Extrasystole: what is it?

A dip in the heart, or a “suspended” beat, a “palpitation” or, again, a feeling of discomfort and anxiety. These are the main manifestations of extrasystole: an alteration of the rhythm of contraction of the heart (arrhythmia) generally benign and not linked to particular heart diseases, but which can still create a certain discomfort to those who experience it.

On the other hand, it should be noted that not all extrasystoles give a clear sign of themselves. In many cases, in fact, this arrhythmia is found in a very occasional way during routine cardiological checks carried out for other purposes, such as the evaluations required to obtain clearance for amateur or competitive sports activity.

In this second case, to indicate that extrasystoles are present is the trace of the electrocardiogram (ECG), which shows a variation in the sequence of waves that graphically represents the electrical activity of the heart.

The most common causes

By way of reassurance, it must immediately be said that, although it is always advisable to deepen with the help of the doctor and some instrumental examination any unusual cardiac symptom, extrasystoles should not worry because, in the vast majority of cases, they are transient disorders not immediately dangerous and without consequences for general health.

To determine them can be factors of a very different nature, sometimes even quite trivial. They range from a few cups of coffee too much to work stress, from insufficient sleep to excessive physical activity, from generalized fatigue to smoking, from a more or less consolidated state of anxiety to an extemporaneous worry.

Other possible common causes of extrasystole include taking drugs with a more or less marked secondary activity on the heart, a meal that is too abundant or otherwise indigestible, or the presence of gastroesophageal reflux or a hiatal hernia (condition determined by the passage from the abdomen to the thoracic cavity of a small portion of the upper part of the stomach through the “hole” of the diaphragm).

More rarely, extrasystoles can appear in conjunction with electrolyte disorders (in particular, potassium deficiency), thyroid disease (for example, hyperthyroidism), hormonal alterations (especially estrogen drops that typically occur before menstrual flow and at the beginning of menopause), or as a corollary of other heart diseases (for example, heart failure).

Complications

As mentioned, isolated, occasional or mild extrasystoles can be considered completely physiological and without consequences for the activity of the heart.

However, any ventricular extrasystoles found in athletes or in apparently healthy young people who intend to undertake a sporting activity must be investigated with specialized investigations (different depending on the case) to verify that there are no undiagnosed heart diseases or conditions that predispose to more severe arrhythmias.

Particular attention should also be paid when extrasystoles begin to persist for a long time, turning into alterations in heart rhythm (atrial flutter or atrial fibrillation) that must be treated specifically to avoid serious sequelae (in particular, increased risk of thromboembolic and cerebral stroke).

Another possible serious, but rare, complication of very frequent and persistent extrasystoles consists in the development of dilated cardiomyopathy, due to the abnormal contraction imposed by arrhythmia on the heart muscle.

What to do

Given that, almost always, it is a temporary disorder and without significant effects, the only necessary precaution in case of extrasystole is to remove the predisposing / triggering factors that may be present and correct the lifestyle.

So, if you smoke you will have to quit or, at least, reduce the number of cigarettes smoked; care must be taken not to overdo it with coffee and other caffeinated beverages / foods, possibly interrupting their intake for a more or less prolonged period; you will have to dose your energies better during the day, avoiding excessive efforts, and rest more at night; Last but not least, nervousness and stress must be avoided, two factors with a significant negative impact and often underestimated not only on heart rhythm, but on health in general.

In the rare cases in which extrasystoles have a more defined organic origin and related to specific pathologies or risks, the doctor will indicate, on the basis of the results of the cardiological examination and the instrumental examinations of the case (ECG, Holter 24-72 hours, echocardiography under stress, coronary angiography, etc.), the treatments to be carried out (antiarrhythmic drugs or ablation surgery).