Treatment of ventricular premature beats

After comprehensive and detailed examination, it can not be proved that there is premature ventricular contraction of organic heart disease, which can be considered benign and does not need treatment. Those with organic heart disease and one of the following conditions are considered to have potential malignant or malignant ventricular premature beats and must be treated: ① those with an average frequency of ≥5 beats/minute; ② Polymorphic or multi-source, but attention should be paid to exclude atrial premature beats with differential conduction; (3) duplex or triplex; (4) More than 3 consecutive cases showed transient paroxysmal ventricular tachycardia; ⑤ Acute myocardial infarction, even occasional ventricular premature beats, should be treated in time.

Treatment: In addition to the treatment according to the etiology, antiarrhythmic drugs can be selected for treatment, and more drugs can be used as class I and class III drugs in ventricles. For patients with premature beats, the risks and benefits of long-term use of antiarrhythmic drugs should be comprehensively considered, and patients with heart failure and myocardial infarction should not use Class I antiarrhythmic drugs. Potentially fatal ventricular premature beats usually require emergency intravenous administration. Amiodarone or lidocaine can be injected intravenously at the initial stage of acute myocardial infarction. If there are no contraindications after myocardial infarction, β -blockers or amiodarone are often used for treatment. Some single-source frequent ventricular premature beats can be treated by radiofrequency ablation on the basis of electrophysiological examination. This method is effective for patients with unknown organic heart disease, and can improve left ventricular enlargement and ejection fraction reduction caused by frequent ventricular premature beats. Class I antiarrhythmic drugs are prohibited in patients with long QT interval syndrome. Patients with primary long QT syndrome can use β -blockers and phenytoin sodium or carbamazepine, while patients with secondary long Qt syndrome should use isoproterenol or atrial or ventricular pacing on the basis of etiological treatment.