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ATRIAL OR VENTRICULAR EXTRASYSTOLES

Atrial and ventricular extrasystoles are abnormal heartbeats, outside the normal rhythm, experienced by patients in various ways (missed beat, irregular beat, intense beat, shortness of breath, palpitations, etc.). There are different types in relation to their origin, frequency and repetitiveness. They can be absolutely trivial, without clinical relevance, they can be a sign of a heart disease, they can be secondary to the intake of certain substances, they can trigger other arrhythmias or they can repeat in sequences so long as to compromise the normal contraction of the heart. They are divided into two large categories, those that originate from the atria and those that originate from the ventricles.

ATRIAL EXTRASYSTOLES

They are generally more benign than ventricular extrasystoles, originating in the heart chambers called atria. Their origin is varied but the most common locations are the vena cava, the terminal crest, the pulmonary veins and the coronary sinus. Atrial extrasystole is often associated with hypertensive heart disease, heart valve disorders, hormonal disorders, previous heart surgery, gastric problems etc. For the screening of these patients, tests such as cardiac Holter and some blood and hormonal tests and echocardiogram if necessary are often useful. In these patients, based on the symptoms and characteristics of the extrasystole (frequency, number, repetitiveness), the arrhythmologist decides whether to do nothing, whether to undertake medical therapy, or propose a percutaneous intervention (Transcatheter Ablation of atrial extrasystole).

VENTRICULAR EXTRASYSTOLES

They originate in heart chambers called ventricles. Their origin is varied and they can originate from either the right or left ventricle. Ventricular extrasystoles are sometimes not associated with any other heart disease and are therefore relatively benign and are called idiopathic ventricular extrasystoles. Some of the most common sites of ventricular extrasystoles in the structurally healthy heart are the right and left outflow tract, the coronary cusps, the papillary muscles, etc. Other times, this type of arrhythmia is associated with hypertensive heart disease, previous heart attack, dilated heart disease, arrhythmogenic dysplasia, heart valve disorders, hormonal disorders, previous heart surgery, etc. Tests such as echocardiogram, 12-lead cardiac Holter, stress test, and some blood and hormone tests are often useful for screening these patients. In these patients, based on the symptoms and characteristics of the arrhythmia (frequency, number, repetitiveness), the arrhythmologist decides whether to do nothing, whether to undertake medical therapy or propose a percutaneous intervention (Transcatheter Ablation of ventricular extrasystoles).

LUCA PANCHETTI
MD - Ph.D.Medical Surgeon – Doctor of Research
Specialist in Cardiology, Clinical and Interventional Arrhythmology

Medical Director I level at Fondazione Toscana G. Monasterio /CNR

Tel: +39 340 746 8584

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