Atrial premature beat

Introduction Atrial prematurebeats, referred to as atrial premature, originate from any part of the atrium outside the sinus node. Normal adults underwent 24-hour ECG monitoring, and approximately 60% had premature ventricular development. A variety of organic heart disease can occur in people with early onset, and often a precursor to rapid atrial arrhythmias. Symptoms of atrial premature beats are mainly palpitations, chest tightness, discomfort in the precordial area, dizziness, fatigue, intermittent pauses. There are also asymptomatic people. It may be that the contraction lasts for a long time and the patient has adapted. In addition, the symptoms of pre-contraction are closely related to the mental state of the patient. Many of the symptoms of many patients are due to the incorrect understanding of pre-contraction and fear, anxiety and other emotions.

Cause

Premature beats can occur in normal people. However, patients with cardiac neurosis and organic heart disease are more likely to develop. Emotional, nervous, fatigue, indigestion, excessive smoking, drinking or drinking tea can cause seizures, or no obvious incentives, digitalis, expectorant, quinidine, sympathomimetic drugs, chloroform, ring Toxic effects such as propane anesthetics, potassium deficiency, and cardiac surgery or cardiac catheterization can be caused. Coronary heart disease, advanced mitral valve disease, heart disease, myocarditis, hyperthyroidism, mitral valve prolapse, etc. are often prone to premature beats.

an examination

1. The P wave of the atrial premature beat occurs in advance, and the sinus P wave has different forms. If it occurs in the early stage of diastole, it is not the refractory period of the previous pulsation, which may cause conduction interruption (wave called block or premature atrial premature beat) or slow conduction (post PR) Period extension) phenomenon.

2. The P wave that occurs early in the premature atrial contraction can overlap with the previous T wave, and can not be transmitted to the ventricle, so no QRS wave occurs, which is easy to be mistaken for sinus arrest or sinus conduction block.

3. The T wave pattern should be carefully checked for abnormalities. Premature atrial contraction causes the sinus node to depolarize in advance, and thus includes the interval between the two sinus P waves before and after the contraction, which is shorter than the sinus PP interval, which is called incomplete compensatory interval.

4. If the premature atrial premature beat occurs later, or the refractory period of the tissue around the sinus node is long, the rhythm of the sinus node is not disturbed, and the inter-PP contraction is twice as high as that of the sinus before and after the contraction. Complete compensation for the interval.

Differential diagnosis

(1) Functional premature beats

It is not uncommon among young and middle-aged people, and most of them cannot find pathological incentives. It is often caused by nervousness, overwork, smoking, alcoholism, drinking tea, and drinking coffee. It usually occurs before quiet or before going to sleep, and the premature beat disappears after exercise. Functional premature beats generally do not affect the health of the body. After a period of time, most of these premature beats will be cured, so there is no need for treatment. However, we should pay attention to the combination of work and rest, avoid excessive tension and fatigue, be optimistic, have regular life, not overeating, excessive drinking, and proper physical exercise every day.

(2) pathological premature beats

Premature beats often occur in patients with myocarditis, coronary atherosclerotic heart disease, rheumatic heart disease, hyperthyroidism, mitral valve prolapse and digitalis poisoning. This is a pathological premature beat, occurring in the elderly or children. The number of premature beats increased after exercise. The original diagnosed as a heart disease, ECG examination often has other abnormal ECG changes in addition to premature beats. For pathological premature beats, it should be highly valued, and the hospital should be electrocardiogram in the morning, and treated under the guidance of a doctor. If there is a severe and frequent premature beat, it is best to be hospitalized for observation and treatment.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.