Sinus arrhythmia

Sinus arrhythmia is a violation of the heart rate, as a result of which there is a violation of the frequency of contractions and the rhythm of the heart. With sinus arrhythmia, cardiac contractions do not occur at the same time intervals, but at the same time, the co-ordination or correct sequence of contraction of the heart is maintained.

In certain cases, sinus arrhythmia can be represented as a physiological condition, for example, with breathing or after eating, after physical activity, and transferred stress. With sinus arrhythmia, a person can not notice absolutely no symptoms of its manifestation or they are weakly expressed.

Sinus arrhythmia of the cause of

In explaining the causes of sinus arrhythmia, several groups of disorders that cause it are distinguished.

Heart disorders are the main cause of severe sinus arrhythmia. Ischemic disease is in the first place among the factors of development. With this disease, there is an insufficient supply of oxygen to the heart muscle, which causes hypoxia, accompanied by a marked pain syndrome in the heart.

Myocardial infarction is also accompanied by severe sinus arrhythmia. With it, a definite site in the cardiac muscle is killed due to hypoxia, followed by scarring of the site. With heart failure, a condition is observed in which the function of pumping blood in the heart is violated, which is also accompanied by cardiac rhythm disturbances.

Cardiomyopathy manifests, in addition to arrhythmia, structural changes in the heart muscle. A certain role is played by acquired or congenital malformations of the heart;Myocarditis( inflammatory processes of the heart muscle).

Also, the causes of sinus arrhythmia may be states that are not related to the work of the cardiovascular system. So, with vegetative-vascular dystonia, the neurogenic nature of the appearance of sinus arrhythmia is observed. It should be noted that if the nervous system is disturbed, sinus arrhythmia is usually mild. With bronchitis or asthma, there is a certain hypocalic dysfunction, in which sinus arrhythmia may also occur. Also, for reasons of a non-cardiac nature in the occurrence of sinus arrhythmia of the heart, it can include: diabetes, disorders in the thyroid gland, adrenal gland diseases.

With the use of certain medications, reversible sinus arrhythmia can develop. This often happens after the use of drugs that stimulate the work of the heart( glycosides);Drugs that affect the rhythm of heartbeats( antiarrhythmic substances);Diuretics. The use of alcoholic beverages and smoking causes violations in the work of the heart, usually such violations become irreversible and even after quitting smoking or drinking alcohol, the arrhythmia persists, but has a weak character.

Sinus arrhythmia in pregnant women develops due to physiological characteristics and passes on their own after the birth of the child. This is due to an increase in the volume of blood and an increase in the burden on the heart.

Sinus arrhythmia in adolescents is observed during puberty because of the increased function of the hormone-producing organs( adrenal glands, genitals, thyroid gland).Such an arrhythmia passes independently after the end of puberty.

Sinus arrhythmia symptoms

The normal pulse of cardiac contraction begins its formation in the sinus node. This node is a group of certain cells that are in the heart wall and produce an electrical impulse. After that, this impulse flows through the fibers in the heart wall, which are called the conductive system of the heart. Such a system diverges into a large number of fibers, of which the smallest have their ending in each muscle fiber of the heart wall. As a result, with the physiological origin of the cardiac pulse, the cardiac muscle works rhythmically and smoothly, that is, the contractions are made through an equal time interval with its optimal frequency of about 60-90 beats / min.

It should be noted that the conducting system is responsible for the correct operation and consistency of ventricular and atrial contractions. If certain disorders occur in this system, then this leads to the emergence, first of all, of heart diseases, and as a result, sinus arrhythmia of the heart.

Sinus arrhythmia is represented by a variety of symptoms depending on the frequency of contractions of the heart muscle. With an increase in the frequency of contractions, there are: shortness of breath, a feeling of lack of oxygen, a sensation of pulsation in the temples and in the heart area, a pain syndrome behind the sternum or on the left in the chest area. With a decrease in the frequency of contractions, weakness, headache, dizziness are noted.

Severe sinus arrhythmia is accompanied by impaired blood flow to the brain, which can lead to loss of consciousness. Moderate sinus arrhythmia has no significant symptoms.

Diagnosis of sinus arrhythmia is established based on patient complaints and survey data. Carry out electrocardiography, which helps to detect changes in heart rate. Also used Holter monitoring - prodeduru, consisting in wearing a small device type ECG for 24 hours. When wearing a holter, a diary of records is kept, which includes daily activities of the patient( eating, climbing stairs, lifting weights, going to sleep and waking up from him, emotional swings, etc.).After the removal of the device, decryption is carried out, with the results on the conclusion sheet.

In some cases, cardiac uzi diagnosis is performed. In addition to ECG, ultrasound and holter, it is necessary to conduct a biochemical analysis of urine and blood, as well as the study of sex hormones to identify non-cardiac causes of sinus arrhythmia.

Sinus arrhythmia in children

Sinus arrhythmia in children and adolescents is a frequent condition, and is mainly caused by physiological conditions, for example, such as respiratory arrhythmia. But also it can lead to: congenital heart diseases, vegetative-vascular dystonia and hormonal changes, especially in adolescence.

The diagnosis of this disease is determined on the basis of the examination and the results of the examination. They collect anamnesis of complaints about the feeling of "heaviness" in the heart, weakness and shortness of breath. Establish a period of occurrence of such symptoms and the causes associated with such conditions in the child. Conduct a general examination of the child with ascultation and listening to the pulse. Also apply percussion of the heart, in which it is possible to detect a disturbance in the work of the heart caused by sinus arrhythmia. Carry out electrocardiography with exercise and no load, ultrasound examination of the heart with the use of Doppler. With severe arrhythmia Holter research is required.

Consultation of pediatrician and children's cardiologist is obligatory, in some cases it is important to undergo examination from an endocrinologist and neurologist. Often, if there are abnormalities in the work of the central nervous system, there is a worsening of the cardiac system, so it is important to exclude the pathology of the nervous system.

Treatment of sinus arrhythmia in children should include proper organization of work and rest. It is desirable to conduct treatment in a sanatorium. This applies to arrhythmia of mild or moderate severity. With severe arrhythmia of the sinus node, treatment is performed in pediatric cardiology.

First of all, the child is assigned a diet with restriction of simple carbohydrates and the intake of a large amount of fiber( vegetables and fruits).An important condition is the use of psychotherapeutic methods of treatment to restore the emotional state of the child and limit it from stress. A good result is the method of acupuncture and physiotherapy.

It is important to note that in itself such an arrhythmia does not give special complications, but it can have a combination with complications of another, more serious disease. Frequent complications are cardiac dysfunction or cardiac insufficiency.

It is important for the child to create conditions for the prevention of sinus arrhythmia of the heart. These include: proper nutrition, work and rest regime, intake of vitamin supplements and amino acids( Elkar ½ tsp 2p / day), restriction from stressful situations, smoking and alcohol refusal( concerns adolescents), early diagnosis and treatment of cardiac pathologiesVascular system and other organs.

Sinus arrhythmia ECG

Sinus arrhythmia on ECG is defined in periodic changes of R-intervals, where R is represented by more than 0.1 second and often depends on the type of breathing. A characteristic ECG-sign of this disease is a slow change in the time duration of the R-interval, where R after a short interval infrequently follows a long one. And also with sinus tachycardia or bradycardia, an increase and decrease in the R-interval, where R is due to the TP intervals. Significant violations of P-Q intervals and Q-T intervals are important.

In normal heart function, the centers of automatism of ectopic nature, as well as those located in its atria, have a lower rate of diastolic depolarization and a small pulse frequency than the sinus node. Because of this, sinus impulses, flowing through the heart muscle, excite both the contracting myocardium and the fibers of the heart tissues, thereby violating the diastolic depolarization of those cells that are concentrated in ectopic centers. As a consequence, the sinus rhythm does not allow the ectopic centers to function. Certain fibers accumulate in the right atrium in front in the upper part, in the middle part laterally in the wall and in the lower part near the right septum with an artioventricular orifice. The left atrium includes the location of such centers at the top of the back and at the bottom. In addition, cells from the automatic centers can be in the region of the lower-left region of the right atrium in the coronary sinus mouths.

Automatism of other centers and atrial automatism can show its work in such cases, when: when the automatism of the sinus node decreases, the level of automatism in the ectopic center decreases;With increased function of automatism in the atria of the ectopic center;With blockade of the sinoatrial character, and also in other cases of long pauses in the excited work of the atria. The rhythm of the atria can be observed for several weeks, months and even years, and can also be persistent. It can be short, for example, if it is determined in long intervals between cycles with sinus arrhythmia of the heart, blockade of the sinoatrial character and other forms of arrhythmias.

A change in the shape, amplitude, and direction of the P-tooth is considered a definite sign of the altered rhythm in the atria. This tooth changes depending on the location in the ectopic source of rhythm and speed with the direction of the wave with excitation in the atria. For the atrial rhythm, the P-tooth is in front of the QRS complex. In a large number of examinations of this rhythm, the P-tooth has a difference from the P-wave of the sinus rhythm in the direction downwards or upwards from the isoline. Also, their differences are found in shape or amplitude in different leads. An exception may be a rhythm from the upper region of the right atrium, in which the P-tooth is similar to the sinus.

Very important is the difference in the atrial rhythm that changed the sinus one in one patient according to the heart rate, the duration of Q-P intervals and the greatest regularity. The QRS complex of the supraventricular region can be aberrant, in combination with the blockade of the legs of the bundle with a heart rate of 45 to 70 beats / min. With a rapid atrial rhythm, the heart rate is 71-100 beats / min( more rapid rhythm is referred to as sinus tachycardia).

Sinus arrhythmia treatment

Often, heart rhythm disorders go away without any treatment after eliminating the cause that caused them. In other words, they do not require specific or specific treatment. But despite this, with pronounced sinus arrhythmia, it is necessary to carry out drug therapy. With this form of arrhythmia, both therapeutic methods and cardiac pacemakers can be used. This type of therapy is used, as a rule, with pronounced sinus bradycardia( slowing the frequency of heart contractions), which is accompanied by a periodic loss of consciousness.

The choice of medication is determined by the characteristic and individual characteristics of the organism and should be determined exclusively by the cardiologist. But in cases where sinus arrhythmia is caused by emotional instability or stressful situations, the therapy can also be prescribed by a neurologist. With such causes of sinus arrhythmia, sedatives are prescribed( Novopassit according to Table 2, 3 tablets, Valerian or Pustyrnik according to Table 2, 4 tablets, Kovrolol for 25 caps 3 r / day) and nootropics( Pantogam 1 tab. 3P / day, Glycine according to 1 table 4 p / day under the tongue, Picamellone at 40 mg 2p / day, Cetirizine according to 1 table 2p / day).But in some cases, you may need tranquilizers and neuroleptics, which are prescribed directly by the psychiatrist.

With sinus arrhythmia with a heart rate of less than 50 per minute( in athletes less than 45 per minute), at which there is a pronounced violation of central hemodynamics, it is important to resolve the issue of installing a pacemaker. This device is implanted under the skin in the area of ​​the clavicle and has a miniature size. With the help of certain programs, an electric pulse is sent, which is conducted along the electrodes to the atria and ventricles. The device starts its work when its frequency of contractions reaches the lower limit of the critical mark.

Also in the treatment of sinus arrhythmia, general recommendations should be followed, in which a diet with a restriction of flour, fatty and sweet, a restriction of physical activity and stressful moments is prescribed. It is necessary to take a multivitamin( potassium asparcam and magnesium sulfate).Mandatory in the treatment of arrhythmia is phytotherapy( chamomile, sage, raspberry leaf, etc.) and physiotherapy without the use of current( Magnetolaser).

Sinus arrhythmia in pregnancy, as a rule, does not require specific therapy, as it often passes after childbirth, but pregnant women still need to take precautions and preventive measures. These include: the advance setting of a pregnant woman to the perinatologist;A timely visit to the perinatologist( once a month to 12 weeks, once every two weeks to 30 weeks, once a week until the end of pregnancy);Conducting various surveys during pregnancy( Holter study, ECG, echocardiography);Taking multivitamins for pregnant women;Balanced and rational nutrition with a large amount of fiber;Mandatory observance of the rest and labor regime;Limitation of stressful situations.