It refers to the heartbeat caused by premature beating of ectopic pacing point, which is the most common arrhythmia. It can occur on the basis of sinus rhythm or ectopic rhythm (such as atrial fibrillation). It can occur occasionally or frequently, or irregularly or regularly after each or several normal beats, forming biphasic or biphasic premature beats. According to the origin, it can be divided into sinus, atrium, atrioventricular junction and ventricle. Among them, ventricular premature beats are the most common, followed by atrial, nodal and sinus premature beats. The principle of treatment should refer to whether there is organic heart disease, whether it affects cardiac output and the possibility of serious arrhythmia.
Most premature beats without organic heart disease do not need special treatment. Symptoms should be relieved, and premature beats induced by nervousness, emotional overexcitation or exercise can be tried with sedatives and beta blockers.
Those with frequent attacks, obvious symptoms or accompanied by organic heart disease should find out the cause of premature beats as soon as possible.
premature beat
At the same time, correctly identify the potential fatal possibility, actively treat the cause and prescribe the right medicine.
In addition to etiological treatment, antiarrhythmic drugs can also be selected for treatment. Atrial and atrioventricular junctional premature beats are mostly used as Class I, Class I, Class III, Class II and Class IV drugs for atrioventricular junctional areas, while ventricular premature beats are mostly used as Class I and Class III drugs for ventricles (see the above drug classification, please also refer to Chapter VII "Introduction to Clinical Pharmacology"). Potentially fatal ventricular premature beats usually require emergency intravenous administration. Class ⅰ b is the first choice. Intravenous lidocaine is still the first choice in the early stage of acute myocardial infarction. If there are no contraindications after myocardial infarction, β -blockers are often used for treatment. In patients with primary or secondary QT prolongation syndrome, class I drugs are prohibited, and β-blockers, phenytoin sodium or carbamazepine can be used for primary patients. Secondary patients should use isoproterenol or atrial or ventricular pacing to eliminate the cause.
Recent research (CAST 1989) shows that antiarrhythmia may increase mortality. Even if patients with heart disease have ventricular premature beats, there is no evidence that the sudden death rate can be reduced (except for β -blockers after myocardial infarction). So we should weigh the advantages and disadvantages of antiarrhythmic drugs. There have been a series of multicenter trials and long-term follow-up for patients with arrhythmia (mainly premature beats) without myocardial infarction in China. Propafenone, morexizine, propafenone, morexizine and mexiletine were effective in treating supraventricular arrhythmia, and no serious cardiac events were found. However, it is still necessary to closely follow up and monitor its curative effect and possible adverse reactions during medication. Be especially cautious about people with cardiac insufficiency.
1. Don't be too nervous when premature beats occur. Ask the doctor to further examine the causes of premature beats and evaluate the severity of premature beats. If the causes of premature beats can be found, as long as the causes of premature beats are removed and the diseases that induce premature beats are cured, premature beats can be gradually eliminated. If the cause of premature beats cannot be found, please ask the doctor to decide whether it is necessary to treat premature beats. Most patients with premature beats recover well.
2. Occasional premature beats have little effect on blood circulation, especially if they are not caused by other diseases. Premature beat itself is not a very serious disease and generally does not need treatment. Therefore, patients should eliminate their worries and remain optimistic.
3. Frequent premature beats, especially those that may develop into serious arrhythmia on the basis of heart disease, or may lead to angina pectoris and heart failure, should be paid attention to. There are many drugs to relieve premature beats, such as propranolol, isosorbide dinitrate, bradycardia, amiodarone, quinidine and procainamide. These drugs are more violent and should be taken under the guidance of a doctor. Be patient in treatment and don't change medicine frequently. After the premature beat is controlled, a small amount of medicine is still needed to avoid the recurrence of the disease.
If the drug treatment is ineffective, patients can't tolerate it, or have frequent premature beats with a certain degree of malignancy, radiofrequency ablation can be used, and some patients can be cured.
It may have been a long time ago for the frequent unexplained premature beats. Many patients are used to it, and if the doctor evaluates it as benign, there is no need for treatment.
4. Don't smoke, drink, overeat and eat less irritating food. Pay attention to the combination of work and rest and get enough sleep. Chronic patients with no increase in premature beats after exercise should participate in cultural and sports activities appropriately.
Edit this period of disease care
1. Premature beat itself is not a serious disease, so it is important for patients to eliminate ideological concerns, maintain emotional stability and always maintain a happy mood. Avoid excessive excitement or sadness. Emotional fluctuation is easy to induce premature beats.
Pay attention to rest, go to bed early at night and don't stay up late. If you have insomnia, you should take some sedatives or sleeping pills under the guidance of a doctor to ensure that the cerebral cortex gets enough rest, otherwise it will cause dysfunction of the central nervous system, increase myocardial excitement and induce premature beats.
3. Pay attention to the care of premature beats in diet: do not smoke, drink alcohol, overeat, eat less irritating foods such as hot and sour condiments, and drink less strong tea or coffee, because these foods can increase myocardial excitability and induce premature beats.
4. Chronic patients with no increase in premature beats after activities should participate in cultural and sports activities appropriately.
Patients with severe heart disease or obvious symptoms must take antiarrhythmic drugs. This medicine should be taken according to the doctor's advice, and attention should be paid to whether there are any adverse drug reactions during taking it. This is a point that needs special attention in premature beat nursing. Commonly used drugs such as amiodarone and verapamil can slow down the heartbeat. If the heartbeat is below 50 beats per minute after taking the medicine, stop taking the medicine in time. Batroxobin is also easy to cause nervous system side effects, such as dizziness, finger tremor, trembling and so on. , should be used with caution.
Edit this paragraph about disease prevention.
1, keep a regular life and proper physical exercise, don't stay up late, don't watch TV or sit in front of the computer for a long time; Walking, playing Tai Ji Chuan and using some fitness equipment for fitness training will bring long-term benefits to your health.
2. Quit smoking and avoid drinking heavily, because smoking and drinking are the main inducing factors of coronary heart disease.
3. To maintain emotional stability, we should straighten out the relationship between work, life and study. High emotional tension and fluctuation are the main causes of functional "premature beats".
4. Go to the hospital for physical examination regularly, and go to the hospital in time once you find palpitations and missed jumps.
5. Premature beats, referred to as premature beats or premature beats, are common clinical manifestations of heart disease patients. Premature beat itself is not a serious disease, so it is important for patients to eliminate ideological concerns, maintain emotional stability and always maintain a happy mood. Avoid excessive excitement or sadness. Emotional fluctuation is easy to induce premature beats.
6. Pay attention to the care of premature beats in diet: do not smoke, drink alcohol, overeat, eat less irritating foods such as hot and sour condiments, and drink less strong tea or coffee, because these foods can increase the excitability of myocardium and induce premature beats.
7, pay attention to rest, should go to bed early at night, don't stay up late, insomnia, nursing premature beats should take some sedatives or sleeping pills under the guidance of a doctor, to ensure that the cerebral cortex can get enough rest, otherwise it can cause dysfunction of the central nervous system, increase myocardial excitement and induce premature beats.
8. Chronic patients with no increase in premature beats after activities should participate in cultural and sports activities appropriately.
9, accompanied by severe heart disease or obvious symptoms must take antiarrhythmic peony. This medicine should be taken according to the doctor's advice, and attention should be paid to whether there are any adverse drug reactions during taking it. This is a point that needs special attention in premature beat nursing. Commonly used drugs such as amiodarone and verapamil can slow down the heartbeat. If the heartbeat is below 50 beats per minute after taking the medicine, stop taking the medicine in time. Batroxobin is also easy to cause nervous system side effects, such as dizziness, finger tremor, trembling and so on. , should be used with caution.