| Abstract [eng] |
Ventricular extrasystole is one of the most common arrhythmias, with a population prevalence of 1 perc. – 4 perc. on 12-lead electrocardiogram (1). Ventricular extrasystoles are often found in asymptomatic patients, but episodic or prolonged symptoms may occur (2). Although ventricular extrasystoles can be a benign condition without structural heart disease, they can cause arrhythmic cardiomyopathy—changes in heart structure and function (3). This paper describes a 34-year-old patient with ventricular extrasystole without structural heart disease and pronounced symptoms. The main diagnostic methods used are 12-lead electrocardiogram and 24-hour Holter monitoring to assess QRS morphology and ventricular extrasystole frequency (4). Instrumental tests such as transthoracic cardiac ultrasound, veloergometry or even cardiac magnetic resonance imaging are necessary to evaluate structural heart diseases or left and right ventricular functions. For patients without structural heart disease and infrequent, asymptomatic ventricular extrasystole, medical treatment is usually not prescribed. Factors provoking rhythm disorder, lifestyle are corrected. If ventricular extrasystoles are symptomatic, frequent, drug treatment is prescribed. In the case of frequent extrasystoles, especially those causing changes in the structure and function of the heart - cardiomyopathy - interventional percatheter treatment is suggested (5). The treatment of ventricular extrasystole should primarily focus on the diagnosis and treatment of the most common causes, such as electrolyte abnormalities, illegal psychotropic substances that can increase the level of catecholamines in the blood. Beta adrenoblockers are the drugs of first choice in the treatment of symptomatic ventricular extrasystoles. Catheter ablation of the arrhythmia focus is recommended for patients in whom medical treatment is ineffective (6). The aim of the work is to review the literature on the causes of ventricular extrasystoles without structural heart disease and treatment recommendations, to describe a clinical case, assessing the importance of choosing the appropriate treatment method for such patients. |
