When going out of the clinic, I often encounter patients who are often flustered and suspect that they have a serious heart disease. As a result, a number of tests did not reveal a clear organic disease, but the electrocardiogram or 24-hour dynamic electrocardiogram showed premature beats; some patients did not There are no symptoms, but the physical examination found premature beats, and I was worried. It can be seen that many people still don’t recognize “premature beats.”
Everyone knows that our heart contracts constantly to promote blood circulation and deliver oxygen and nutrients to all parts of the body. Its contraction behavior follows a complex set of electrophysiological mechanisms: cardiomyocytes are responsible for movement, some cells are responsible for the conduction of electrical signals, and some are responsible for the initiation of electrical signals, and all of these have to listen to the commands of the sinus node. After the contraction signal is transmitted from the sinoatrial node, it is transmitted downward along the route of the internodal bundle, atrioventricular node, atrioventricular bundle, left and right bundle branches, and Purkimje fibers to control the contraction of the cardiomyocytes passing by. If the sinus node does not signal in advance according to the established rules due to various reasons, or if there are “heretical” commands in other parts of the heart, the first to send the signal will cause the occurrence of premature beats, which will affect the pumping of the heart and cause dizziness. , Darkening, panic, chest tightness and other symptoms. But sometimes if the body is overworked and the mental pressure is too great, the sinus node will also cause small emotions, leading to the occurrence of premature beats. This situation will mostly disappear by itself after adjusting the life state.
The diagnosis of premature beats mainly relies on electrocardiogram and 24-hour dynamic electrocardiogram. Studies have shown that the vast majority of premature beats are benign, which neither affects life expectancy nor quality of life, and does not require treatment. The harm of premature beats mainly depends on the underlying disease, location of origin, morphology and frequency of premature beats. Premature beats that are harmful to the human body include frequent ventricular premature beats, multi-source premature beats, RonT phenomenon and so on. Among them, premature ventricular beats are more common. In addition to causing discomfort to the patient and affecting the blood drainage function of the heart, severe cases can also lead to ventricular tachycardia, and even life-threatening ventricular fibrillation, leading to sudden death. Therefore, premature ventricular contractions should not be taken lightly.
At present, it is clinically recommended that medication should be considered for the following premature ventricular beats: ① More than 10,000 premature ventricular beats per 24 hours, or more than 10% of the total number of heartbeats (for 80,000 heartbeats, it is at least 8,000 or more) ); ②The morphology of ventricular premature beats is diverse (identified by electrocardiogram examination); ③Ventricular premature beats presents dual rhythm, triple rhythm, or transient ventricular tachycardia; ④The time of occurrence of ectopic beats Too early.
There are mainly two kinds of drugs for the treatment of premature beats: class II antiarrhythmic drugs β-receptor blockers, and class IV antiarrhythmic drugs calcium channel blockers. When using, be sure to follow the doctor’s advice, pay attention to contraindications and adverse reactions.
Frequent premature beats that are ineffective in drug therapy, or the patient cannot tolerate the side effects of drugs or premature symptoms of the room, can be treated with radiofrequency ablation, and most patients can be cured. Radiofrequency ablation is a method of interventional treatment of tachyarrhythmia. It is to puncture a very thin catheter from the femoral vein of the thigh and place it into the blood vessel. After reaching the heart cavity, it accurately marks the target and releases the radiofrequency current. Eliminate ectopic excitement “lesions”, no surgery or sutures, small trauma and quick recovery. After successful treatment, the patient not only avoids the trouble of recurrent symptoms, but also avoids the adverse effects of rapid heart rate on the structure and function of the heart and the toxic side effects of long-term antiarrhythmic drugs. The operation is usually performed under general anesthesia, and you can get out of bed 12 to 24 hours after surgery.
People with a history of premature beats or poor physical condition should pay attention to some things in life to avoid recurrence or occurrence of premature beats: avoid excessive exercise, exercise should be based on gentle activities such as walking and Tai Chi, and play basketball, long-distance running, etc. Physical exercise is best not to participate; mood plays a vital role in the recovery process of illness, so try to maintain a calm mind and not lose your temper at will; regular daily life plays an important role in the recovery of patients with arrhythmia Therefore, it is necessary to reasonably arrange rest and activities to ensure adequate sleep time, avoid long-term, continuous staying up late, and reverse black and white; balance the diet, quit smoking and limit alcohol, drink less strong tea and coffee; regularly check the electrocardiogram, etc., once found Go to the hospital in time for heart palpitations and missed beats.
