How dangerous is the syndrome of early repolarization of the ventricles of the heart? Early repolarization syndrome ECG showed early repolarization syndrome.

Infrequently, one can hear from a cardiologist about the syndrome of early polarization of the ventricles. This disease is rare, but this does not reduce its danger. Relatively recently, such a condition of the heart muscle has become a separate pathology, which is closely studied and studied in detail. So we got close to this ailment, which will be devoted to all further conversation.

What does SRRG mean?

We will try to explain in an accessible form what early ventricular repolarization is. There is no need to delve into the topic and deal with complex terminology. The main thing is to understand the basics and understand what the syndrome of early repolarization of the ventricles means.

By this term, cardiologists mean changes that are visible on the ECG. This is even a kind of ECG phenomenon that does not have a pronounced cause and manifestations. Contractions occur in the heart, which are possible due to changes in the charge in cardiomyocytes - special cells of the heart. This process consists of two phases: depolarization or contraction and repolarization or relaxation of the heart. These phases replace each other. In other words, RRW are disturbances in the process of relaxation of the heart.

On the ECG, such changes appear as a pseudo-tooth of the descending knee of the R wave. This is followed by an uneven rise in the ST segment. Such changes are associated with the early appearance of the excitatory wave in the subepicardial layers.

Only some time ago, such a condition was no longer considered harmless and even singled out as the norm. It is useful to know how dangerous early repolarization syndrome is. Not only cardiac pathologies can develop, but also sudden death occurs, in which the provision of emergency medical care only in some cases can bring a person back to life.

Causes

The problem has only recently begun to be seriously studied by specialists. Even the causes of such a violation of the work of the heart muscle are not fully understood. It only remains for us to consider the most relevant assumptions, which so far have the greatest evidence base.

High susceptibility to development heart attack on the background of ischemic diseases.
Minor changes in the action potential of cardiomyocytes. The reason is hidden in the processes of potassium release from the heart cells.
The presence of a connection between the phases of heart contractions (depolarization and repolarization) in cells that are located in different parts of the heart. This mechanism clearly demonstrates type 1 Brugada syndrome.
Genetic mutations mostly cause early ventricular repolarization syndrome in children. These causal factors continue to be studied by scientists. These changes are based on mutations of those genes that are responsible for the balance of entry and exit of ions at the cellular level.
Long-term use of adrenomimetics or violation of the dosage.
Dysplastic collagenoses, during the development of which additional chords are formed in the ventricles.
Congenital tendency to hyperlipidemia, which can cause the development of atherosclerosis of the heart.
The development of hypertrophic.
Various congenital/acquired heart defects, among which is also the process of occurrence of ventricular arrhythmias.

Classification

The phenomenon of early ventricular repolarization in most cases affects the myocardium of both ventricles. But this is not always the case. Pathology may acquire a different character, which determines its classification:

Hypertrophy of the left ventricle, accompanied by a violation in the processes of repolarization. Such a pathology occurs against the background of the development arterial hypertension or hypertrophic cardiomyopathy.
Disorders affecting the anterior septum can cause disturbances in the propagation of excitation, which is transmitted by the atrioventricular connections to the ventricles. With such a pathology, combined blockades of one of the legs of the bundle of His can occur. Another comorbidity may be the expansion of the QRS complex, which is caused by delayed impulse conduction.
Violations affecting the posterior lateral wall of the right ventricle are characteristic of critical occlusion of the branch of the left coronary artery. With such a pathology, there is a high risk of developing extrasystoles and disorders in the internal ventricular patency.
Violations concentrated in the lower wall of the left ventricle. A similar pathology often occurs after the apex of the heart. Complications are similar in those that were described for the previous variety of pathology.

Symptoms and signs

Signs of the syndrome of early repolarization of the ventricles are conventionally divided into two groups.

The first group of symptoms is typical for people in whom the pathology causes complications. The main ones are fainting and cardiac arrest. Fainting occurs against the background of impaired blood supply to the brain, which, in turn, occurs due to impaired contractile function ventricles. The second symptom occurs against the background of ventricular fibrillation. In this case, a person can be saved only if medical assistance is provided. Otherwise, death occurs.
The second group of symptoms is typical for most people diagnosed with SRPG. In the early stages of the development of pathology, a person does not feel any symptoms. It is possible to identify the presence of the disease only on the ECG, this happens most often by accident or during a routine medical examination. For such patients, the development of complications is very low.

Diagnostic Measures

Ambiguous is the question of the diagnosis of SRRG. Firstly, many cardiologists continue to consider this condition to be the norm, and, secondly, in the vast majority of cases, the pathology does not have any manifestations. And yet, experts have identified several methods that can fix the problem.

The syndrome of early repolarization of the ventricles on the ECG is clearly visible. This technique is primarily used to diagnose the problem of interest to us.
You can also conduct a test, the essence of which will be a short, but strong load. During testing and after it, you need to monitor the state of the body, especially the behavior of the heart.
To identify the problem in patients who are not prone to the development of complications and the manifestation of symptoms, a potassium test is performed. This substance is introduced into the body in the amount of two grams. Also practiced intravenous administration"Novocainamide". For children, such tests are not used.
Deep biochemical analysis blood and.

Treatment of the syndrome

In the absence of symptoms and the development of complications against the background of SRCC, no special treatment is required, even if early ventricular repolarization syndrome is detected in children. A patient with such a diagnosis is required to visit a cardiologist regularly and undergo routine diagnostics. Such a conscious approach will make it possible to identify negative changes even at the stage of their inception. When SRHR is detected in athletes, it is imperative to reduce the load.

A completely different matter is severe cases in which a person's condition deteriorates sharply and even a threat to his life appears. This requires an operation that does not require delay. The essence of the surgical intervention is the implantation of a defibrillator-cardioverter.

Whatever the symptoms and the degree of development of the disease, in any case, a person needs to adjust his lifestyle. In this way, you can reduce the risk of complications and related problems, strengthen the heart and increase its ability to withstand such negative processes as HRW. A person with such a diagnosis must definitely refuse bad habits that poison the body with toxic substances, normalize your daily routine, try to eliminate stress and nervous tension. For prevention, you can periodically repeat the course of taking vitamin-mineral complexes.

Risk of Complications

You should not consider the syndrome of early repolarization of the ventricles as a non-dangerous disease with which you can live in peace, lead a former lifestyle and not think about anything. If the previous lifestyle is not changed and scheduled visits to the cardiologist are not carried out, then you may face a high risk of complications. Which ones? Let's figure it out.

Episode development.
There is a high probability of transition ventricular tachycardia into ventricular fibrillation, which is an urgent and very dangerous condition.
Oxygen starvation of all internal organs and systems.
There is always the possibility of cardiac arrest, which leads to death.

You should always be aware of these complications, especially when a visit to a cardiologist is postponed.

Disease prognosis

The diagnosis of SRGC in most cases has a positive and very favorable prognosis. Only a small number of owners of such a pathology may face serious changes in the electrophysiological characteristics of the heart muscle, which entail the onset of catastrophic consequences. The cardiologist should identify the presence of a predisposition to such changes even before the onset of the initial episode.

Early diagnosis cardiovascular disease- this is the basis for a speedy recovery, the absence of dangerous complications and the occurrence of high risks to human life. An elementary diagnostic method that does not require much time is an ECG. But according to its results, a large number of problems can be identified even on initial stage. This also includes the syndrome of early polarization of the ventricles.

There is no consensus in the medical community - the syndrome of early repolarization of the ventricles - what is dangerous and is there a threat from it in general? Traditionally, this change on the ECG was considered just a phenomenon - an accidental finding on the electrocardiogram, which has no meaning. To date, there is no such diagnosis in the ICD-10 codes. However, over the past 10 years, evidence has emerged that disputes this conclusion. How to identify the syndrome and whether it should be treated, you will learn from this article.

The human heart consists of connective tissue structures, muscle (cardiomyocytes) and nerve cells. Cardiac muscle tissue is capable of independent generation of nerve impulses, as is nervous tissue. The process of their joint interaction ensures the normal functioning of the entire organ and human life.

Each muscle cell goes through a series of successive stages, during which the ratio of potassium and sodium ions changes. The physiological cell cycle consists of 5 stages:

Cell cycle stage	What happens to the heart?	Does the heart respond to external stimuli?
0 - fast depolarization. A lot of sodium enters the cell, which provides energy for muscle contraction.	The heart begins to contract and ejects most of the blood into the large vessels/ventricles.	No - even if the body needs additional blood, heart contractions do not occur at this time. Also, if an injury to the heart area was inflicted at this time, the organ completely stops and death occurs.
1 - slow repolarization. A small amount of potassium leaves the cell and the gradual preparation of the muscles for new contractions begins.	The final stage of organ contraction, during which an additional, relatively small amount of blood is ejected.
2 - "plateau". Potassium leaves the cell and calcium enters. This allows you to equalize the potential difference and give the cardiomyocyte time to rest.
3 - fast repolarization. Almost all potassium ions enter this phase, which means a rapid start of preparation before a new contraction.	The beginning of the "rest" of the heart, during which there is a gradual process of relaxation of cardiomyocytes.	Normally, a new contraction does not occur. But with rhythm disturbances (fibrillation, flutter, extrasystoles) and during exercise, additional contraction is possible.
4 - peace. The final preparatory stage, during which sodium, potassium and calcium return to their places.	“Rest” of the heart is normal and in the absence of physical / mental stress, contractions do not occur.	The body is completely ready for new work.

Ventricular repolarization - what is it? These are 1-3 stages of the cell cycle muscle tissue ventricles. If the cells pass it faster (by 0.1-0.3 seconds) and the “plateau” phase is reduced, an additional “J” wave appears on the electrocardiogram in different leads - signs of early ventricular repolarization syndrome (ERVR).

Disease prevalence

It is practically impossible to judge the real prevalence of this syndrome in the world, including in the Russian Federation. Data from various authors who examined people with the same indicators of age, sex, chronic diseases, are very different. Researchers determine the frequency of occurrence from 1% to 32% among the general population.

More often premature repolarization of the ventricles occurs:

RRR classification

Pathology is usually divided depending on the time of manifestation of ECG changes into:

A classification according to the severity of violations of repolarization processes in humans has also been proposed:

Professor Skorobogaty suggested dividing the syndrome depending on the localization of the greatest changes in repolarization:

V1-V2 - predominant violation of the left ventricle in front in the septal region.
V4-V6 - a predominant violation of the repolarization of the lower wall of the left ventricle.
The lack of a clear localization of the process.

Causes and risk factors

It is not known for certain what causes can lead to violations of the repolarization process. However, during clinical research managed to identify the following factors risk:

Symptoms and ECG signs of early repolarization

In 40-60% of cases, even a diffuse violation of the processes of repolarization of the left ventricular myocardium may not manifest itself in any way and be detected by chance during a preventive examination.

Possible symptoms in people with early repolarization syndrome may include:

A number of authors associate the appearance of signs chronic insufficiency heart (CHF) also with changes in repolarization processes. This point of view is controversial, since against the background of such changes, other pathologies are more often formed, such as ischemic disease, damage to the heart in arterial hypertension (severe hypertrophy or expansion of the chambers of the heart). Nevertheless, we list the signs of CHF:

the appearance of shortness of breath with a load on the heart (deterioration leads to the fact that it happens at rest);
the formation of dense edema, mainly on the legs. With the progression of insufficiency, edema can spread to any part of the body;
the appearance of wet rales.

The classic signs of the syndrome of early repolarization of the ventricles on the cardiogram are:

Features in children

Information on the presence of repolarization disorders in children is extremely limited. In infants and infants, it is rarely found due to the lack of periodic ECG examinations. Most doctors attribute its discovery to childhood with the syndrome of impaired formation of connective tissue structures (HNST). In addition to changes in appearance, it can lead to valvular heart disease, lung damage (often - spontaneous pneumothorax under load) and joints. Therefore, if accelerated repolarization of the ventricular myocardium is detected, it is recommended to examine the child for the presence of signs of HNST and damage to "target organs".

Diagnosis of the disease

Detection of SRRG is not difficult. To identify a permanent form, a single electrocardiographic study is sufficient, followed by an ECG analysis by a competent cardiologist or therapist.

Identification of a periodic variant of the syndrome is carried out using Holter monitoring - a daily ECG recording during the patient's normal daily routine. For this to chest The necessary electrodes are connected to a person, and a small device for collecting information is fixed on the neck. After the end of the study period, the holter is connected to the cardiologist's computer and the cardiogram is studied for all 24 hours.

Treatment of SRPC

On the this moment, there is no single consensus among specialists - should repolarization change be treated or not? Most doctors, including Komarovsky, consider the optimal tactic to be constant monitoring of the patient and identifying other chronic cardiovascular pathologies. It should be noted that this approach is applicable only in the absence of complaints listed above. During pregnancy, specific therapy is also rarely prescribed.

In the scientific literature, there are a few studies that describe the treatment of patients with this syndrome, manifested by complaints of well-being. Reduction of discomfort in the region of the heart and signs of rhythm disturbance was demonstrated by the following combination of drugs:

A drug	Mechanism of action	Contraindications	average price
"Preductal" - trematazidine	It improves the energy supply of the heart muscle, prevents the development of electrolyte disorders (due to the normalization of the potassium-sodium pump), reduces the oxygen starvation of cardiomyocytes.	Hypersensitivity to a pharmacological drug; Violation of the excretory function of the kidneys of severe degree; Syndrome/Parkinson's disease; Not recommended under 18 years of age (no safety data available).	350-480 r. for 60 tablets.
"Magnerot" - magnesium orotate	Compensates for existing metabolic disorders of magnesium in the myocardium, by increasing its concentration in the blood.	The presence of an allergy to the components of the drug; Cholelithiasis and urolithiasis; Severe hepatic and renal disorders; Milk intolerance; Childhood age of the patient.	170-280 r. for 20 tablets; 560-620 rubles for 50 tablets.

Any folk remedies There is no cure for this arrhythmia. Their use is not recommended by the national associations of doctors, so if you want to use traditional methods of therapy at home, the patient assumes all possible risks.

Complications and prognosis

The presence of this ECG syndrome is a reason for consulting a therapist and a thorough examination. circulatory system. Early ventricular repolarization does not have independent complications and negative prognosis for a person. However, this is a likely sign of other disorders, such as HHCT, cardiovascular disease, or the negative effects on the body of chronic intoxications (smoking, alcohol, psychoactive drugs).

There are also no unequivocal recommendations on professional sports and military service for teenagers. At the moment, the presence of this syndrome does not matter for the military registration and enlistment office. However, if other chronic CCC pathologies are present, military service is dangerous and contraindicated.

Do you have any questions? Ask them in the comments! They will be answered by a cardiologist.

The syndrome of early repolarization of the ventricles of the heart is a purely electrocardiographic concept. This syndrome does not have any effect on the activity of the heart. This is the main thing that the patient must learn. This phenomenon is a fairly common ECG finding; according to some reports, early repolarization syndrome occurs in almost 8% of people.

What does early ventricular repolarization syndrome (ERRS) mean?

With established diagnosis this disease it is necessary to examine the heart completely. The specialist prescribes various methods for examining the heart. It is possible that this change is due precisely to age-related hormonal changes in the body.

For a long time (SRP) was considered a variant of the norm and no treatment was required. But today, the syndrome is increasingly being diagnosed in young people, as well as in athletes. This ailment of the ventricles of the heart can lead to the appearance of certain types of arrhythmia, as well as connective tissue dysplasia, etc.

With the results of additional examinations, you need to go to a cardiologist. Only a specialist, having studied all the indications of the study, can say whether there are any pathologies from the side of the heart.

The etiology of the syndrome of this repolarization of the ventricles of the heart

Since RRW is detected in healthy individuals and in people with various diseases, at the moment there is no unambiguous opinion about the origin of the syndrome.

It is known that RRJ can cause:

taking medications, for example, a2-adrenergic agonists (this is clonidine), an overdose of such a drug can provoke the appearance of heart HRW;
some physical factors, such as hypothermia.

Quite often, this syndrome is recorded in certain diseases and pathological conditions: familial hyperlipidemia, according to some data, ECG changes that are characteristic of SRHR were observed in children from families in which cases of early (up to 50 years) development of the pathology of the cardiovascular system were noted. This was associated with a change in the spectrum of blood serum (lipid) - a decrease in the level of anti-atherogenic and an increase in the level of atherogenic lipids.

Connective tissue dysplasia (CTD). Many experts consider RRW as a cardiac marker of this dysplasia. According to some data, in subjects with early ventricular repolarization syndrome, more often than in people without this phenomenon, some isolated symptoms of undifferentiated CTD are detected (hypermobility of the joints, arachnodactyly, dolichomorphia, the presence of prolapse mitral valve and additional chords). As the severity of the syndrome increases, the number of registered signs of CTD increases markedly. Especially often this syndrome is observed in the presence of additional longitudinal chords of the left ventricle. The presence of transverse, oblique and additional chords is mainly accompanied by SRRG. In people with CTD without this syndrome, additional chords are observed much less frequently.

Some experts have suggested a relationship between HRSG and borderline forms of hypertrophic obstructive cardiomyopathy (HCM) due to similar echocardiographic signs (ventricular hyperkinesia, the state of the (basal) interventricular septum, a decrease in the volume of the outflow tract of the left ventricle, the type of movement of the anterior mitral valve leaflet).

In addition, quite often SRHR is observed with acquired and congenital heart defects, as well as with congenital anomalies in the structure of the heart conduction system itself.

Recently, there have also been suggestions about the genetic nature of this syndrome, about the presence of specific genes that are responsible for its severity.

SRRG is treated with an invasive method of radiofrequency ablation of an additional beam. The catheter at the same time efficient way lead to the place of this beam, and destroy it. Premature repolarization of the ventricles of the heart can lead to coronary acute syndrome. Therefore, it is very important to identify the cause of such a violation of the activity of the heart and its valves in time. coronary syndrome in its acute form can lead to sudden death.

When using specific treatment, antiarrhythmic drugs, energy-tropic therapy are prescribed. Proper Treatment normalizes the work of the ion transport system of the body.

For modern cardiologists, such a diagnosis as the syndrome of early repolarization of the ventricles of the heart, in most cases, is of no interest. That is, from the point of view of physicians, the phenomenon does not pose a serious danger to the patient and does not require any specific treatment, except for general recommendations for a healthy lifestyle. Is this really so, we understand below.

What is early ventricular repolarization syndrome?

Doctors speak of early ventricular repolarization syndrome (ERRS) when a patient has obvious changes in the results of an electrocardiogram, but at the same time he does not have obvious signs of a pathological condition. That is why SRW is more of a medical cardiological term than an independent disease. But, despite this, according to the ICD, the pathology has its own code - I45–I45.9.

To date, the phenomenon of early ventricular repolarization is detected in approximately 3–8% of cases in perfectly healthy patients with a third-party ECG. At the same time, it is much more difficult to detect the syndrome in older patients, since they already have age-related changes in the work of the heart. Remarkably, the syndrome is more common in black men, male athletes or men leading a sedentary and sedentary lifestyle.

Changes caused in the heart by the syndrome

The identified syndrome does not pose a danger to most patients. Until recently, it was generally considered the norm. But there is a group of patients in whom the syndrome can provoke serious violations in the work of the heart and the same serious consequences. This group includes persons with a history of such conditions and pathologies:

frequent fainting of unknown etiology;
sudden death from in family history;
early repolarization of the heart ventricles only in the lower leads of the ECG (II, III, aVF).

These patients may develop serious cardiac complications:

(slow heart rate);
sinus tachycardia;
heart block;
arrhythmia is atrial;
ischemia of the heart;
fibrillation of the heart ventricles.

Also, in this group of patients, sudden and sudden death can occur with untimely medical care.

Cause of the syndrome

As such, the immediate causes of early repolarization of the ventricles of the heart in children and adults have not been identified. However, doctors cite a number of provoking factors that can have a significant impact on changes in the work of the heart. They are:

Frequent and prolonged hypothermia. They are a kind of stress for the cardiovascular system.
Failures in the electrolyte balance. Often occurs with dehydration. It, in turn, in most cases occurs against the background of frequent use of alcohol.
Congenital heart defects in children.
Long-term medication (Mezaton, Adrenaline, Ephedrine, etc.).
Inflammation of the myocardium and its hypertrophy.
The presence of defects in the structures of the connective tissues of the body.
Dystonia of a neurocircular nature.

Often SRW is diagnosed in athletes, so sport can also become one of the factors provoking the syndrome. In addition, the phenomenon of early repolarization is also detected in children who are emotionally unstable or do not comply with the regime of work and rest. The connection between the syndrome and the emotional component in this case should not be ruled out.

Syndrome symptoms

As a rule, outwardly, the symptoms and signs of the syndrome of early repolarization of the ventricles in the patient are not observed. Many studies have been carried out to identify them, but medicine has not been successful in this regard. The main signs of SRRS are only visible changes in the results of the electrocardiogram. On it, doctors determine such changes:

The presence of the ST segment and its rise above the existing isoline by 1–3 mm (most often the segment begins to rise after a notch).
The T wave changes in a positive direction, and the ST segment passes into it.

Diagnosis of pathology

In order to diagnose the pathological condition of a patient with SRCC, it is enough to pay attention to the ECG result. However, this applies only to patients who do not have concomitant cardiac pathologies. If we are talking about patients with other heart pathologies, then the cardiologist may prescribe other hardware diagnostic methods, such as ultrasound of the heart.

In general, to identify SRW in a healthy-looking person, the following diagnostic methods are used:

potassium test. The drug is administered intravenously. And if the patient has cardiac pathologies, their symptoms will increase somewhat.

Important: for children, this method of diagnosis is not used.

Testing for short-term intense load. The patient is tested on special simulators with a gradual increase in load, while simultaneously monitoring the work of the heart through ECG sensors.
Biochemistry of blood with the addition of lipidogram data.

If the diagnosis is carried out on a child, then it is very important to find out possible cause phenomenon formed on the ECG. For this, a small patient undergoes a number of the following studies:

electrocardiographic study;
Ultrasound of the heart (sometimes Doppler);
general urine analysis;
general and biochemical analysis of blood.

Important: the child should be observed by a cardiologist even in the absence of obvious cardiac pathologies. To do this, it is advisable to do an ultrasound of the heart and a cardiogram every six months.

Treatment

If the patient did not have any additional cardiac pathologies, then the entire treatment of the syndrome is reduced to general recommendations. That is, the cardiologist recommends that the patient give up all bad habits and optimize physical activity. In particular, it is desirable for a patient with SRPG to avoid static physical exertion or sudden exorbitant efforts with weight lifting. Interval training is also prohibited.

Rarely, a cardiologist may order radiofrequency ablation of the Kent's bundle. An apparatus is brought through the catheter and an additional beam is destroyed.

Also, as maintenance therapy, a patient with early repolarization syndrome is prescribed vitamins and minerals. In particular, preparations of magnesium, phosphorus and potassium, as well as B vitamins are used.

Children with the detection of SRRS can be prescribed drugs from the following groups:

magnesium;
energy-tropic;

It is advisable to include in the diet foods rich in potassium (dried apricots, raisins, bananas). It also shows the elimination and avoidance of any stressful situations.

Important: it is desirable to save all previous transcripts of the electrocardiogram (ECG) so that when next examinations compare changes in the work of the heart in dynamics.

Prevention

To prevent various cardiac pathologies, including SRHR, cardiologists around the world recommend taking care of the cardiovascular system. In general, this is maintaining a healthy lifestyle and maintaining a normal psycho-emotional background. A balanced diet will not be superfluous. Hiking in the fresh air and optimal regular exercise will help maintain heart health.

With the phenomenon of early repolarization of the heart ventricles, the prognosis for patients is favorable. But if the patient has other cardiac pathologies in the form of palpitations, arrhythmia or tachycardia, valve insufficiency, etc., then you should be on the lookout. Dispensary observation a cardiologist in this case is mandatory.

Scientific editor: Strokina O.A., therapist, doctor of functional diagnostics.
November, 2018.

Early ventricular repolarization syndrome (ERRS) is a medical concept that includes only ECG changes without characteristic external symptoms. It is believed that SRRG is a variant of the norm and does not pose a threat to the life of the patient.

Recently, however, this syndrome has been treated with caution. It is quite widespread and occurs in 2-8% of cases in healthy people. The older a person becomes, the less likely it is to detect SRW in him, this is due to the occurrence of other cardiac problems with increasing age, similar in electrocardiographic signs.

Most often, early ventricular repolarization syndrome is diagnosed in young men who are actively involved in sports, in men who lead a sedentary lifestyle, and in individuals with dark skin (Africans, Asians, and Hispanics).

Causes

The exact causes of RRS have not been established to date. However, a number of factors have been identified that contribute to the occurrence of repolarization syndrome:

taking certain medications, such as a2-agonists (clonidine);
familial hyperlipidemia (high blood fat);
connective tissue dysplasia (in persons with SRRG, its symptoms are more often detected: joint hypermobility, "spider" fingers, mitral valve prolapse);
hypertrophic cardiomyopathies.

In addition, this anomaly is often diagnosed in people with congenital and acquired heart defects and in the presence of a congenital pathology of the conduction system of the heart.

Also, the genetic nature of the disease is not ruled out (there are certain genes that are responsible for the occurrence of RRW).

Kinds

There are two options for the RRR:

without damage to the cardiovascular and other systems;
involving the cardiovascular and other systems.

From the point of view of the nature of the course, SRRF is distinguished as transient and permanent.

According to the localization of ECG signs, doctor A.M. Skorobogaty proposed the following classification:

type 1 - with a predominance of signs in leads V1-V2;
type 2 - with a predominance in leads V4-V6;
3rd type (intermediate) - without a predominance of signs in any leads.

Signs of SRRS

characteristic clinical signs syndrome of early repolarization of the ventricles does not exist. There are only specific changes on the ECG:

ST segment and T wave changes;
in a number of branches, the rise of the ST segment is 1-2-3 mm higher than the isoline;
quite often the rise of the ST segment begins after a notch;
the ST segment is rounded and goes directly into a high positive T-wave;
the convexity of the ST segment is turned downward;
the base of the T wave is wide.

Diagnostics

Since this syndrome is an electrocardiographic phenomenon, it can only be established with a certain examination:

Ultrasound of the heart (echocardiography):
- stress echocardiography (for impaired ventricular contractility)
- echocardiography at rest;
Holter monitoring during the day;
electrophysiological study.

In addition, tests are carried out on a bicycle ergometer or treadmill: after exercise, the heart rate rises, and the ECG signs of RRW disappear.

A potassium test is used: after taking potassium chloride, panangin or rhythmocor at least 2 grams, the severity of ECG signs of repolarization syndrome increases.

A test with isoproterenol and atropine is not used due to severe side effects.

It is important to distinguish between SRCC and myocardial infarction, pericarditis, Brugada syndrome. For this purpose, differential diagnosis is carried out.

Treatment of early ventricular repolarization syndrome

Repolarization syndrome does not require specific treatment. The only thing that is offered to the patient is observation by a cardiologist.

However, a person with HRH should avoid alcohol and strenuous exercise to avoid triggering a tachycardia attack.

In some cases, radiofrequency ablation of the additional bundle is performed in an invasive way (the catheter is brought to the site of the bundle and destroys it).

Sometimes energy-tropic therapy is used (vitamins of group B, carnitine, phosphorus and magnesium preparations, mexidol, kudesan), antiarrhythmic drugs (amiodarone).

Important! The patient should keep all the previous ECG, which is required to exclude the diagnosis of myocardial infarction in the event of pain in the heart.

Complications and prognosis

SRRZh can provoke the occurrence of the following complications: - Abstract of the doctor No. 61, 2011.