{"id":156,"date":"2024-06-22T16:24:35","date_gmt":"2024-06-22T14:24:35","guid":{"rendered":"https:\/\/grossicardiologo.it\/?p=156"},"modified":"2026-03-09T10:14:43","modified_gmt":"2026-03-09T09:14:43","slug":"extrasistoli","status":"publish","type":"post","link":"https:\/\/grossicardiologo.it\/en\/extrasistoli\/","title":{"rendered":"Extrasystoles"},"content":{"rendered":"<div class=\"kb-row-layout-wrap kb-row-layout-id156_645293-b0 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top kb-theme-content-width\">\n\n<div class=\"wp-block-kadence-column kadence-column156_d6a217-f0\"><div class=\"kt-inside-inner-col\">\n<p><strong>Extrasystoles are heartbeats that occur earlier than expected during cardiac activity, temporarily interrupting its usual rhythm.<\/strong><\/p>\n\n\n\n<p>In physiological conditions, the heart is activated by specific cells of the activation and conduction tissue that generate and transmit the impulse of each single beat to the entire heart. The other cells are passively activated and give rise to the contraction of the cardiac muscle. When instead \u201canarchic\u201d cells autonomously generate electrical impulses outside the physiological activation cycle, an extrasystole occurs. The patient who is affected feels a sensation described as a blow, a dip in the chest, a feeling of emptiness, a momentary lack of breath or sudden weakness, a fleeting sensation of fainting.&nbsp;<\/p>\n\n\n\n<p>&nbsp;Depending on their origin, they can be distinguished into supraventricular and ventricular depending on the location of the focus that determines them.<\/p>\n\n\n\n<p>The diagnosis is made with the electrocardiogram: the cardiologist raises the clinical suspicion that is confirmed when an abnormal heartbeat is recorded on the electrocardiogram, both standard and Holter (extended recording from 24 hours up to 7 and 15 days).<\/p>\n\n\n<div class=\"kb-row-layout-wrap kb-row-layout-id156_092490-c1 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n\n<div class=\"wp-block-kadence-column kadence-column156_100aac-e0\"><div class=\"kt-inside-inner-col\">\n<div class=\"wp-block-group has-border-color has-accent-3-border-color has-global-padding is-layout-constrained wp-container-core-group-is-layout-d7a40c7c wp-block-group-is-layout-constrained\" style=\"border-width:4px;margin-top:var(--wp--preset--spacing--50);margin-bottom:var(--wp--preset--spacing--50);padding-top:var(--wp--preset--spacing--30);padding-right:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--30);padding-left:var(--wp--preset--spacing--30)\">\n<h3 class=\"wp-block-heading\">Are you looking for a therapeutic solution or do you want to book a consultation for your extrasystoles?<\/h3>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/grossicardiologo.it\/en\/trattamento-extrasistoli\/\"><strong>GO TO THE EXTRASYSTOLES TREATMENT CENTER PAGE<\/strong><\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading has--font-size\">Supraventricular extrasystoles<\/h2>\n\n\n\n<p>They originate from the atria or from the junction between the atria and ventricles (Fig 1). In general, this entails a lower risk. However, they can be symptomatic and in some cases trigger sustained supraventricular arrhythmias such as paroxysmal tachycardia and atrial fibrillation.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/extrasistoli-fig-1.jpg\" alt=\"A sinistra la rappresentazione di sede focolaio extrasistolico atriale, a destra registrazione elettrocardiografica di extrasistole atriale.\" class=\"wp-image-1035\" style=\"aspect-ratio:2.9595744680851066;width:864px;height:auto\"\/><figcaption class=\"wp-element-caption\">Fig. 1. On the left, representation of the location of the atrial extrasystole focus, on the right, electrocardiographic recording of atrial extrasystole.<\/figcaption><\/figure>\n\n\n<div class=\"kb-row-layout-wrap kb-row-layout-id156_096b16-14 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n\n<div class=\"wp-block-kadence-column kadence-column156_4b8b17-e7\"><div class=\"kt-inside-inner-col\">\n<p class=\"translation-block\">The treatment of supraventricular extrasystoles therefore depends on the symptoms they cause and their role in causing more serious arrhythmias such as <strong>atrial fibrillation.<\/strong><\/p>\n\n\n\n<p>In case of need for treatment, the first level consists of antiarrhythmic therapy.&nbsp;<\/p>\n\n\n\n<p>Where pharmacological treatment is not effective, not tolerated or not accepted by the patient, the next step is ablative therapy.<\/p>\n\n\n\n<p class=\"translation-block\">The patient undergoes electrophysiological study and electroanatomical mapping of the atrial chambers and once the source has been identified it is neutralized <strong>by CT ablation<\/strong> (Fig 2).<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-kadence-column kadence-column156_6078eb-49\"><div class=\"kt-inside-inner-col\">\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/extrasistoli-fig-2.jpg\" alt=\"extrasistoli sopraventricolari\" class=\"wp-image-1038\" style=\"aspect-ratio:0.9421338155515371;width:418px;height:auto\"\/><figcaption class=\"wp-element-caption\">The patient undergoes electrophysiological study and electroanatomical mapping of the atrial chambers and once the source has been identified it is neutralized by CT ablation (Fig 2).<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div><\/div><\/div>\n\n<\/div><\/div><\/div><\/div>\n\n<\/div><\/div>\n\n<div class=\"kb-row-layout-wrap kb-row-layout-id156_689844-2b alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top kb-theme-content-width\">\n\n<div class=\"wp-block-kadence-column kadence-column156_d8a87e-61\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading has--font-size\">Ventricular extrasystoles<\/h2>\n\n\n\n<p>These originate from the ventricular cavities which constitute the actual pumps that push blood into the cardiovascular system.<\/p>\n\n\n\n<p>For this reason, arrhythmias that arise at this level are considered more important than those that originate from the atria (Fig 3).&nbsp;<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-kadence-column kadence-column156_f59b65-b9\"><div class=\"kt-inside-inner-col\">\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/extrasistoli-fig3.jpg\" alt=\"extrasistoli ventricolare\" class=\"wp-image-1043\" style=\"aspect-ratio:0.9421338155515371;width:380px;height:auto\"\/><figcaption class=\"wp-element-caption\">Fig. 3 above, representation of the site of ventricular extrasystole, below, electrocardiographic recording of ventricular extrasystole.<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n<div class=\"kb-row-layout-wrap kb-row-layout-id156_eaa6f8-89 alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-1-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top kb-theme-content-width\">\n\n<div class=\"wp-block-kadence-column kadence-column156_1e009e-31\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading has--font-size\">Ventricular extrasystoles in healthy heart<\/h2>\n\n\n\n<p>Most ventricular extrasystoles are not dangerous, especially those that are not associated with concomitant heart disease. Ventricular extrasystoles in a normal heart very often originate from the part of the ventricles that goes towards the aorta (left ventricle) and the pulmonary artery (right ventricle), the latter being by far the most frequent. These are infundibular extrasystoles that are often symptomatic and bring the patient to the cardiologist even though they are not generally dangerous. The arrhythmologist, once identified, excludes the presence of an associated heart disease and decides on the treatment that will be applied only if they are very symptomatic or extremely numerous.<\/p>\n\n\n\n<p class=\"translation-block\">The first level of treatment is represented by the administration of antiarrhythmic drugs, the most commonly used of which are beta blockers. In case of ineffectiveness, intolerance or refusal of medical therapy, the patient is subjected to an electrophysiological study and electroanatomical mapping of the ventricular chambers and once the source focus has been identified, it is neutralized <strong>by CT ablation<\/strong> (Fig 4).<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/extrasistoli-fig4.jpg\" alt=\"extrasistoli ventricolari in cuor sano\" class=\"wp-image-1046\" style=\"aspect-ratio:1.9168081494057725;width:650px;height:auto\"\/><figcaption class=\"wp-element-caption\">Fig 4:\nA) Right ventricular outflow tract extrasystole.\nB) Mapping and ablation of the ventricular extrasystolic focus: electroanatomical reconstruction of the right ventricle. The red\/yellow area represents the origin of the extrasystolic focus. The red dots indicate the sites where radiofrequency energy is delivered to neutralize the activity of the extrasystolic focus (ablation).<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading has--font-size\">Ventricular extrasystoles in a diseased heart<\/h2>\n\n\n\n<p>In the presence of concomitant heart disease, the clinical significance of ventricular extrasystoles may differ, as in the case of structural or electrical cardiac abnormalities. Extrasystoles can act as a trigger for a rapid and prolonged arrhythmia, potentially causing severe symptoms and, in some cases, cardiac arrest (Fig. 5).<\/p>\n\n\n\n<p>The cardiologist must determine the type of heart disease affecting the patient with ventricular extrasystole. On one hand, there are cardiopathies caused by disturbances in coronary circulation, such as myocardial infarction, heart diseases due to abnormalities of the heart valves, cardiopathies related to conditions affecting the cardiac muscle cells (cardiomyopathies), those caused by congenital heart malformations, and inflammatory conditions (myocarditis). \n\nOn the other hand, there are primarily electrical heart diseases caused by abnormalities in the ion channels located on the membrane of cardiac cells. Such abnormalities, as seen in Brugada Syndrome, Long QT, Short QT, and catecholaminergic polymorphic tachycardia, lead to electrical instability in a heart that is morphologically and structurally normal.&nbsp;<\/p>\n\n\n\n<p>The presence of very frequent forms, with multiple morphologies (polymorphic) and closely following the preceding heartbeat (premature), indicates a higher risk situation. In such cases, treatment will be necessary. The treatment will vary from case to case, depending on the underlying heart disease and the presentation of the extrasystoles.<\/p>\n\n\n\n<p>It may involve the use of antiarrhythmic drugs and catheter ablation, combined in various ways depending on the patient's clinical condition. This is because the treatment for these patients must also address the underlying heart disease.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/grossicardiologo.it\/wp-content\/uploads\/extrasistoli-fig5.jpg\" alt=\"Fig 5:\u00a0extrasistole ventricolare in presenza di una malattia dei canali ionici(QT lungo) che provoca una aritmia ventricolare prolungata che provoca arresto cardiaco.\" class=\"wp-image-1047\" style=\"aspect-ratio:1.068241469816273;width:479px;height:auto\"\/><figcaption class=\"wp-element-caption translation-block\">Fig 5: Ventricular extrasystole in the presence of an ion channel disease  \n(Long QT syndrome), causing a prolonged ventricular arrhythmia that leads to cardiac arrest.<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n\n<h2 class=\"wp-block-heading\"><em>Are your extrasystoles frequent and worrying you?<\/em><\/h2>\n\n\n\n<p><em>Book a check-up consultation to rule out underlying pathologies.<\/em><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/grossicardiologo.it\/en\/contatti\/\">Contacts<\/a><\/div>\n<\/div>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>Le extrasistoli sono battiti cardiaci che insorgono pi\u00f9 precocemente del dovuto nel corso dell\u2019attivit\u00e0 cardiaca interrompendone momentaneamente la usuale ritmicit\u00e0. In condizioni fisiologiche il cuore viene infatti attivato da cellule specifiche del tessuto di attivazione e conduzione che genera e trasmette l\u2019impulso di ogni singolo battito a tutto il cuore. Le altre cellule vengono attivate [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":124,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,6],"tags":[],"class_list":["post-156","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aritmie-disturbi-del-ritmo","category-disturbi-del-ritmo"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Extrasistoli: Sono Pericolose? Quando Preoccuparsi - Dr. Grossi<\/title>\n<meta name=\"description\" content=\"Senti il cuore &quot;perdere un colpo&quot;? Scopri la differenza tra extrasistoli benigne e maligne. 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