Cardiac contractions, which occur automatically due to other contractions in the myocardium or in the conduction system, are called ectopic atrial rhythm. What is it, we will understand in this article.
Pathology Description
When the sinus node is weakened or stops working, and this happens either on an ongoing basis or from time to time, ectopic rhythms arise (or they are also called replacement rhythms).
Their frequency is less than that of the sinus rhythm. Ectopic atrial rhythm can be considered non-sinus. The further its source is located, the less often its pulses will be. What is the reason for changes in the work of the heart?
The main reasons why the rhythm changes
Changes occurring in the region of the sinus node and other conductive departments lead to the appearance of a non-sinus rhythm. These deviations from the normal rhythm can be:
- sclerotic;
- ischemic;
- inflammatory.
Classification of non-sinus rhythms
The classification of non-sinus rhythms can be different. The following are the most common forms.
- Non-sinus rhythm may be an ectopic supraventricular rhythm. This happens due to an overdose of cardiac glycosides, as well as vegetovascular dystonia. The automatism of the ectopic focus increases, as a result, this form of non-sinus rhythm appears. There is a high heart rate, in contrast to accelerated and replacing ectopic rhythms.
- Non-sinus rhythm can also be ventricular. This indicates significant changes in the myocardium. With too low a frequency of ventricular contractions, the likelihood of developing coronary heart disease, which is fraught with serious consequences.
- In addition, the rhythm may be atrial. Often develops with rheumatism, heart defects, hypertension , diabetes mellitus, coronary heart disease. Neurocirculatory dystonia can lead to such a rhythm. However, ectopic atrial rhythm also occurs in completely healthy people. It has a transient character, but can last a long time. May develop congenitally.
Interestingly, the ectopic rhythm happens not only in adults, but also in young children. This is possible with the existing additional foci of excitation, which 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 can be:
- Active, which are characterized by paroxysmal tachycardia and extrasystole.
- Accelerated (characterized by atrial fibrillation).
Cardiac organic pathology leads to ventricular extrasystoles in childhood. This pathology can already be diagnosed in a newborn healthy child.
Viral infection can lead to paroxysmal tachycardia in young children. This type of tachycardia has a severe form, which is called supraventicular.
Congenital heart defects, an overdose of aspirin, carditis provoke this severe form of atrial tachycardia .
An attack can occur when a child has just woken up or has sharply changed his body position. The supraventicular form of paroxysmal tachycardia is very dangerous.
What signs distinguish an ectopic atrial rhythm?
As already mentioned, the underlying disease leads to non-sinus rhythms. It is not characterized by any specific symptoms. The main ailments and causes of rhythm determine the symptoms.
Below are the symptoms that should be paid close attention, and then immediately consult a doctor:
- an attack of paroxysmal tachycardia begins suddenly and ends just as suddenly;
- there are no harbingers of an attack;
- there is no shortness of breath or heart pain at the beginning of the attack;
- the emergence of feelings of intense anxiety and fear;
- the appearance of motor anxiety, such that a person is looking for a position in the body that helps to stop the attack;
- a person’s hands begin to tremble, darkens in his eyes, dizzy;
- the appearance of increased sweating;
- the presence of nausea and bloating;
- there may be a urge to urinate and bowel movement: a person can urinate every 10-15 minutes from the beginning of tachycardia, while the urine is light in color, almost transparent, urge to defecate less often.
Paroxysmal tachycardia can begin when a person is sleeping. Then his heart begins to beat intensely because he had a dream, for example, some kind of dream. At the end of the attack, the heart begins to work calmly, while the person no longer feels shortness of breath.
After a sinking heart beat is observed, then the rhythm becomes normal sinus. Sometimes during a jolt there is pain. In some cases, a slowdown in heart rate occurs gradually.
Other symptoms
With non-sinus rhythm, there are certain signs. Depending on what the possible ectopic atrial rhythm is accompanied by, they can be different:
- So, for example, with extrasystoles, the heart can work intermittently, a person feels as if his heart is stopping, feels heat in the throat and heart. But these symptoms may not be. Excess body weight and hypersthenic constitution often lead to vagotopic extrasystoles.
- In a child, an attack of paroxysmal tachycardia leads to a fainting, darkening in the eyes, dizziness, a feeling of tension and anxiety, pallor, cyanosis, shortness of breath, pain in the abdomen. This distinguishes ectopic atrial rhythm in children.
Diagnostic methods for ectopic rhythm
If a person has the above symptoms, he needs to urgently consult a therapist or cardiologist. The specialist will prescribe an ECG, which will show certain changes in the work of the heart or ectopic atrial rhythm.
The R wave changes its configuration at atrial rhythm. It does not have clear diagnostic signs. The PQ interval does not change with left atrial rhythm. Due to the usual excitation in the ventricles, the QRST complex does not change. It will be positive PaVR and negative P in the third and second leads of aVF when the pacemaker is located in the left and right atria, namely in their lower sections. The exact localization of the ectopic rhythm has not been determined in cases of lower atrial rhythm.
With a right rhythm, there will be an arrangement of the source of automatism (P-cells) in the right atrium. So the ectopic atrial rhythm is manifested in adolescents.
Children also need 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 maybe an accelerated ectopic atrial rhythm.
Extrasystoles can be atrioventicular in nature, on the ECG this is reflected by the absence of a P wave in front of the ventricular complex. With right ventricular extrasystole, the P wave is standardly pulled up (and down with left ventricular extrasystole).
The presence of embryocardia is characteristic of paroxysmal tachycardia. It is not possible to count the pulse. There is a decrease in blood pressure. The presence of rigid rhythm and ventricular aberrant complexes. If the ECG is performed without an attack or with supraventicular tachycardia, then a separate extrasystole can be observed, and at the time of the attack, a group extrasystole with a shortened QRS complex is recorded.
In addition to the usual ECG studies, daily monitoring of the ECG according to Holter and transesophageal electrophysiological studies are also used. All this is able to identify an ectopic atrial rhythm.
Treatment
If a person has a non-sinus rhythm, then treatment is selected depending on the underlying disease. In order for the 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 sedation will be required. If the vagus is strengthened, then belladonna and Atropine! Will help. Tachycardia requires the use of beta-blockers (Cordaron, Anaprilin, Isoptin, Obzidan).
With extrasystoles
With extrasystoles, which have an organic origin, a course of "Panangin" or potassium chloride is prescribed. Medicines against arrhythmias in some cases can also have a positive effect (Novocainamide, Aimalin). In case of myocardial infarction and simultaneous extrasystole, “Panangin” and “Lidocaine” are used. A person receives these drugs with a dropper.
With cardiac glycoside intoxication
With digitalis intoxication, polytopic extrasystoles occur, which lead to ventricular fibrillation. Immediate drug withdrawal and treatment with Inderal, Potassium, and Lidocaine are required. “Unithiol” and diuretics will help to eliminate intoxication. What else should be done with a diagnosis of ectopic atrial heart rhythm?
Sometimes the carotid sinus is massaged for 20 seconds on the left and right sides, if there is a supraventricular form. Pressure on the abdomen and in the eye area helps. The lack of relief requires the appointment of beta-blockers. They are introduced at a slow speed, while pulse and blood pressure control is needed. Mixing Propanol and Verapamil intravenously is not recommended.
What if the attack does not stop?
If the attack does not stop and has been going on for some time, the patient’s condition worsens, electro-pulse therapy is used. Cardiac glycoside intoxication is a contraindication to such therapy. With frequent and severe attacks, pacing is used constantly.
Exacerbations of heart problems can be complications. Timely access to a doctor guarantees the absence of an 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 by ECG is detected. What is it, we examined.
special instructions
In order for the heart to have a clear and coordinated work, you need to be less nervous and adhere to a healthy lifestyle. The more often a person spends time in the fresh air, engages in moderate physical labor, the healthier his heart will be. In nutrition, it is necessary to limit fatty foods, which contributes to the formation of cholesterol plaques. You need to eat more fiber, fresh vegetables, fruits, which contain vitamins. The most important for the heart are calcium, magnesium, potassium.
Dairy products are rich in calcium, in bananas and tomatoes a huge amount of potassium, magnesium is present in spinach, buckwheat, carrots.
Conclusion
Sometimes the reason for deviations of the heart rhythm from the norm lies in the human psyche. In this case, after visiting a therapist or cardiologist, it makes sense to get a consultation with a therapist. A full course of psychotherapy may be required.
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 cannot be allowed.
With neurocircular dystonia, it makes sense to take sedatives for a long time, better than herbal origin, since they are safe and practically have no contraindications and side effects. These include tincture of valerian, tincture of motherwort, Novopassit, Persen.
This is how dangerous the ectopic atrial rhythm is. What is it, we hope, now it has become clear to everyone.