Ectopic rhythm what. Ectopic activity of the heart. How do ectopic foci occur?

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 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 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 taking place in the area sinus node and other conducting sections, lead to the occurrence 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 the appearance this form non-sinus rhythm. Here it is observed high frequency heart contractions, as opposed to accelerated and replacement ectopic rhythms.

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

In addition, the rhythm may be atrial. Often develops with rheumatism, disease defects, diabetes mellitus. Neurocirculatory dystonia 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 to childhood To ventricular extrasystoles. This pathology can be diagnosed in a newborn healthy child.

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

Congenital heart defects, aspirin overdose, carditis provoke this severe form 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. It is not characterized by any specific symptoms. 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;

The appearance of 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, slowdown heart rate happens 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 parts. The exact localization of the ectopic rhythm is not determined in cases 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 examination, it is used daily monitoring Holter ECG and transesophageal All this can reveal 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 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 the prescription of sedatives will be required. 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 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. For frequent and severe attacks, cardiac pacing is used continuously.

Complications may include exacerbation of heart problems. Timely appeal to a doctor guarantees 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

In order for the heart to work clearly and harmoniously, you need to be less nervous and adhere to a healthy lifestyle. The more often a person spends time fresh air, exercises moderately physical labor, the healthier his heart will be. Diet must be limited fatty foods which promotes education 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.

At neurocircular dystonia it makes sense to take it for a long time sedatives, better plant 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.

Ectopic, also characterized as replacement, rhythms are contractions of the heart caused by automaticity manifested in other parts of the myocardium or conduction system. Arise if the activity of the sinus node is stopped or weakened, which can happen either permanently or temporarily. The further away the source of a non-sinus rhythm is (we will apply this name to rhythms of an ectopic nature), the frequency is usually lower and the frequency of impulses of the sinus node is less frequent.

Reasons for rhythm changes

Non-sinus rhythms can occur due to changes occurring in the area of ​​the sinus node, as well as in other conducting sections. These modifications can be:

• sclerotic;
• ischemic;
• inflammatory.

Ectopic disorders are classified in different ways. There are several forms:

1. Supraventricular rhythm of ectopic nature. Its causes are an overdose of cardiac glycosides, as well as autonomic dystonia. It rarely happens that this form is caused by increased automatism of the ectopic focus. In this case, the heart rate will be higher than with an accelerated or replacement rhythm of an ectopic nature.
2. Ventricular rhythm. Typically, this form indicates that significant changes have occurred in the myocardium. If the ventricular rate is very low, ischemia may occur, affecting important organs.
3. Atrial rhythm. Occurs often in the presence of rheumatism, heart disease, hypertension, diabetes mellitus, ischemia, neurocirculatory dystonia, also even in healthy people. As a rule, it is present temporarily, but sometimes it lasts for a long period. It happens that atrial rhythm is congenital.

Changes occurring in the myocardium due to neuroendocrine influences can also occur in children. This means that in the child’s heart there are additional foci of excitation that function independently of each other. Such violations are divided into several forms:

• active: and extrasystole;
• accelerated: atrial fibrillation.

begin to develop in cases of cardiac organic pathology. Very rare, but there are cases when this type can be diagnosed in a healthy child, even a newborn.

Against the background of infection viral in nature V early age attacks of paroxysmal tachycardia occur, which can occur in a very severe form, called supraventricular. This is possible with congenital heart defects, atropine overdose and carditis. Attacks of this form often occur when the patient awakens and changes body position.

Symptoms of the disease

We have learned that non-sinus rhythms depend on the underlying disease and its causes. It means that specific symptoms not visible. Let's look at some signs that indicate that it is time to see a doctor yourself or together with your child if his condition worsens.

Let's take paroxysmal tachycardia as an example. Most often it begins as unexpectedly as it ends. At the same time, its precursors, such as dizziness, chest pain, and so on, are not observed. At the very beginning of the crisis there is usually no shortness of breath or heart pain, but these symptoms can appear during a prolonged attack. Initially, there arises: a feeling of anxiety and fear that something serious is happening to the heart, motor restlessness, in which a person wants to find a position in which the disturbing state will stop. Next, hand trembling, darkening of the eyes and dizziness may begin. Then it is observed:

• increased sweating;
• nausea;
• bloating;
• the urge to urinate, even if the person has not consumed much liquid, occurs every fifteen or ten minutes, and about 250 ml of light, transparent urine is released each time; this feature persists even after an attack, then gradually disappears;
• urge to defecate; this symptom It is not observed often and occurs after the onset of a seizure.

Seizures short duration may occur during sleep, and the patient may experience a sharply increased heart rate due to some kind of dream. After it ends, heart activity returns to normal, shortness of breath disappears; a person feels a “fading” of the heart, followed by a heartbeat, which indicates the beginning of a normal sinus rhythm. It happens that this impulse is accompanied by a painful sensation. However, this does not mean that the attack always ends so abruptly; sometimes heart contractions slow down gradually.

Separately, it is worth considering the symptoms that occur in children with the development of ectopic rhythm. Each mentioned form of disorder of this nature has its own symptoms.

Extrasystoles are characterized by:

• interruptions in cardiac function;
• a feeling of “fading” of the heart;
• feeling of heat in the throat and heart.

However, there may be no symptoms at all. Vagotopic extrasystoles in children are accompanied by overweight body and hypersthenic constitution. Paroxysmal tachycardia at an early age has the following symptoms:

• fainting;
• feeling of tension and anxiety;
• dizziness;
• pallor;
• dyspnea;
• stomach ache.

Diagnosis of the disease

Diagnosis of the disease, in addition to the symptoms indicated by the patient, is based on ECG data. Some forms of ectopic rhythm disturbances have their own characteristics that are visible in this study.

The atrial rhythm is different in that the configuration of the R wave changes, its diagnostic signs are not clear. With a left atrial rhythm, there is no change in the PQ interval; it is also equal to 0.12 s or exceeds this level. The QRST complex does not differ, since excitation through the ventricles occurs in the usual way. If the pacemaker is located in the lower parts of the left or right atrium, then the ECG will show the same picture as with coronary sinus rhythm, that is, positive PaVR and negative P in the third and second leads aVF. In this case we're talking about about the lower atrial rhythm, and it is very difficult to find out the exact localization of the ectopic focus. The right atrial rhythm is characterized by the fact that the source of automatism is P-cells, which are located in the right atrium.

In childhood, a thorough diagnosis is also carried out. Atrial extrasystoles are characterized by a modified P wave, as well as a shortened P-Q interval with an incomplete compensatory pause and a narrow ventricular complex. Extrasystoles of an atrioventricular connection differ from the atrial form in that there is no P wave in front of the ventricular complex. The right ventricular extrasystole is characterized by the fact that the main R wave has a standard upward lead, and the left ventricular one is distinguished by the downward lead of the same tooth.

With paroxysmal tachycardia, embryocardia is detected during the examination. In this case, the pulse has a small filling and is difficult to count. Reduced blood pressure is also observed. The ECG shows a rigid rhythm and ventricular aberrant complexes. In the period between attacks and with the supraventricular form, extrasystole is sometimes recorded, and during the crisis itself the picture is the same as with group extrasystole with a narrow QRS complex.

Treatment methods

When diagnosing non-sinus rhythms, treatment is aimed at the underlying disease. Accordingly, it is very important to identify the cause of cardiac dysfunction. For vegetative-vascular disorders it is usually prescribed sedatives, with strengthening of the vagus - preparations of belladonna and atropine. If there is a tendency to tachycardia, beta-blockers, for example, obzidan, anaprilin and propranolol, are considered effective. Known drugs are cordarone and isoptin.

Extrasystoles of organic origin are usually treated with panangin and potassium chloride. Sometimes antiarrhythmic drugs such as ajmaline and procainamide may be used. If extrasystole is accompanied by myocardial infarction, it is possible to use panangin together with lidocaine, which are administered by intravenous drip infusion.

Intoxication with digitalis can lead to the occurrence of polytopic extrasystoles, which is why it occurs. In this case, you need to urgently stop the drug, and use potassium preparations, Inderal, and lidocaine as treatment. To relieve intoxication associated with cardiac glycosides, the doctor may prescribe diuretics and unithiol.

With the supraventricular form, you can massage the carotid sinus on the left and right for about twenty seconds. They also apply pressure on abdominal Press And eyeballs. If these methods do not provide relief, your doctor may prescribe beta blockers, such as verapamil or procainamide. Drugs should be administered slowly while monitoring pulse and blood pressure. It is not recommended to alternate propanol and verapamil intravenously. Digitalis can be used only if it has not entered the patient’s body for the next few days before the attack.

If the patient's condition worsens, electropulse therapy is used. However, it cannot be used in case of intoxication with cardiac glycosides. Cardiac pacing can be used continuously if attacks are severe and frequent.

Complications may include heart problems, or rather their exacerbation. To avoid this, you should apply for timely medical care and do not start treatment of underlying diseases that provoke the development of ectopic rhythm. For clear and coordinated work of the heart, it is simply necessary to maintain healthy image life and avoid stress.

When the sinus node loses the functions of the main pacemaker, ectopic foci. When they are located in the lower parts of the atria, a lower atrial heart rhythm appears on the ECG. Clinical manifestations may be absent, and the ECG shows minor changes in the form of negative atrial waves.

Treatment is aimed at normalizing the autonomic regulation of heart contractions, therapy background disease. At normal frequency No medications are prescribed for heart rate.

Read in this article

Why can the lower atrial rhythm be fast or slow?

Normally, a cardiac impulse should form only in the sinus node, and then spread through the conduction system of the heart. If for some reason the node loses its dominant role, then other areas of the myocardium may be the source of excitation waves.

If the ectopic (any other than the sinus node) focus is located in the lower part of the left or right atrium, then the rhythm generated by it is called inferior atrial. Since the new pacemaker is located not far from the main one, changes in the order of contractions of the heart parts are insignificant, they do not lead to severe circulatory disorders.

The appearance of an ectopic rhythm is possible in two cases:

• the automaticity of the cells of the sinus node is impaired, so the underlying center shows activity, the rhythm of its impulse generation is lower than that of the main driver, therefore it is called slow or replacing, it is formed during vagotonia, and occurs in athletes;
• if the emerging focus becomes more active than the sinus one, then it suppresses normal signals, leading to accelerated reductions hearts. The occurrence of such arrhythmias most often results from myocarditis, intoxication, and vegetative-vascular dystonia with a predominance of sympathetic tone.

Features of the occurrence of lower atrial rhythms in a child

The neonatal period is characterized by insufficient maturation of the fibers of the cardiac conduction system and autonomic rhythm regulation. Therefore, the appearance of an atrial rhythm is not regarded as pathological condition. The activity of the sinus node in such a child is usually inconsistent - the normal rhythm alternates with the lower atrial one.

There is often a combination of an ectopic focus in the atria and minor anomalies in the development of the heart - additional chords, trabeculae, valve prolapse.

A more serious condition is arrhythmia in the presence of heart disease, intoxication during intrauterine development, unfavorable course of pregnancy, complications of childbirth, premature babies. Therefore, if there is weakness, shortness of breath, cyanosis when crying or feeding, the child needs a thorough examination of the heart.

Manifestations of pathology

Expert opinion

Alena Ariko

Expert in Cardiology

There are no specific manifestations of the lower atrial rhythm, but since in the vast majority of cases it reflects an autonomic imbalance in the body, patients may have significant clinical symptoms.

Many complaints about heart function (interruptions, fading, palpitations) in this case does not reflect the severity of the changes. Characteristic feature is the variability of manifestations, improvement after taking sedatives.

If the patient has a predominant tone sympathetic division nervous system, then the main signs of arrhythmia will be:

• hot flashes alternating with chills;
• pale skin;
• increased heart rate;
• anxiety;
• hand trembling.

With vagotonia, the heart rate slows down, which is accompanied by dizziness, freezing of the heartbeat, sweating, lightheadedness, and a drop in blood pressure. Typically, such sharp manifestations are characteristic of the crisis course of vegetative-vascular dystonia, and in milder variants the symptoms are mild.

If the inferior atrial rhythm occurs when organic lesions heart (ischemia, inflammation, scar tissue), then clinical picture completely determined by the underlying disease.

Inferior atrial rhythm on ECG

Due to the fact that the appearance of a rhythm with a source of impulses in the lower atrium is often a variable phenomenon, it is not always possible to detect it during routine diagnostics. With a one-time registration, you can get a completely normal record.

Therefore, many patients require a long examination - monitoring throughout the day or even 2 - 3 days, as well as the use of stress tests, rhythmography, electrophysiological study.

Criteria for classifying heart rhythms as lower atrial:

Treatment of rhythm disturbances

If the heart rate is normal, patients do not require antiarrhythmic medications. For bradycardia or palpitations, therapy is aimed at the cause of the lower atrial rhythm. IN complex treatment with severe symptoms may include:

• anticholinergics (if slowed down) - Atropine, Platiphylline;
• beta blockers for tachycardia - Corvitol, Betalok;
• for improvement metabolic processes myocardium – Carnitine, Mildronate, Pantogam, ;
• sedatives – Novo-passit, valocordin (for sympathicotonia);
• tonic (with vagotonia) – eleutherococcus.

For functional arrhythmia (without myocardial disease) good effect give non-drug methods– reflexology, massage thoracic spine, electrophoresis of magnesium or caffeine, baths with herbal extracts, circular shower, physical therapy.

Surgical treatment methods (and) for lower atrial heart rhythm are practically not used.

Watch the video about heart rhythm disturbances and arrhythmias:

Prognosis and prevention

Despite the fact that this rhythm disorder is characterized by a benign course, patients with ectopic foci of excitation in the myocardium should be under medical supervision. This is due to the fact that when concomitant pathology or physical psycho-emotional stress such arrhythmia can transform into more serious forms. Therefore they are shown:

• daily and heart rate;
• undergoing an ECG at least once a quarter;
• Once every six months, a coagulogram and ultrasound of the heart are required.

For athletes and those with a professional risk of stress on the heart (pilots, electric locomotive drivers, truck drivers), restrictions on further activities or a ban on admission to sports sections or employment may be introduced.

Inferior atrial rhythm appears when the sinus node loses its role as the main source of impulses for heart contraction. This may be due to diseases of the heart muscle, a failure of autonomic regulation, or hormonal imbalance.

Specific symptoms are absent or mild. The diagnosis is made when ECG study, often in monitoring mode. Treatment is aimed at the cause of the occurrence, antiarrhythmic therapy is carried out only when signs of circulatory disorders appear.

Read also

An ectopic rhythm can occur in a child, teenager, and adult. The ECG readings will tell you which one it is - nodal, right atrial. An accelerated rhythm may also indicate the onset of another disease.

Atrial rhythm is a special condition in which the function of the sinus node weakens, and the source of impulses is the lower premedian centers. Frequency heart pulse at the same time significantly weakens. The number of blows ranges from 90 to 160 per minute.

Origin of the disease

The source of the atrial rhythm is the so-called ectopic focus located in the fibers of the atria. In cases where the functioning of the sinus node is disrupted, other parts of the heart are activated that are capable of producing impulses, but when normal operation hearts that are not active. Such areas are called ectopic centers.

Automatic centers located in the atria can provoke an ectopic rhythm, which is characterized by a decrease in sinus and an increase in atrial impulse. The heart rate during atrial rhythm is similar to sinus rhythm. But with atrial bradycardia the pulse slows down, and with atrial tachycardia, on the contrary, it increases.

The left atrial rhythm originates from the lower part of the left atrium, right atrial rhythm- from the right atrium. This factor is not important when prescribing treatment. The mere fact of the presence of an atrial rhythm will be sufficient.

Causes of the disease

Atrial rhythm is a disease that can develop in people of any age, it occurs even in children. Malaise in in rare cases lasts for several days, or even months. However, this illness usually lasts no more than a day.

There are often cases when the disease is hereditary. In this case, changes in the myocardium occur during intrauterine development. In children at birth, ectopic foci are noted in the atria. Ectopic rhythm may occur in a child under the influence of certain cardiotropic viral diseases.

Ectopic rhythms can also occur in completely healthy people under the influence of external factors. Such disturbances are not dangerous and are transient.

The following ailments lead to ectopic contractions:

• inflammatory processes;
• ischemic changes;
• sclerotic processes.

Ectopic atrial rhythm can be caused by several diseases, including:

• rheumatism;
• cardiac ischemia;
• heart disease;
• hypertension;
• cardiopsychoneurosis;
• diabetes.

Additional diagnostic procedures will allow you to determine the exact cause of the pathology and allow you to create a course of treatment for the disease.

Symptoms

Symptoms of atrial rhythm can be expressed in different ways, depending on the underlying disease. Characteristic signs not observed with ectopic rhythm. The patient may not feel any disturbances. And yet, several main symptoms accompanying the disease can be noted:

• unexpected manifestation of abnormal heart rate;
• dizziness and shortness of breath with prolonged course of the disease;
• profuse sweating;
• pain in the chest area;
• nausea;
• paleness of the skin;
• darkening of the eyes.

The patient may worry and feel panic; an uneasy feeling does not leave him.

Short-term attacks are characterized by failure of heart contractions and subsequent cardiac arrest. Such conditions do not last long and usually occur at night. The disease is accompanied by minor painful sensations. Your head may feel hot.

The painful condition can pass quickly, or it can drag on for a long time. With a prolonged course of the disease, a blood clot may begin to form in the atrium. There is a high risk of getting into big circle blood circulation As a result, a stroke or heart attack may occur.

In some cases, the pathology may not manifest itself in any way and can only be determined on an ECG and be irregular. If the patient has no complaints about the state of health, there are no heart diseases, then this condition is not classified as pathological manifestations and consider it as normal.

Diagnostics

Diagnosis of atrial rhythm is made based on ECG readings. This method is the most informative. An electrocardiogram allows you to clarify the diagnosis and study ectopic rhythms in more detail. On ECG this violation expressed quite specifically.

The atrial rhythm may be expressed at a slow pace. This condition is observed when the sinus node is depressed. Accelerated atrial rhythm is diagnosed when increased activity ectopic centers.

For a more detailed study of the disease, the doctor may prescribe a Holter ECG.

Treatment

Atrial rhythm does not always require treatment. In cases where a person does not experience any painful sensations, and his heart functions smoothly, no therapy is required. The doctor diagnoses the condition as normal.

In other cases, treatment is prescribed concomitant diseases, which contributed to the development of the disease. Treatment is carried out in the following areas:

• elimination of vegetative-vascular disorders using sedatives;
• accelerated atrial rhythm is treated with beta-blockers;
• heart rate stabilization;
• prevention of myocardial infarction.

If therapeutic measures did not bring the desired result, and the patient’s condition worsens, then doctors prescribe electropulse therapy.

In some cases, atrial rhythm is the cause of a malfunction of the heart. To prevent this from happening, you should consult a doctor for any heart-related ailments. It is important to have an electrocardiogram regularly. This is the only way to prevent unwanted complications of the disease.

Traditional methods

Atrial rhythm can be treated folk ways. You can start treatment only after consulting your doctor. It is also important to know the cause that caused the disease.

A medicinal plant such as calendula can help with atrial rhythm. For treatment, an infusion is prepared, for which 2 tsp is taken. calendula flowers and pour a glass of boiling water. The medicine must infuse well. This will take an hour or two. Ready product consume twice a day, drink half a glass at a time.

Cornflower infusion also helps eliminate unpleasant consequences illness. The medicine is prepared from 1/3 tablespoon of cornflower flowers; you can also use the leaves of the plant. The raw materials are poured with a glass of boiling water. They also drink the infusion - twice a day, half a glass in the morning and evening.

These normalize the heart rhythm medicinal plants, How:

• mint;
• motherwort;
• blackberry;
• hawthorn;
• rose hip;
• cottonweed;
• chamomile.

During therapy it is necessary to avoid stressful situations and emotional turmoil. Otherwise, the treatment will not bring the desired results.

To keep your heart healthy, it is important to avoid bad habits. Alcohol and smoking are contraindicated. Breathing exercises have a general strengthening effect.

Not last place in the treatment of heart diseases also occupies proper nutrition. To normalize cardiac activity, it is important to consume foods rich in calcium. The diet must certainly include cereals, vegetables and fruits. But from spicy food, coffee and strong tea It's better to refuse.

In order for the treatment of atrial rhythm to be effective, it is important to know the reasons that provoked the disease and, first of all, to address the symptoms of concomitant diseases.

Excitation of the heart does not come from the suture system, but from certain parts of the left or right atrium, therefore, with this rhythm disturbance, the P wave is deformed, of an unusual shape (P), and the QRS complex is not changed. V.N. Orlov (1983) highlights:

1) right atrial ectopic rhythms (RAER),

2) coronary sinus rhythm (CSR),

3) left atrial ectopic rhythms (LAER).

Electrocardiographic criteria for left atrial rhythm:

1) –Р in II, III, aVF and from V 3 to V 6;

2) Р in V 1 in the form of “shield and sword”;

3)PQ is normal;

4) QRST is not changed.

When the pacemaker is located in the lower parts of the right or left atria, the same picture is observed on the ECG, i.e. –P in II, III, aVF and +P in aVR. In such cases, we can talk about the lower atrial rhythm (Fig. 74).

Rice. 74. Inferior atrial rhythm.

Ectopic av-rhythm

Excitation of the heart comes from the AV junction. There are “upper”, “middle” and “lower” atrioventricular or nodal rhythms. The “upper” nodal rhythm is virtually indistinguishable from the lower atrial rhythm. Therefore, it is advisable to talk about only two options for nodal rhythm. In option I, the impulses come from the middle sections of the AV junction. As a result, the impulse to the atria goes retrograde, and they are excited simultaneously with the ventricles (Fig. 75). In option II, the impulses come from the lower parts of the AV junction, while the atria are excited retrogradely and later than the ventricles (Fig. 76).

Rice. 76. Inferior nodal rhythm: Heart rate = 46 per minute, at V = 25 mm/s RR = RR, Р(–) follows QRS.

Electrocardiographic criteria of AV rhythm (Fig. 75, 76):

1) heart rate 40–60 per minute, the distance between R–R is equal;

2) QRST is not changed;

3) Р is absent in option I and –Р follows after QRS in option II;

4) RP is equal to 0.1–0.2 s with option II.

Ectopic ventricular (idioventricular) rhythm

With this rhythm, the excitation and contraction of the ventricles is carried out from a center located in the ventricles themselves. Most often, this center is localized in the interventricular septum, in one of the bundle branches or branches, and less often in Purkinje fibers.

Electrocardiographic criteria for ventricular rhythm (Fig. 77):

1) widened and sharply deformed (blocked) QRS. Moreover, the duration of this complex is more than 0.12 s;

2) heart rate 30–40 per 1 min, with a terminal rhythm less than 30 per 1 min;

3) R–R are equal, but may be different in the presence of several ectopic foci of excitation;

4) almost always the atrial rhythm does not depend on the ventricular rhythm, i.e. there is complete atrioventricular dissociation. Atrial rhythm can be sinus, ectopic, atrial fibrillation or flutter, atrial asystole; Retrograde atrial excitation is extremely rare.

Rice. 77. Idioventricular rhythm: Heart rate = 36 per 1 min, with V = 25 mm/s QRS - wide; R - absent.

Escaped (jumping, replacing) complexes or contractions

Just like slow rhythms, they can be atrial, from the AV junction (most often) and ventricular. This rhythm disturbance is compensatory and occurs against the background of a rare rhythm, periods of asystole, and therefore is also called passive.

Electrocardiographic criteria for escape complexes (Fig. 78):

1) the R–R interval before the jumping contraction is always longer than usual;

2) the R–R interval after the jump-out contraction is of normal duration or shorter.

Rice. 78. Slipping complexes.