Iskra Bayraktarova, Milko Stoyanov, Tchavdar Shalganov
National Heart Hospital – Sofia
Address for correspondence:
Assoc. prof. Tchavdar Shalganov, MD, PhD
National Heart Hospital
65, Koniovitsa Str
Extrasystolic arrhythmia is a common clinical finding. Treatment is indicated in case of limiting symptoms and/or large proportion of the ectopy. The possible treatment options as well as the long-term prognosis depend on the precise type of the extrasystoles. Standard surface electrocardiogram does not always provide sufficient information for a differential diagnosis. We present a case of rare extrasystolic arrhythmia with ECG features typical of both supraventricular and ventricular ectopy. The precise diagnosis was established through an electrophysiological study.
Key words: extrasystoles; atrioventricular block; electrocardiogram; electrophysiological study; radiofrequency ablation.
Supraventricular premature beats are commonly identified in clinical practice. Despite the possibility of sometimes identifying a precipitating factor for their occurrence (inflammation, ischaemia, hormonal imbalance, emotional or physical stress, alcohol usage, caffeine and nicotine-product consumption or other types of stimulants), it is not uncommon for extrasystoles to appear completely unprovoked. Their incidence rises with age, and the prognosis is in general favourable, except in cases where they trigger another type of supraventricular arrhythmia, for instance atrial flutter or atrial fibrillation. [3, 5] Therapy is indicated in cases of arrhythmia of a different type induced by the ectopic beats, or in the presence of disabling symptoms.