Wandering Atrial Pacemaker and Ectopic Atrial Rhythms in Adolescents – Electrocardiographic Variants, Prevalence and Their Clinical Significance

Kozmin-Sokolov N. B.
PhD, Lecturer, Advanced Training Department¹

1 - St. Petersburg Medical College No. 2

Kozmin-Sokolov Nikolay; e-mail: super.kit62@yandex.ru

None declared.

The study had no sponsorship.

The results of the study of the prevalence of wandering atrial pacemaker (MAP) and ectopic supraventricular rhythms in adolescents based on the population-based clinical and electrocardiographic examination of 1242 adolescents aged 14-18 are presented. In the study, the expediency of the allocation of two groups of ectopic atrial arrhythmias is justified – arrhythmias associated with the manifestation of activity of the lower atrial centers of automatism (LACA) and arrhythmias associated with the manifestation of the activity of medium-atrial centers of automatism (MACA). ECG criteria for these two types of arrhythmias are proposed. Arrhythmias associated with the manifestation of activity of MACA (MAP to the middle divisions of the right atrium, middle atrial rhythm) were found in 26.4% of adolescents and were not associated with any diseases. Arrhythmias associated with the manifestation of the activity of the LACA (MAP to the lower parts of right atrium, lower atrial rhythm and complexes) were detected only in 12 adolescents (0.97%) – 5 of them are deemed healthy; one teenager is diagnosed with mild myocarditis; in the remaining 6 adolescents, no organic diseases of the cardiovascular system were detected, but chronic tonsillitis or other concomitant diseases were detected. Atrioventricular junctional escape complexes were found in 1 teenager actively engaged in sports. It is recommended in the analysis of ECG of adolescents to evaluate arrhythmias associated with the manifestation of activity of MACA, as a variant of the norm; arrhythmias associated with the manifestation of LACA as «borderline» conditions requiring additional examination.

wandering atrial pacemaker, ectopic atrial rhythms, adolescent electrocardiogram

10.29234/2308-9113-2018-6-2-79-93

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