Ectopic lesions in the heart. Atrial rhythm on ECG

The normal heart works in an orderly manner due to the direction of the main pacemaker called the sinus node. If abnormal, ectopic activity occurs in the heart, the functioning of the organ is altered and in some cases significantly impaired. Then it is extremely important to carry out timely diagnosis and appropriate treatment.

The sinus node is a group of cells located in the right atrium, which are the first to contract and then electrical impulses spread from them to all other parts of the heart. However, all cells in the heart have the ability to start their own heartbeat regardless of sinus node. If this happens, it causes an early (or premature) heartbeat known as an ectopic heartbeat, also called an extra beat.

““Ectopic” means out of place, in this case implying that the extra rhythm is an extraordinary, unscheduled heartbeat.

Usually, after a short pause after the ectopic reaction, an additional sensation of a “missed” blow occurs. In fact, many people who experience ectopic cardiac activity perceive only the sensation of missed beats rather than the presence of the ectopic lesion itself.

Video: Sinus node weakness

Symptoms

The term “heartbeat” is used to describe the sensation of your own heartbeat. Some say it feels like a fluttering sensation in the chest, or a feeling of “heart pounding.” Others describe it as a pounding or movement on the left side of the chest, which can also be felt in the neck or ears when lying down.

Such a manifestation as palpitations is very common, and in most cases completely harmless. However, it can be a nuisance and sometimes pose a threat to human life.

Palpitations and ectopic beats are usually not a cause for concern. Almost every person has at least a few ectopics every day, but the vast majority of them do not manifest themselves in any way. Often, their occurrence is considered as a completely normal phenomenon of cardiac activity.

The timing of ectopic activity affects sensations. Because the ectopic rhythm occurs prematurely, this means that the lower chambers of the heart (the ventricles) have less time to fill with blood than normal, and therefore the amount of blood pumped out during the ectopic rhythm is reduced. However, because of the subsequent short pause after the ectopic excitation, the ventricles have a longer than normal period of filling with blood, and therefore the subsequent shock is felt as more forceful.

Types of ectopic activity

There are two most common types of ectopic rhythm:

Atrial ectopy - an early (extraordinary) electrical impulse comes from the atria, which are the upper chambers of the heart.
Ventricular ectopy - the early electrical impulse comes from the ventricles, which are defined as the lower chambers of the heart.

Depending on the order of pathological and normal heart contractions, the following are distinguished:

Bigeminy - every second contraction of the heart is extraordinary, that is, ectopic
Trigeminy - every third contraction of the heart is extraordinary, that is, ectopic.

It should be noted that many patients with bigeminy or trigeminy do not have any symptoms, and it is unknown why some people feel ectopia and others do not, although stress certainly makes them more noticeable.

Causes

Ectopic activity is often detected even in clinically healthy people, and the chances of its development increase if a person is often exposed to stress or consumes too much caffeine. The use of stimulants such as alcohol, smoking or recreational drugs can also cause rhythm disturbances.

Ectopics, which cause palpitations, most often occur when a person does not get enough sleep or does a lot of physical activity.

It is important to note that ectopic activity can occur in certain cardiac conditions. Ectopia is most typical for diseases accompanied by weakening of the heart muscle - with cardiomyopathies, in people who have had heart attacks (myocardial infarction). Therefore, if a patient has frequent ectopics, cardiac function must be fully and fully assessed.

Chemical imbalances in the blood can also contribute to the development of ectopia. This is especially common when there is a low level of potassium in the blood, which can be caused by some rare metabolic conditions or taking certain medications, such as diuretics.

The development of palpitations or ectopic beats is often observed during pregnancy or menopause.

It happens that the frequency of occurrence of ectopics is very unstable - on some days or weeks they are very annoying, and in other periods they are practically not felt. However, it may not be clear what exactly the triggers are in these situations. Also, a person may notice ectopia at rest, and not while awake or physical activity. The reasons for this are that the heart usually beats much slower at rest, which leaves more time for ectopia to occur, interrupting the normal heart rhythm.

Diagnostics

If you are concerned about your heartbeat, you should contact your doctor. general practice or a specialist in cardiovascular diseases (cardiologist, arrhythmologist). They usually prescribe first additional methods studies such as electrocardiography (ECG) and/or 24-hour monitoring of cardiac activity, which makes it possible to calculate how many ectopics are detected in a patient per day.

By comparison, the average clinically healthy person has about 100,000 heartbeats/day, with people suffering from symptoms of ectopic activity typically experiencing several hundred to several thousand ectopics per day, or 0.5 to 1-5% loads.

If ectopic activity is determined to be frequent, then echocardiography is performed ( ultrasound scan heart), necessary to assess heart function and exclude cardiomyopathy (weakness of the heart muscle). This is especially important if the patient has hereditary predisposition to heart rhythm disturbances or have occurred among close relatives sudden deaths without obvious explanation.

Additionally, routine blood tests may be performed to rule out problems with metabolism according to type low level potassium. Also using laboratory tests work is being examined thyroid gland.

Tests for diagnosing ectopic activity:

Electrocardiography (ECG)
24-hour cardiac monitoring (also known as Holter monitoring)
Echocardiography (ultrasound of the heart)
MRI scan of the heart
Blood tests, including thyroid function testing

24-hour (or longer) cardiac monitoring allows calculation of the frequency and other characteristics of ectopic activity. Moreover, this research method helps determine whether ectopics arise predominantly in one place in the heart muscle or whether impulses come from several foci. For example, it is possible that all ectopics originate from one area in one chamber, or they are generated from several areas of one chamber. Also, extraordinary impulses can come from various chambers and parts of the myocardium.

Conservative treatment

Depending on the underlying cause of ectopic activity, an appropriate treatment strategy is selected. Additionally, the severity of clinical signs is taken into account.

Eliminating triggers (risk factors) helps avoid palpitations and ectopic beats. It is generally recommended to avoid alcohol and caffeine. Another important requirement is to stop smoking completely! If the underlying heart problem is identified, then treating it helps improve the patient's condition.

It's good to know that most people stop noticing or may ignore ectopic rhythms, if there is sufficient positive attitude. Some people do regular exercise to help reduce the amount of ectopia. This is especially necessary if you have a sedentary lifestyle or eat certain types of food.

Stress reduction is a relevant and important element of therapy, although in practice this is not always easy to achieve. For this reason, medications such as beta blockers or calcium channel blockers may be used to prevent ectopia. It is important that medications are prescribed by a doctor, especially if there is a concomitant heart disease or ectopia is defined as very frequent or continuous. Sometimes it is advisable to change the medications that were prescribed, especially if they cause ectopic activity.

Thus, treatment for ectopic activity includes:

Excluding triggers:
- reducing the amount of alcohol;
- reducing caffeine consumption;
- use of decaffeinated coffee;
- avoiding carbonated drinks (especially energy drinks);
- to give up smoking;
- eliminating or reducing the effects of stress
- getting enough sleep.
Use of medications as prescribed by a doctor:
- beta blockers, such as bisoprolol, propranolol, metoprolol;
- calcium channel blockers such as verapamil or diltiazem;
Treatment of underlying diseases that cause ectopia (thyroid pathology or electrolyte imbalance in the blood).

Alternative Treatment

In rare cases, the therapy mentioned above is unsuccessful. This is mainly due to the fact that the patient has extreme ectopic activity, that is, extraordinary beats are generated continuously, every 2-10 normal contractions. This usually means that the cause of the ectopia is not related to stress or a temporary phenomenon. The most common finding is that a cell or small group of cells in the heart is continuously generating impulses on its own.

Ectopia, associated with a violation of the flow of calcium into the heart cells, can be eliminated by calcium channel blockers, which help suppress unpleasant manifestations.

If medications do not help eliminate very frequent ectopia, and especially if continuous ectopic strokes are detected (the so-called ventricular tachycardia), the procedure is performed using ablation catheters.

Catheter ablation

Catheter ablation is a technique in which thin wires (catheters) are inserted into the heart through veins in the upper thigh. With their help, a 3D computer model of the inside of the chamber is created and ectopic foci are identified. Information about the electrical signals recorded by the catheter during ectopic beats helps determine where they originate. The catheter is then advanced to this place and, using electricity, acts on the site of excitation. Under the influence of high temperatures, local destruction of the myocardium occurs (a very small area), due to which ectopia does not develop in the future.

What are the successes of ablation?

The success of catheter treatment largely depends on how often ectopia occurs during ablation. The more often, the better the chances of success. Ablation may sometimes be performed when very rare ectopic lesions are identified. This usually means that the effectiveness of the procedure is significantly reduced.

In most cases, the success rate of ablation is about 80% of permanent treatment. If ectopia is frequently present at the beginning of the procedure and disappears during ablation and does not recur until the very end of the procedure, this usually indicates a good outcome. As a rule, in such cases, ectopic activity will not recur subsequently. But in some cases there are exceptions.

Risks of ablation

For ectopia, the risk of catheter ablation is usually very low. General risk Damage to the blood vessels in the upper thigh where the catheters are inserted is believed to occur. This can cause bruising or bleeding, and much less often, more serious injury occurs when an artery adjacent to a vein is damaged. Such complications may require injection or surgical treatment. The risk of vascular damage is about 1%.

More serious risks are associated with:

The catheter perforates the wall of the heart, and this may mean that blood will begin to leak into the pericardial sac. Then, for treatment, a drainage is inserted under the ribs, or in rare cases, surgery.
There is a possibility of damaging the normal conduction system of the heart (especially if the ectopic lesion is located near this area). If postoperative conduction disturbances develop, a pacemaker may be required.
If the ectopic lesion is located on the left side of the heart, there is a rare risk of causing a stroke as a result of exposure to left side blood circulation of the heart.

Thus, the risks of catheter ablation to eliminate an ectopic focus are as follows:

General (1%):
- damage to the vein (the operation is practically not performed).
Rare (<1%):
- perforation of the heart wall by the catheter, which may require drainage or, in rare cases, surgery;
- stroke if the ectopic focus is located on the left side of the heart;
- damage to the conduction system of the heart, which sometimes requires the use of a pacemaker.

Ablation usually takes about 2 hours, after which most patients return home the same day.

After ablation, some time is allowed for recovery, which is almost entirely related to the healing of the puncture sites in the upper thigh. This usually requires several days of rest and, as a rule, within a week the ability to perform moderate physical activity is restored.

Forecast

The presence of ectopia is almost always defined as a benign condition that does not affect the length or quality of life, or the development of other diseases. The most important test to confirm this is echocardiography and sometimes MRI scans of the heart, which help to fully assess the functioning of the organ. If cardiac function is preserved and normal, the prognosis is good, and the presence of ectopic activity is just an unpleasant symptom.

If cardiac function is impaired or there is another major organic defect (for example, valvular insufficiency or valve stenosis), then the presence of ectopia is usually a consequence of this defect and requires separate study and treatment.

It is important to note that in people with very frequent ectopies (mostly ventricular, very rarely atrial), the ectopies themselves can cause the left ventricle (the main pump chamber of the heart) to dilate or increase in size, and this contributes to cardiac dysfunction.

The risk of left ventricular dilatation increases when the extra-contraction load is >10%. An ectopic load > 25% has a strong impact on cardiac function. If ectopic rhythms arise from a single site, catheter ablation is usually performed to completely eliminate the disorder.

Thus, the forecast for ectopic activity:

Almost always excellent
Patients usually begin to develop symptoms when the ectopic load is >0.5-5%/day
In rare cases, very frequent extraordinary contractions may cause enlargement of the left ventricle and ultimately deterioration of cardiac function.

An unfavorable prognosis is given when the ectopic load is >10-25%/day.

Video: Here's How to Return Your Heart Rate to Normal in Just 1 Minute

The heart, being one of the main muscles in the human body, has a number of special properties. It can be reduced regardless of nerve impulses, coming from the brain and taking part in the control of the neurohumoral system. The correct route for transmitting information in the heart muscle begins in the area of the right atrium (sinus node), continues in the area of the atrioventricular node and then spreads across the entire area of the septum. All other contractions that do not follow this route are considered an ectopic rhythm.

How do atrial rhythms appear?

An ectopic impulse, appearing outside the sinus node, is formed and excites the heart muscle before the signal is transmitted from the main pacemaker. Such situations allow us to say that an accelerated atrial rhythm appears due to the “advanced” of the main rhythm by a secondary contraction of the ectopic type.

The theoretical basis for the ectopic rhythm is the re-entry theory, according to which a certain area of the atrium is not excited in parallel with others due to the fact that there is a local blocking of the propagation of the nerve impulse. At the time of its activation, this area experiences an additional contraction - thus, it goes out of turn and thereby disrupts the overall rhythm of the heart.

Some theories suggest the autonomic and endocrine nature of the occurrence of atrial rhythms. As a rule, such phenomena occur in children in puberty or in adults with certain hormonal changes(age-related or resulting from pathologies).

There is also a version the following type: hypoxic and inflammatory processes in the myocardium with cardiopathy and inflammatory diseases capable of causing atrial rhythms. Thus, in children who suffer from a sore throat or flu, there is a risk of myocarditis with a subsequent change in atrial rhythm.

The heart, being one of the main muscles in the human body, is endowed with special properties. It can contract regardless of the nerve impulses coming from the brain, which control the neurohumoral system. The correct route for receiving information in the heart muscle begins in the area of the right atrium (sinus node), passes in the area of the atrioventricular node and then spreads along the septum. All other beats that do not follow this route are called ectopic rhythm.

Etiology of atrial rhythm

As noted above, the reasons for changes in atrial rhythm are changes that take place in the sinus node. All changes are divided into ischemic, inflammatory and sclerotic. Non-sinus rhythms that appear as a result of such changes appear in the following forms:

Supraventricular ectopic rhythm;
Atrial rhythm.

Accelerated atrial rhythm usually occurs in people who suffer from rheumatic diseases, various diseases heart disease, dystonia, diabetes, coronary artery disease or hypertension. In some cases, atrial rhythm can appear even in healthy adults and children, and can also be congenital in nature.

Impulses can come from different departments heart, since the source of emerging impulses moves through the atrium. IN medical practice This phenomenon is called migrating rhythm. When measuring such an atrial rhythm, the amplitude on the ECG changes according to the source of the location of the impulses.

Clinical picture

Atrial rhythm has a direct relationship with a certain disease which caused it. It means that specific symptoms absent. The clinical picture is directly determined by the pathological picture in the patient’s body. This rule applies only to short-term attacks of rhythm disturbance. With prolonged attacks, it is possible following symptoms:

Initially there is a feeling of anxiety and fear. The person tries to take the most comfortable position that would stop the further development of the attack.
The next stage is accompanied by severe tremor (shaking) in the limbs, and in some cases, dizziness.
The next step appears severe symptoms- observed increased sweating, dyspeptic disorders, manifested in the form of bloating and nausea, frequent urge to urinate.

Short attacks may be accompanied by an increase in heart rate and shortness of breath, after which the heart stops for a moment and a noticeable jolt is felt. A similar impulse in the heart indicates that sinus rhythm has been restored - this can also be confirmed by minor painful sensations in the chest and heart area.

The change in atrial rhythm resembles paroxysmal tachycardia. Patients themselves can determine that they have an abnormal heart rhythm. If the heart rate is high, these changes will not be noticeable. An ECG examination helps to accurately determine this condition. In the case of atrial fibrillation, patients may complain of chest pain characteristic of angina pectoris.

Long-term attacks of atrial rhythm disturbance are dangerous for a person - at this moment, blood clots can form in the heart muscle, which, if they enter the blood vessels, can cause a heart attack or stroke. The danger also lies in the fact that when the disease is latent, patients may ignore the above symptoms, and therefore are not able to determine its further development.

Diagnosis of atrial rhythm

The main method for studying atrial rhythm is ECG. A cardiogram allows you to accurately determine where the rhythm disturbance occurs, as well as accurately determine the nature of such a rhythm. An ECG allows you to determine the following types of atrial escape rhythm:

Left atrial rhythm: aVL is negative, aVF, PII, III are positive, PI, in some cases, smoothed. PV1/PV2 are positive, and PV5-6 are negative. According to Mirovski et al., the P wave in left atrial rhythm consists of two parts: the first has a low-voltage and dome-shaped rise (affected by depolarization of the left atrium), the second part is characterized by a narrow and high peak ( right atrium- depolarized).
Right atrial rhythm: characterized by a negative P wave in the area of the third standard branch, in the first and second - positive. This phenomenon is characteristic of a mid-lateral right atrial rhythm. The lower rhythm of this form is characterized by the indication of the P wave, negative in the second and third branches, as well as aVF, smoothed in the 5-6 thoracic.

The lower atrial rhythm is characterized by a shortening of the PQ interval, in which its value is less than 0.12 seconds, and the P wave is negative in branches II, III and aVF.

We can draw the following conclusion: based on electrocardiogram data, the doctor can determine a change in atrial rhythm based on changes in the P wave, which has an amplitude and polarity different from the physiological norm.

Note that to determine the right atrial rhythm, a specialist must have extensive experience, since ECG data with such a rhythm are blurry and difficult to differentiate. In view of this, Holter monitoring can be used to form the most complete and accurate picture of cardiac activity.

cardioplanet.ru

What happens with ectopic heart rhythm?

IN normal heart In humans, there is only one path for conducting an electrical impulse, leading to sequential excitation of different parts of the heart and to productive cardiac contraction with sufficient release of blood into the heart. large vessels. This path begins in the right atrial appendage, where the sinus node (1st order pacemaker) is located, then passes through the atrial conduction system to the atrioventricular (atrioventricular) junction, and then through the His system and Purkinje fibers reaches the most distant fibers in the tissue of the ventricles.

But sometimes, due to the action of various reasons on the cardiac tissue, the cells of the sinus node are not able to generate electricity and release impulses to the underlying sections. Then the process of transmitting excitation through the heart changes - after all, in order for the heart not to stop completely, it should develop a compensatory, replacement system for generating and transmitting impulses. This is how ectopic or replacement rhythms arise.

So, ectopic rhythm is the occurrence of electrical excitation in any part of the conducting fibers of the myocardium, but not in the sinus node. Literally, ectopia means the appearance of something in the wrong place.

The ectopic rhythm can originate from the tissue of the atria (atrial ectopic rhythm), from the cells between the atria and the ventricles (rhythm from the AV junction), and also from the tissue of the ventricles (ventricular idioventricular rhythm).

Why does ectopic rhythm appear?

Ectopic rhythm occurs due to a weakening of the rhythmic functioning of the sinus node, or a complete cessation of its activity.

In turn, complete or partial inhibition of the sinus node is the result various diseases and states:

Inflammation. Inflammatory processes in the heart muscle can affect both the cells of the sinus node and the muscle fibers in the atria and ventricles. As a result, the ability of cells to produce impulses and transmit them to underlying sections is impaired. At the same time, the atrial tissue begins to intensively generate excitation, which is supplied to the atrioventricular node at a frequency higher or lower than usual. Such processes are caused mainly by viral myocarditis.
Ischemia. Acute and chronic myocardial ischemia also contributes to impaired activity of the sinus node, since cells deprived sufficient quantity oxygen, cannot function normally. Therefore, myocardial ischemia occupies one of the leading places in the statistics of the occurrence of rhythm disturbances, including ectopic rhythms.

Cardiosclerosis. Replacement of normal myocardium with growing scar tissue due to previous myocarditis and heart attacks interferes with the normal transmission of impulses. In this case, in persons with ischemia and post-infarction cardiosclerosis (PICS), for example, the risk of ectopic heart rhythm increases significantly.

In addition to pathology of the cardiovascular system, vegetative-vascular dystonia, as well as hormonal imbalances in the body - diabetes mellitus, pathology of the adrenal glands, thyroid gland, etc., can lead to ectopic rhythm.

Symptoms of ectopic rhythm

The clinical picture of replacement heart rhythms can be clearly expressed or not manifested at all. Usually, the symptoms of the underlying disease come first in the clinical picture, for example, shortness of breath on exertion, attacks of burning pain in the chest, swelling lower limbs etc. Depending on the nature of the ectopic rhythm, symptoms may be different:

With ectopic atrial rhythm, when the source of impulse generation is located entirely in one of the atria, in most cases there are no symptoms, and disturbances are detected by a cardiogram.

With rhythm from the AV connection a heart rate close to normal is observed - 60-80 beats per minute, or below normal. In the first case, no symptoms are observed, but in the second, attacks of dizziness, a feeling of lightheadedness and muscle weakness are noted.
With extrasystole the patient notes a feeling of freezing, cardiac arrest, followed by a sharp jolt in the chest and a further absence of sensations in the chest. The more often or less often the extrasystoles, the more varied the symptoms in duration and intensity.
With atrial bradycardia As a rule, the heart rate is not much lower than normal, within 50-55 per minute, as a result of which the patient may not notice any complaints. Sometimes he is bothered by attacks of weakness and sudden fatigue, which is caused by a reduced flow of blood to the skeletal muscles and brain cells.
Paroxysmal tachycardia shows itself much more clearly. During paroxysm, the patient notes a sharp and sudden sensation of accelerated heartbeat. According to many patients, the heart flutters in the chest like a “hare’s tail.” The heart rate can reach 150 beats per minute. The pulse is rhythmic, and may remain around 100 per minute, due to the fact that not all heartbeats reach the peripheral arteries at the wrist. In addition, there is a feeling of lack of air and chest pain caused by insufficient oxygen supply to the heart muscle.

Atrial fibrillation and flutter may have paroxysmal or permanent forms. At the core atrial fibrillation The disease is characterized by chaotic, irregular contraction of different parts of the atrium tissue, and the heart rate in the paroxysmal form is more than 150 per minute. However, there are normo- and bradysystolic variants, in which the heart rate is within the normal range or less than 55 per minute. Symptoms paroxysmal form resembles an attack of tachycardia, only with an irregular pulse, as well as a feeling of irregular heartbeat and interruptions in heart function. The bradysystolic form may be accompanied by dizziness and lightheadedness. With a permanent form of arrhythmia, the symptoms of the underlying disease that led to it come to the fore.
Idioventricular rhythm is almost always a sign of serious heart disease, such as severe acute myocardial infarction. In most cases, symptoms are noted, since the myocardium in the ventricles is capable of generating electricity at a frequency of no more than 30-40 per minute. In this regard, the patient may experience Morgagni-Edams-Stokes episodes (MES) - attacks of loss of consciousness lasting several seconds, but no more than one or two minutes, since during this time the heart “turns on” compensatory mechanisms, and begins to shrink again. In such cases, they say that the patient is “massing.” Such conditions are very dangerous due to the possibility of complete cardiac arrest. Patients with idioventricular rhythm are at risk of developing sudden cardiac death.

Ectopic rhythms in children

In children this type arrhythmias can be congenital or acquired.

Thus, ectopic atrial rhythm occurs most often with vegetative-vascular dystonia, with hormonal changes during puberty (in adolescents), as well as with pathology of the thyroid gland.

In newborns and children early age right atrial, left or lower atrial rhythm may be a consequence of prematurity, hypoxia or pathology during childbirth. Besides, neurohumoral regulation heart activity in very young children is characterized by immaturity, and as the baby grows, all indicators heart rate may return to normal.

If the child does not have any pathology of the heart or central nervous system, then the atrial rhythm should be considered transient, functional disorder, but the baby should be regularly monitored by a cardiologist.

But the presence of more serious ectopic rhythms - paroxysmal tachycardia, atrial fibrillation, atrioventricular and ventricular rhythms - require more detailed diagnosis, as this may be due to congenital cardiomyopathy, congenital and acquired heart defects, rheumatic fever, viral myocarditis.

Diagnosis of ectopic rhythm

The leading diagnostic method is the electrocardiogram. If an ectopic rhythm is detected on the ECG, the doctor should prescribe a further examination plan, which includes cardiac ultrasound (ECHO-CS) and daily ECG monitoring. In addition, patients with myocardial ischemia are prescribed coronary angiography (CAG), and patients with other arrhythmias are prescribed transesophageal electrophysiological examination (TEPE).

ECG signs for different types of ectopic rhythm differ:

With an atrial rhythm, negative, high, or biphasic P waves appear, with a right atrial rhythm - in additional leads V1-V4, with a left atrial rhythm - in V5-V6, which may precede or overlap the QRST complexes.

The rhythm from the AV junction is characterized by the presence of a negative P wave, superimposed on the QRST complexes, or present after them.

Idioventricular rhythm is characterized by a low heart rate (30-40 per minute) and the presence of altered, deformed and widened QRST complexes. There is no P wave.

With atrial extrasystole, premature, extraordinary, unchanged PQRST complexes appear, and with ventricular extrasystole, altered QRST complexes appear followed by a compensatory pause.

Paroxysmal tachycardia is characterized by a regular rhythm with a high frequency of contractions (100-150 per minute), P waves are often quite difficult to determine.
Atrial fibrillation and flutter on the ECG are characterized by an irregular rhythm, the P wave is absent, and fibrillation f waves or flutter waves F are characteristic.

Treatment of ectopic rhythm

Treatment when the patient has an ectopic atrial rhythm that does not cause unpleasant symptoms, but pathologies of the heart, hormonal and nervous systems have not been identified, and are not being carried out.

In the case of moderate extrasystole, the prescription of sedatives and restorative drugs (adaptogens) is indicated.

Therapy for bradycardia, for example, with an atrial rhythm with a low contraction frequency, with the bradyform of atrial fibrillation, consists of prescribing atropine, ginseng preparations, Eleutherococcus, Schisandra and other adaptogens. In severe cases, with a heart rate less than 40-50 per minute, with attacks of MES, implantation of an artificial pacemaker (pacemaker) is justified.

Accelerated ectopic rhythm, for example, paroxysms of tachycardia and atrial fibrillation-flutter require assistance emergency assistance, for example, administering a 4% solution of potassium chloride (panangin) intravenously, or a 10% solution of novocainamide intravenously. Subsequently, the patient is prescribed beta blockers or antiarrhythmic drugs - Concor, Coronal, verapamil, propanorm, digoxin, etc.

In both cases - both slow and accelerated rhythms, treatment is indicated underlying disease, if any.

Forecast

The prognosis in the presence of an ectopic rhythm is determined by the presence and nature of the underlying disease. For example, if a patient has an atrial rhythm on an ECG, but no heart disease is detected, the prognosis is favorable. But the appearance of paroxysmal accelerated rhythms against the background of acute myocardial infarction poses prognostic value ectopia in the category of relatively unfavorable.

In any case, the prognosis improves with timely consultation with a doctor, as well as with the fulfillment of all medical prescriptions in terms of examination and treatment. Sometimes medications have to be taken for the rest of your life, but this greatly improves the quality of life and increases its duration.

sosudinfo.ru

Types of atrial arrhythmia

Since the manifestations of ectopic rhythms are a direct derivative of disturbances in the functioning of the sinus node, their occurrence occurs under the influence of changes in the rhythm of cardiac impulses or myocardial rhythm. The following diseases are common causes of ectopic rhythm:

Cardiac ischemia.
Inflammatory processes.
Diabetes.
High pressure in the heart area.
Rheumatism.
Neurocircular dystonia.
Sclerosis and its manifestations.

Other heart defects, such as hypertension, can also trigger the development of the disease. A strange pattern of occurrence of ectopic right atrial rhythms is manifested by the appearance in people with excellent health. The disease is transient, but there are cases of congenital pathology.

Among the features of the ectopic rhythm, a characteristic heart rate is noted. In people with this defect, during diagnosis they reveal increased performance heartbeats.

With routine blood pressure measurements, it is easy to confuse ectopic atrial rhythm with an increase in heart rate due to high temperature, with inflammatory diseases or ordinary tachycardia.

If the arrhythmia does not go away long time, talk about the persistence of the violation. Separate item note paroxysmal disorders accelerated atrial rhythm. The peculiarity of this type of disease is sudden development, pulse can reach 150-200 per minute.

A feature of such ectopic rhythms is the sudden onset of an attack and unexpected termination. Most often occurs with atrial tachycardia.

On the cardiogram, such contractions are reflected at regular intervals, but some forms of ectopia look different. The question: is this normal or pathological can be answered by studying different types of deviations.

There are two types of uneven changes in the intervals between atrial rhythms:

Extrasystole is an extraordinary atrial contraction against the background of a normal heart rhythm. The patient can physically feel a pause in the rhythm that occurs against the background of myocarditis, nervous breakdown or bad habits. There are cases of manifestations of causeless extrasystole. A healthy person can feel up to 1500 extrasystoles per day without harm to health, and there is no need to seek medical help.

Atrial fibrillation is one of the cyclic stages of the heart. There may be no symptoms at all. The atrium muscles stop contracting rhythmically, and chaotic flicker occurs. The ventricles, under the influence of flickering, are knocked out of rhythm.

The danger of developing an atrial rhythm exists regardless of age and can occur in a child. Knowing that this abnormality can occur over a period of days or months will make it easier to identify. Although medicine treats such deviations as a temporary manifestation of an illness.

IN childhood the appearance of ectopic atrial rhythm may occur under the influence of a virus. This is the most dangerous form illness, usually the patient is in serious condition, and exacerbations of atrial heart rhythm in children can occur even with a change in body position.

Symptoms of atrial rhythm

External manifestations of the disease appear only against the background of arrhythmia and another complication. The ectopic rhythm itself does not have characteristic symptoms. Although it is possible to pay attention to long-term disturbances in the rhythm of heart contractions. If you discover such a deviation, you should immediately consult a doctor.

Among the indirect symptoms indicating heart problems are:

Frequent attacks of shortness of breath.
Dizziness.
Chest pain.
Increased feeling of anxiety and panic.

Important! A characteristic sign of the onset of an attack of ectopic rhythm is the patient’s desire to take a body position in which uncomfortable state will pass.

In cases where the attack does not go away for a long time, it may begin copious discharge sweat, blurred vision, bloating, hands will begin to shake.

There are deviations in heart rate that cause problems with the digestive system, sudden vomiting and the desire to urinate. The urge to empty your bladder occurs every 15-20 minutes, regardless of the amount of fluid you drink. As soon as the attack stops, the urge will stop and your overall health will improve.

An attack of extrasystole can occur at night and be provoked by a dream. As soon as it is completed, the heart may freeze, after which its operation will return to normal. Symptoms of fever and a burning sensation in the throat may occur during sleep.

Diagnostic techniques

Identification is made based on data obtained during the anamnesis. After this, the patient is sent to an electrocardiogram to detail the obtained data. By inner sensations the patient can draw conclusions about the nature of the disease.

With the help of an ECG, the features of the disease are revealed; with ectopic heart rhythm, they are of a specific nature. Characteristic signs manifested by changes in readings on the “P” wave, can be positive and negative depending on the lesion.

The presence of atrial rhythm on an ECG can be determined based on the following indicators:

The compensatory pause does not have a full form.
The P-Q interval is shorter than it should be.
The “P” wave configuration is uncharacteristic.
The ventricular complex is excessively narrow.

Treatment of ectopic rhythm

To select an appropriate treatment, an accurate diagnosis of the abnormality must be established. The lower atrial rhythm may varying degrees influence heart diseases, which changes treatment tactics.

Sedatives are prescribed to combat vegetative-vascular disorders. Increased heart rate suggests the use of beta-blockers. To stop extrasystoles, Panalgin and Potassium chloride are used.

Manifestations of atrial fibrillation are determined by the prescription of drugs that stop the manifestation of arrhythmia during attacks. Controlling the contraction of cardiac impulses with medications depends on age group patient.

Massage of the carotid sinus, located near the carotid artery, is necessary after diagnosing the supraventricular form of heart rhythm disturbance. To carry out the massage, apply gentle pressure in the neck area on the carotid artery for 20 seconds. Rotational movements on the eyeballs will help relieve the manifestation of unpleasant symptoms during an attack.

If the attacks are not stopped by massage of the carotid artery and pressure on the eyeballs, a specialist may prescribe medication treatment.

Important! Repetition of attacks 4 times in a row or more, severe deterioration of the patient’s condition can lead to serious consequences. Therefore, to restore normal heart function, the doctor uses electromagnetic therapy.

Although the extrasystole defect can be irregular, the appearance of ectopic arrhythmia is a dangerous form of development of heart damage, as it entails serious complications. To avoid becoming a victim of unforeseen attacks that result in an abnormal heart rhythm, you should regularly undergo examinations and diagnostics of the functioning of the cardiovascular system. Adherence to this approach allows you to avoid the development of dangerous diseases.

Heart contractions that occur automatically due to other contractions in the myocardium or conduction system are called ectopic atrial rhythm. We'll figure out what it is in this article.

Description of the pathology

When the sinus node is weakened or stops working, and this happens either on permanent basis or from time to time, ectopic rhythms arise (or they are also called replacement rhythms).

Their frequency is less than that of sinus rhythm. Ectopic atrial rhythm can be considered non-sinus. The further away its source is, the less frequent its pulses will be. What is the reason for changes in heart function?

The main reasons why the rhythm changes

Changes occurring in the area of the sinus node and other conducting parts lead to the appearance of non-sinus rhythm. These deviations from the normal rhythm may be:

Sclerotic;

Ischemic;

Inflammatory.

Classification of non-sinus rhythms

The classification of non-sinus rhythms may vary. Below are the most common forms.

A non-sinus rhythm may be a supraventricular rhythm of an ectopic nature. This happens due to an overdose of cardiac glycosides, as well as vegetative-vascular dystonia. The automaticity of the ectopic focus increases, resulting in this form of non-sinus rhythm. Here, a high heart rate is observed, in contrast to the accelerated and replacement ectopic rhythms.

Non-sinus rhythm can also be ventricular. This indicates significant changes in the myocardium. If the frequency is too low ventricular contractions there is a high probability of developing coronary heart disease, which is fraught with serious consequences.

In addition, the rhythm may be atrial. Often develops with rheumatism, disease defects, diabetes mellitus, Cardiopsychoneurosis can lead to such a rhythm. However, ectopic atrial rhythm also occurs in completely healthy people. It is transient in nature, but can last for a long time. May develop congenitally.

It is interesting that ectopic rhythm occurs not only in adults, but also in young children. This is possible with existing additional foci of excitation that function independently of each other. This is influenced by neuroendocrine factors and changes occurring in the myocardium.

Types of violations

Such episodes of ectopic atrial rhythm in a child may be:

Active, which are characterized by paroxysmal tachycardia and extrasystole.

Accelerated (differing in atrial fibrillation).

Cardiac organic pathology leads in childhood to ventricular extrasystoles. This pathology can be diagnosed in a healthy newborn child.

A viral infection can lead to attacks of paroxysmal tachycardia in young children. This type of tachycardia has a severe form, which is called supraventicular.

Congenital heart defects, aspirin overdose, and carditis provoke this severe form of rhythm.

An attack can occur when the child has just woken up or has suddenly changed the position of his body. The supraventicular form is very dangerous.

What are the signs of ectopic atrial rhythm?

As already mentioned, the underlying disease leads to non-sinus rhythms. By any means specific symptoms it is not characterized. The main ailments and causes of the rhythm determine the symptoms.

Below are symptoms that you should pay close attention to and then consult a doctor immediately:

An attack of paroxysmal tachycardia begins suddenly and ends just as suddenly;

There are no warning signs of an attack;

There is no shortness of breath or heart pain at the onset of the attack;

The emergence of feelings of severe anxiety and fear;

Appearance motor restlessness, such that a person seeks a body position that will help stop the attack;

The person’s hands begin to tremble, his vision darkens, his head begins to spin;

The appearance of increased sweating;

Presence of nausea and bloating;

There may be an urge to urinate and have bowel movements: a person may urinate every 10-15 minutes from the onset of tachycardia, while urine is released light color, almost transparent, the urge to defecate occurs less frequently.

Paroxysmal tachycardia can begin while a person is sleeping. Then his heart begins to beat intensely because he had, for example, some kind of dream. After the attack ends, the heart begins to work calmly, and the person no longer feels shortness of breath.

Afterwards a shock is observed, then the rhythm becomes normal sinus. Sometimes there is pain during the push. In some cases, the slowing of the heart rate occurs gradually.

Other symptoms

There are certain signs of non-sinus rhythm. Depending on what the possible ectopic atrial rhythm is accompanied by, they can be different:

So, for example, with extrasystoles the heart may work intermittently, a person feels as if his heart is stopping, feels heat in the throat and heart. But these symptoms may not exist. Excess body weight and hypersthenic constitution often lead to vagotopic extrasystoles.

In a child it leads to fainting, darkening of the eyes, dizziness, feelings of tension and anxiety, pallor, cyanosis, shortness of breath, pain in the abdominal area. This is what distinguishes ectopic atrial rhythm in children.

Methods for diagnosing ectopic rhythm

If a person exhibits the above symptoms, he needs to urgently consult a physician or cardiologist. The specialist will prescribe an ECG, which will show certain changes in the heart or ectopic atrial rhythm.

The R wave changes its configuration during atrial rhythm. It does not have clear diagnostic signs. The PQ interval does not change with left atrial rhythm. Due to normal excitation along the ventricles, the QRST complex does not change. There will be a positive PaVR and a negative P in the third and second leads aVF when the pacemaker is located in the left and right atrium, namely in their lower sections. The exact location of the ectopic rhythm is not determined in cases of inferior atrial rhythm.

In a right heart rhythm, the source of automaticity (P-cells) will be located in the right atrium. This is how ectopic atrial rhythm manifests itself in adolescents.

Children also require a thorough diagnosis. With atrial extrasystoles, the P wave changes. The PQ interval is shortened, an incomplete compensatory pause and a narrow ventricular complex are observed.

Or there may be an accelerated ectopic atrial rhythm.

Extrasystoles may have an atrioventricular character; this is reflected on the ECG by the absence of a P wave in front of the ventricular complex. With a right ventricular extrasystole, the P wave is usually retracted upward (and downward with a left ventricular extrasystole).

The presence of embryocardia is characteristic of paroxysmal tachycardia. In this case, it is impossible to calculate the pulse. There is a decrease blood pressure. Presence of rigid rhythm and ventricular aberrant complexes. If an ECG is performed outside an attack or during supraventricular tachycardia, then a separate extrasystole can be observed, and at the time of the attack itself a group extrasystole with a shortened QRS complex is recorded.

In addition to the usual ECG study, 24-hour Holter and transesophageal ECG monitoring is used. All this can detect ectopic atrial rhythm.

Treatment

If a person has a non-sinus rhythm, then treatment is selected depending on the underlying disease. In order for therapy to be effective, it is necessary to carefully understand the cause of the malfunction of the heart. If it is caused by vegetative-vascular disorders, then a prescription will be required sedatives. If the vagus is strengthened, then belladonna and Atropine will help! Tachycardia requires the use of beta-blockers (Cordarone, Anaprilin, Isoptin, Obzidan).

With extrasystoles

For extrasystoles that are of organic origin, a course of “Panangin” or potassium chloride is prescribed. Anti-arrhythmia medications can also help in some cases positive effect(“Novocainamide”, “Aymalin”). For myocardial infarction and simultaneous extrasystole, Panangin and Lidocaine are used. A person receives these medications through a dropper.

In case of intoxication with cardiac glycosides

When intoxicated with digitalis, polytopic extrasystoles occur, which lead to ventricular fibrillation. Immediate discontinuation of the drug and treatment with Inderal, Potassium, and Lidocaine are required. Unithiol and diuretics will help remove intoxication. What else should be done when diagnosed with ectopic atrial heart rhythm?

Sometimes the carotid sinus is massaged for 20 seconds from the left and right side, if there is a supraventricular form. Pressing on the stomach and eye area helps. Lack of relief requires the use of beta blockers. They are administered at a slow speed, and monitoring of pulse and blood pressure is necessary. Mixing Propanol and Verapamil intravenously is not recommended.

What to do if the attack does not stop?

If the attack does not stop and continues for some time, the patient’s condition worsens, electropulse therapy is used. Intoxication with cardiac glycosides is a contraindication to such therapy. With frequent and severe attacks pacing is used continuously.

Complications may include exacerbation of heart problems. Timely consultation with a doctor will ensure the absence of ectopic rhythm, since the underlying diseases will be cured or at least controlled. Therefore, it is important not to panic if an atrial ectopic rhythm is detected on the ECG. We've looked at what it is.

special instructions

So that the heart has a clear and harmonious work, you need to be less nervous and stick to a healthy lifestyle. The more often a person spends time in the fresh air and engages in moderate physical labor, the healthier his heart will be. Diet must be limited fatty foods, which promotes the formation of cholesterol plaques. You need to eat more fiber fresh vegetables, fruits that contain vitamins. The most important for the heart are calcium, magnesium, and potassium.

Dairy products are rich in calcium, found in bananas and tomatoes great amount potassium, magnesium is present in spinach, buckwheat, carrots.

Conclusion

Sometimes the reason for heart rate deviations from the norm lies in the human psyche. In this case, after visiting a therapist or cardiologist, it makes sense to consult a psychotherapist. May be required full course psychotherapy.

Heart problems should not be taken lightly, but at the same time, the development of cardiophobia or fear of heart attack and other serious pathologies should not be allowed to develop.

For neurocircular dystonia, it makes sense to take sedatives for a long time, preferably of herbal origin, since they are safe and have virtually no contraindications and side effects. These include valerian tincture, motherwort tincture, Novopassit, Persen.

This is how dangerous ectopic atrial rhythm is. What this is, we hope, has now become clear to everyone.

Higher education:

Kuban State medical University(KubSMU, KubGMA, KubGMI)

Level of education - Specialist

Additional education:

“Cardiology”, “Course on magnetic resonance imaging of the cardiovascular system”

Research Institute of Cardiology named after. A.L. Myasnikova

"Course on functional diagnostics"

NTsSSKh them. A. N. Bakuleva

"Course in Clinical Pharmacology"

Russian Medical Academy of Postgraduate Education

"Emergency Cardiology"

Cantonal Hospital of Geneva, Geneva (Switzerland)

"Therapy course"

Russian state medical institute Roszdrav

The heart, being one of the main muscles in the human body, has a number of special properties. It can contract regardless of nerve impulses coming from the brain and taking part in the control of the neurohumoral system. The correct route for transmitting information in the heart muscle begins in the area of the right atrium (sinus node), continues in the area of the atrioventricular node and then spreads across the entire area of the septum. All other contractions that do not follow this route are considered an ectopic rhythm.

How do atrial rhythms appear?

Some theories suggest the autonomic and endocrine nature of the occurrence of atrial rhythms. As a rule, such phenomena occur in children during puberty or in adults with certain hormonal changes (age-related or resulting from pathologies).

There is also a version of the following type: hypoxic and inflammatory processes in the myocardium during cardiopathy and inflammatory diseases can cause atrial rhythms. Thus, in children who suffer from a sore throat or flu, there is a risk of myocarditis with a subsequent change in atrial rhythm.

Etiology of atrial rhythm

Supraventricular ectopic rhythm;

An accelerated atrial rhythm is usually formed in people who suffer from rheumatic diseases, various heart diseases, dystonia, diabetes, coronary artery disease or hypertension. In some cases, atrial rhythm can appear even in healthy adults and children, and can also be congenital in nature.

Impulses can come from different parts of the heart, since the source of the emerging impulses moves through the atrium. In medical practice, this phenomenon is called migrating rhythm. When measuring such an atrial rhythm, the amplitude on the ECG changes according to the source of the location of the impulses.

Clinical picture

Atrial rhythm has a direct relationship with the specific disease that caused it. This means that there are no specific symptoms. The clinical picture is directly determined by the pathological picture in the patient’s body. This rule applies only to short-term attacks of rhythm disturbance. With prolonged attacks, the following symptoms are possible:

Initially there is a feeling of anxiety and fear. The person tries to take the most comfortable position that would stop the further development of the attack.
The next stage is accompanied by severe tremor (shaking) in the limbs, and in some cases, dizziness.
The next step is the appearance of pronounced symptoms - increased sweating, dyspeptic disorders manifested in the form of bloating and nausea, and frequent urge to urinate.

Diagnosis of atrial rhythm

Left atrial rhythm: aVL is negative, aVF, PII, III are positive, PI, in some cases, smoothed. PV1/PV2 are positive, and PV5-6 are negative. According to Mirovski et al., the P wave in left atrial rhythm consists of two parts: the first has a low-voltage and dome-shaped rise (affected by depolarization of the left atrium), the second part is characterized by a narrow and high peak (the right atrium is depolarized).
Right atrial rhythm: characterized by a negative P wave in the area of the third standard branch, in the first and second - positive. This phenomenon is characteristic of a mid-lateral right atrial rhythm. The lower rhythm of this form is characterized by the indication of the P wave, negative in the second and third branches, as well as aVF, smoothed in the 5-6 thoracic.

The lower atrial rhythm is characterized by a shortening of the PQ interval, in which its value is less than 0.12 seconds, and the P wave is negative in branches II, III and aVF.

Treatment of pathology

Since the change in rhythm is directly determined by the presence of pathologies in the human body (in particular, the circulatory system and heart), treatment is aimed at identifying and eliminating the root causes. So, for vegetative-vascular disorders they can prescribe sedatives, in case of strengthening of the vagus, drugs based on atropine or belladonna are prescribed. If there is a predisposition to tachycardia, beta-blockers are used - the most popular are isoptin and cordarone. In case of polytopic extrasystoles and ventricular fibrillation, potassium preparations, panangin, and lidocaine are used.

In situations where the above methods do not allow you to get rid of diseases, causing change heart rhythm, the doctor may prescribe the use special therapy — preventive procedures aimed at promoting health, as well as the use of electropulse therapy.

Proper work healthy heart Normally, sinus rhythm is affected. Its source is the main point of the conduction system - the sinoatrial node. But this doesn't always happen. If the center of automatism of the first level for some reason cannot fully perform its function, or it completely falls out of the general scheme of pathways, another source of generation of contractile signals appears - ectopic. What is ectopic atrial rhythm? This is a situation in which electrical impulses begin to be produced by atypical cardiomyocytes. These muscle cells also have the ability to generate a wave of excitation. They are grouped into special foci called ectopic zones. If such areas are localized in the atria, then the sinus rhythm is replaced by the atrial rhythm.

Atrial rhythm is a type of ectopic contraction. Ectopia is an abnormal arrangement of something. That is, the source of excitation of the heart muscle does not appear where it is supposed to be. Such foci can form in any part of the myocardium, causing a disruption in the normal sequence and frequency of contractions of the organ. The ectopic rhythm of the heart is otherwise called a replacement rhythm, since it takes on the function of the main automatic center.

There are two possible atrial rhythm options: slow (it causes a decrease contractility myocardium) and accelerated (heart rate increases).

The first occurs when sinus node blockade causes weak impulse generation. The second is the result of increased pathological excitability of the ectopic centers; it overlaps the main rhythm of the heart.

Abnormal contractions are rare, then they are combined with sinus rhythm. Or the pre-sulfur rhythm becomes the leading one, and the participation of the first-order automatic driver is completely canceled. Such violations can be typical for different time periods: from a day to a month or more. Sometimes the heart works constantly under the start of ectopic foci.

What is inferior atrial rhythm? Active atypical connections of myocardial cells can be located both in the left and right atrium, and in the lower parts of these chambers. Accordingly, lower right atrial and left atrial rhythms are distinguished. But when making a diagnosis, there is no particular need to distinguish between these two types; it is only important to establish that the excitatory signals come from the atria.

The source of impulse generation can change its location within the myocardium. This phenomenon is called rhythm migration.

Causes of the disease

Inferior atrial ectopic rhythm occurs under the influence of various external and internal conditions. A similar conclusion can be given to patients of all age categories. Such a malfunction in the functioning of the heart muscle is not always considered a deviation. Physiological arrhythmia, as a variant of the norm, does not require treatment and goes away on its own.

Types of disorders caused by lower atrial rhythm:

tachycardia of paroxysmal and chronic nature;
extrasystoles;
flutters and fibrillation.

Sometimes the right atrial rhythm is no different from the sinus rhythm and adequately organizes the work of the myocardium. Such a failure can be detected completely by accident using an ECG during the next routine medical examination. At the same time, the person is completely unaware of the existing pathology.

The main reasons for the development of ectopic inferior atrial rhythm:

myocarditis;
weakness of the sinus node;
high blood pressure;

myocardial ischemia;
sclerotic processes in muscle tissue;
cardiomyopathy;
rheumatism;
heart defect;
exposure to nicotine and ethanol;
carbon monoxide poisoning;
side effects of medications;
congenital feature;
vegetative-vascular dystonia;
diabetes.

Inferior atrial rhythm in children can be either congenital or acquired. In the first case, the child is already born with the presence of ectopic foci. This is the result of oxygen starvation during childbirth or a consequence of abnormalities prenatal development. Functional immaturity of the cardiovascular system, especially in premature infants, is also the cause of the formation of ectopic rhythm. Such disorders can normalize on their own with age. However, such babies need medical supervision.

Another situation - adolescence. During this period, boys and girls experience serious changes in their bodies,
hormonal background is disrupted, the sinus heart rhythm may be temporarily replaced by the atrial rhythm. With the end of puberty, all health problems usually end. In adults, hormonal problems may be associated with aging (for example, menopause in women), which also affects the appearance of ectopic heart rhythms.

Professional sports can also be considered as a cause of the development of atrial rhythm. This sign is a consequence dystrophic processes myocardium, arising under the influence of excessive loads in athletes.

Symptoms

Inferior atrial abnormal rhythm may develop asymptomatically. If signs of cardiac dysfunction are present, they will reflect the disease that caused this condition.

A person begins to feel contractions of the myocardium and “hear” its tremors.
The number of minute beats of the organ is growing.
The heart seems to “freeze” for a while.
There is increased sweat production.
A dark, continuous veil appears before your eyes.
My head suddenly began to spin.
The skin became pale, a blue tint appeared on the lips and fingertips.
It became difficult to breathe.
Pain appeared in the chest area.

Frequent urination bothers me.
A person experiences strong fear in all my life.
Nausea or vomiting may occur.
Disorders of the gastrointestinal tract.
Fainting develops.

Short attacks take the patient by surprise, but end as quickly as they begin. Often such rhythm disturbances occur at night during sleep. A person wakes up in panic, feeling tachycardia, chest pain or heat in the head.

Diagnostics

The presence of atrial rhythm can be detected based on data obtained during an ultrasound of the heart or an electrocardiogram.

Since pathology can manifest itself from time to time, and often this happens at night, to obtain a more complete clinical picture Holter ECG monitoring is used. Special sensors are attached to the patient’s body and record changes occurring in the heart chambers around the clock. Based on the results of such a study, the doctor draws up a protocol for monitoring the state of the myocardium, which makes it possible to detect both daytime and nighttime paroxysms of rhythm disturbances.

Transesophageal electrophysiological examination, coronary angiography, and ECG recording under stress are also used. A standard analysis of biological fluids of the body is required: general and biochemical research blood and urine.

Signs on the electrocardiogram

ECG is an accessible, simple and quite informative way to obtain data on various violations heart rate. What does the doctor evaluate on the cardiogram?

The state of the P wave, reflecting the process of depolarization (appearance of an electrical impulse) in the atria.
The P-Q region demonstrates the features of the excitation wave traveling from the atria to the ventricles.
The Q wave marks the initial stage of ventricular excitation.
The R element displays the maximum level of ventricular depolarization.
The S tooth indicates the final stage of propagation of the electrical signal.
The QRS complex is called the ventricular complex; it shows all stages of the development of excitation in these sections.
The T element registers the phase of decline in electrical activity (repolarization).

Using the available information, the specialist determines the characteristics of the heart rhythm (frequency and periodicity of contractions), the source of impulse generation, and the location of the electrical axis of the heart (EOS).

The presence of atrial rhythm is indicated by the following signs on the ECG:

negative P wave with unchanged ventricular complexes;
the right atrial rhythm is reflected by the deformation of the P wave and its amplitude in additional leads V1-V4, the left atrial rhythm - in leads V5-V6;
teeth and intervals have increased duration.

EOS displays electrical parameters cardiac activity. The position of the heart as an organ with a three-dimensional volumetric structure can be represented in a virtual coordinate system. To do this, the data obtained by the electrodes during the ECG is projected onto a coordinate grid to calculate the direction and angle of the electrical axis. These parameters correspond to the localization of the excitation source.

Normally, it has a vertical (from +70 to +90 degrees), horizontal (from 0 to +30 degrees), intermediate (from +30 to + 70 degrees) position. A deviation of the EOS to the right (over +90 degrees) indicates the development of an ectopic abnormal right atrial rhythm; a deviation to the left (up to -30 degrees and beyond) is an indicator of a left atrial rhythm.

Treatment

Treatment measures will not be required if the adult or child does not experience any discomfort when an anomaly has developed, and they have not been diagnosed with heart or other diseases. The occurrence of atrial rhythm in this situation is not dangerous to health.

Otherwise, the therapeutic effect is carried out in the following directions:

Accelerated pathological atrial rhythm is treated with beta blockers (Propranalol, Anaprilin) and other drugs that reduce heart rate.
For bradycardia, medications are prescribed that can accelerate the slow rhythm: drugs based on atropine, sodium caffeine benzoate, are used plant extracts(eleutherococcus, ginseng).
Vegetative-vascular disorders that cause ectopic rhythm require the use of sedatives “Novopassit”, “Valocordin”, motherwort tincture, valerian.
To prevent heart attack, it is proposed to use Panangin.
In addition to antiarrhythmic drugs (Novocainamide, Verapamil), for irregular rhythms it is prescribed specific treatment upon establishing the specific cause of the violations that have developed.
In severe cases that are not amenable to standard drug treatment, cardioversion and installation of an artificial pacemaker are used.

Traditional methods

Atrial rhythm, as one of the types of cardiac disorders, requires constant monitoring by a doctor. Even the absence alarming symptoms- no reason to be negligent similar condition. If the development of ectopic contractions is caused by diseases, it is imperative to find out the cause of the pathology and treat it with all seriousness. Launched severe forms atrial arrhythmias can threaten human life.