystoles in women during the onset of menstruation can also be observed. Functional extrasystoles are caused, among other things, by stress and by the use of beverages as strong as coffee and tea.

In the case of developing a functional extrasystole without any predisposing factor in healthy people, it is defined as an idiopathic functional extrasystole.

Extrasistóles organics: The relevance of this variety of extrasystoles is determined by the injury in the myocardium, which occurs mainly in myocardial infarction, ischemic heart disease, myocarditis, cardiosclerosis, pericarditis, and heart defects.

In athletes, the formation of extrasystoles may, in some cases, arise due to dystrophy of the myocardium, which is formed due to physical overexertion.

During physical exercise, extrasystoles can be triggered due to metabolic and cardiac disorders, and physical activity can also exert a suppressive effect on extrasystoles formed in vegetative dysregulation.

Extra copies: People who have cardiac injuries on an organic scale may, on the contrary, be much more likely to tolerate a state of extrasystole.

In most of its manifestations, the extrasystoles are expressed in a type of impact or a pull that arises from the inner side of the chest. Such images are caused by vigorous contractions of the ventricles that appear after the compensatory pause.

Typical manifestations of functional extrasystole are hot flashes, anxiety, weakness, malaise, shortness of breath, and excessive sweating.

The frequent extrasystoles with their distinct group and early character lead to a decrease in cardiac output; this causes a reduction in the order of up to 25% of the cerebral, renal, and coronary circulation parameters.

Patients who have signs of atherosclerosis, and experience dizziness, may also develop transient forms related to cerebral circulation (paresis, aphasia, fainting).

Major complications

Extracorporeal group type manifestations tend to turn into much more significant disturbances in rhythm. Therefore, atrial disorders enter atrial flutter; ventricular changes become paroxysmal tachycardia.

Patients with dilation or atrial overload may undergo an extrasystole transition to a ciliary arrhythmia. In case of frequent occurrence, the extrasystole causes the appearance of chronic insufficiency of the renal, cerebral and coronary circulation.

The most dangerous is the ventricular premature beats because the peculiarities of its course can lead to the development of fibrillation of the ventricles, which in turn leads to a sudden lethal result.


The primary objective method to diagnose extrasystole is found in the electrocardiogram. Meanwhile, it is possible to assume the possibility of having this type of arrhythmia also during the physical examination.

In addition, a patient complaint also plays a role in the diagnosis of the disease.

Treatment of extrasystoles

  • In determining the appropriate treatment tactics, the shape of the extrasystole and the area of ​​its location are taken into account.
  • Not caused by cardiac pathology, simple extrasystoles do not require any therapy in their relationship.
  • Suppose the development of extrasystoles is due to diseases of the endocrine or digestive system and cardiac muscle diseases. In that case, it is necessary to begin treatment with a therapy focused on the underlying condition.
  • In addition, particular sedation medications are prescribed.

The extrasystole that has emerged as a side effect of taking medications requires immediate cancellation. The ventricular form of extrasystole involves treatment with the radiofrequency ablation method.

This method is also indicated for use in the absence of the efficacy of antiarrhythmic therapy, severe tolerability, or in the presence of unfavorable predictions for this type of treatment.

Suppose you suspect that you have an extrasystole. In that case, you should seek the advice of a cardiologist who, given the urgency of this diagnosis, will determine the necessary treatment based on your complaints and the relevant studies.

Also, as we have already pointed out, you may need a consultation with a neurologist.