Chapter 36 - Sex and cardiac electrophysiology: supraventricular ectopies

Abstract

Supraventricular premature beats (SVPBs) are atrial contractions arising in ectopic foci rather than in the sinoatrial node. SVPBs are found in healthy individuals or in patients with underlying heart disease and can be asymptomatic or felt as palpitations. External triggers (alcohol, caffeine, smoking, stress) and several disease conditions (arterial hypertension, chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, thyroid malfunction, electrolyte imbalances, or drug toxicity) may favor SVPB occurrence. SVPBs increase with age and are slightly more common in males than in females. SVPBs are generally a benign condition; however, frequent SVPBs may beget prolonged repolarization, atrial fibrillation, or even ventricular tachycardia and, rarely, ventricular fibrillation. Asymptomatic SVPBs without underlying structural heart defects generally do not require treatment, while the concomitant disease conditions should be treated, and potential external triggers should be avoided. β-Blockers, calcium antagonists, class 1c antiarrhythmic drugs or amiodarone, or radiofrequency catheter ablation can be used in selected patients with persistent symptoms.