Premature Ventricular Depolarizations

Premature Ventricular Depolarizations General Information

Generally, Premature Ventricular Depolarizations are considered ectopic impulses that come from an ears distal to the heart’s Hiss Purkinje system. This kind of condition is the most common form of ventricular arrhythmia. It is very important to diagnose the disease because if the treatment is not done properly in time, this can become challenging to manage. The exact cause of the disease is still unknown, but it is supposed to appear as a complication of certain conditions such as ventricular ectopy which can cause ventricular tachycardia, which also degenerates into ventricular fibrillation, which if it is not treated properly it can cause cardiac death. The most common mechanisms in evaluating the pathophysiology of Premature Ventricular Depolarizations can include automaticity, which is the development of a new form of depolarization in the nodal ventricular tissue, which can cause the disease to appear.

Usually, the focal mechanisms, without evidence of macro reentry, have a critical role in the origin of ventricular arrhythmia caused by ischemic cardiomyopathy. Increased automaticity can also be caused by electrolyte imbalance or ischemic myocardium; reentry circuit, which usually takes place when the slow conducting tissue, such as infracted myocardium, is present in addition to the normal tissues; and triggered activity, such as after depolarizations which can be caused by a preceding impulse leading to premature activation. The premature activation is considered to cause Premature Ventricular Depolarizations. This kind of disease is uncommon in young patients, but the risk of developing it increases with age, and is more common in men than in women.

Premature Ventricular Depolarizations Symptoms

There are certain signs and symptoms that are specific for Premature Ventricular Depolarizations, but the exact prevalence of these manifestations is still unknown. The most common signs and symptoms the patient experiences can include palpitation, light headedness, syncope, atypical chest pain and fatigue. Usually, palpitations appear due to an augmented post disease beat and can be experienced as a short pause. In most case, the physical manifestations of the disease are associated with decreased intensity of the patient’s heart sounds. There are also cases in which the patient can present a bounding jugular pulse that can be caused by a loss atrioventricular synchrony. When the patient presents the sensation of an extra beat, it actually presents a stronger heart beat that is caused by the postextrasystoloc compensatory pause, allowing the left ventricle to fill more than normal, which can cause a greater intensity of the heart beat.

There are certain causes that can cause Premature Ventricular Depolarizations to appear and can be classified as cardiac and noncardiac. The cardiac causes can appear as acute myocardial infarction, valvular heart disease, particularly mitral valve damage, cardiomyopathy which can appear in many forms such as ischemic, dilated, hypertrophic and infiltrative, myocardial stretch, cardiac contusion, bradycardia, and tachycardia. The non cardiac causes of the disease can appear as electrolyte imbalance, hypokalemia, hypocalcaemia, hypomagnesaemia, certain medicines such as Digoxin, antidepressants, and Fluoxetine, surgery, infection, and stress. There are cases in which Premature Ventricular Depolarizations can be caused by caffeine, alcohol or cocaine.

Premature Ventricular Depolarizations Treatment

It is very difficult to decide when is the proper time to treat Premature Ventricular Depolarizations because not all patients who are suffering from it present an increased risk of developing complications that can lead to death. Usually the available treatment is based on this risk. In most cases, the treatment for this kind of disease depends on the frequency of the manifestations, the present signs and symptoms, the presence or absence of other structural heart conditions, and the estimated risk of evolving to sudden death. The most common structural heart disease can appear as abnormal ventricular function, coronary or valvular heart disease. When the patient presents none of these medical conditions, he is treated depending on the presence of certain symptoms. If Premature Ventricular Depolarizations develops without causing any signs and symptoms, the patient does not need any treatment at all. But, if the patient do experience certain signs, the treatment usually consists in patient education and reassurance, avoiding the factors that can worsen the condition such as stress, caffeine or alcohol containing products, and applying anxiolytic medicines, but only if the avoidance of the mentioned factors is not effective.

The most common medicines used to treat Premature Ventricular Depolarizations can be administered as Beta blockers and Nondihydropyridine calcium channel blockers such as Verapamil or Diltiazem. The Beta blockers medicines can also be used as sympathomimetic medicines to treat and control the abnormalities caused by the disease. There are cases in which doctors choose to apply anti-arrhythmic therapies, but they are generally not recommended, and are considered more a way to prevent the symptoms to appear. It is very important that the doctor inform the patient about the risk of developing complications after applying the treatment so he can weigh the benefits. The most common complication can appear as an increased risk of arrhythmic death caused by pro-arrhythmia. There are also cases in which the patient’s organism can resist the beta blockers or calcium channel blockers medicines, and the first option is the use of Amiodarone.

Some researchers discovered certain medicine that can help controlling and speeding the cure of the disease, and can include Dofetilide and Azimilide. But, if a patient who is suffering from Premature Ventricular Depolarizations also presents specific heart diseases, doctors should first set certain invasive and noninvasive treatment options, which can also depend on the exact diagnosis of it. In most cases, to combine the invasive and noninvasive medical therapies, the patient must present certain variables that can include LV EF lower than 0.30, ventricular late potentials and repetitive form of this medical condition. If the patient presents an increased risk of developing sudden cardiac death doctors must immediately apply a cardioverter defibrillator implantation that can help stabilize the patient’s health status. It is very important to treat Premature Ventricular Depolarizations in the first stages of development because if it is not treated properly or not treated at all it can cause severe complications that can lead to the death of the patient.