Ventricular Ectopia: Types, Symptoms, Causes, Treatment and Prevention

What is it? It is an irregular heartbeat due to premature heartbeats.

The ectopic rhythm is also known as premature atrial contraction, premature ventricular contraction and extrasystole.

When your heart experiences an early rhythm, it usually follows a brief pause. Usually he realizes this in the next stroke, feeling stronger. It can feel like fluttering, as if the heart skipped a beat.

In many of the cases people experience the ectopic rhythm (ventricular ectopia) from time to time. This is generally harmless and is solved without medical intervention. In case the ectopic rhythm continues, seek medical treatment.

A doctor may investigate the cause to check for an underlying condition such as electrolyte imbalance in the blood, heart injury, or heart disease. The specific diagnosis will determine your treatment.

The most common type of ventricular ectopic beat is premature, causing ventricular contraction before the underlying rhythm normally depolarizes the ventricles.

The morphology of the resulting heart beat on the electrocardiogram often seems wider and higher than that observed with the underlying rhythm.

Ventricular ectopic beats may indicate heart disease, be induced by stimulation (for example, stress, alcohol, caffeine, medication, cocaine or amphetamines) or occur naturally.

More than half of the population has silent or asymptomatic ventricular ectopia.

Ventricular ectopy can occur in patterns, such as béllémino (every other stroke), trigeminal (every third stroke), or quadrigémimo (every fourth stroke).

They can also occur in sequences, such as in pairs, three times, from four to seven episodes (up to eight or more).

What are the types of irregular heartbeats?

  • Premature atrial contraction.

An early heartbeat that occurs in the atria (upper chambers of the heart) is a premature atrial contraction. In healthy children, irregular heartbeats are almost always harmless.

  • Premature ventricular contraction.

When the irregularity comes from the ventricles (lower chambers of the heart), it is called a premature ventricular contraction.

The risk increases according to age. You have a higher risk of having it if you have a family history or if you have had a heart attack.

Causes of ventricular ectopia

Often, the cause of the ectopic rhythm is unknown. Some of the factors that can cause or aggravate ventricular ectopy are:

  • Alcohol.
  • Caffeine.
  • Smoke.
  • Medicines.
  • Illegal drugs (stimulants).
  • High levels of adrenaline, usually due to stress.
  • Exercises.

If the condition continues for a long time, there is more likely to be an underlying condition, such as:

  • Heart disease.
  • Chemical imbalance
  • Heart muscle injury due to heart disease, infection or high blood pressure.

What are the symptoms?

Often, you will not be aware that you have an ectopic rhythm. It can feel as if:

  • Your heart is fluttering.
  • Your heart beats strong.
  • Your heart skipped a beat or stopped briefly.
  • You are hyperconscious of your heartbeat.
  • Feels weak or dizzy

It is rare, but sometimes a person with ventricular ectopy will develop ventricular tachycardia (fast and irregular heartbeats) and other arrhythmias (problems with heart rate).

People who have had a heart attack or have heart disease or heart abnormalities have an increased risk of complications or sudden cardiac death.

How is ventricular ectopy diagnosed?

In many of the cases, the origin of ventricular ectopy is unknown and does not demand treatment. If you feel well, otherwise, you should tell your doctor during a physical exam so they can listen carefully to your heart.

In case the symptoms occur frequently or become severe, make an appointment with your doctor. They will perform a physical exam to see if there are abnormalities in your heart.

If you experience chest pain and pressure, rapid sustained heart rate and other symptoms along with ventricular ectopy, seek medical attention immediately.

Diagnostic tests to determine the cause may include:

  1. Echocardiogram: sound waves are used to create a moving image of the heart.
  2. Holter monitor: a portable device that records your heartbeat for 24 to 48 hours.
  3. Coronary angiography: X-rays and contrast dye are used to see how blood flows through your heart.
  4. Electrocardiogram (ECG): records the electrical activity of the heart.
  5. Exercise tests: monitoring the heart rate during exercise, usually through a treadmill.
  6. Magnetic resonance: detailed images using magnets and radio waves.
  7. Computed tomography of the heart: exploration of the heart by X-rays.

What are the treatments for ventricular ectopy?

In most cases, treatment is not necessary. Often, the symptoms resolve themselves. If your symptoms increase, your doctor will base your treatment on the underlying cause.

If you have had a heart attack or heart failure in the past, your doctor may prescribe beta-blockers or other medications.

If you have heart disease, your doctor may suggest angioplasty – in which a balloon is used to open a narrowed blood vessel – or bypass surgery.

How can I prevent ventricular ectopy?

There are some simple things you can do to reduce the likelihood of premature ventricular contractions. Take note of what triggers the symptoms, and eliminate them. The common triggers are alcohol, tobacco and caffeine. Reducing or eliminating these substances can help keep the heartbeat under control.

If your symptoms are related to stress, try self-help techniques such as meditation and exercise. If you are experiencing a period of prolonged stress, consult your doctor for information on how to reduce stress. In severe cases, anxiolytic medication may be useful.

It is a relatively common occurrence for cardiovascular clinicians to see patients with frequent premature ventricular contractions. They can appear in patients without any evident cardiovascular disease, in which case the pathogenesis can be considered idiopathic.

However, although largely asymptomatic, patients may experience disturbing symptoms and there are occasions when it means susceptibility to more sinister arrhythmias, especially when there is heart disease.

The premature ventricular contraction in certain patients is triggered by the same mechanisms that lead to ventricular tachycardia, which can be cured with catheter ablation.