Migration of the supraventricular pacemaker in children

All the causative factors that trigger migration in adults are divided into two groups.

  • Increased tone of the parasympathetic nervous system;
  • Dyshormonal disorders (in adolescents, in pregnant women, during menopause);
  • Vegetative dystonia;
  • Violation of electrolyte metabolism with hypoxia, ac >

Migration of the pacemaker during pregnancy may be due to increased stress on the heart and blood vessels:

  • due to an increase in the volume of circulating blood;
  • as a result of emotional and physical stress during childbirth.

Arrhythmias are dangerous conditions for both a woman and a fetus. In conditions of insufficient blood supply, the fetus is poorly provided with nutrients and oxygen, which leads to hypoxia and developmental delay.

If there is no organic pathology, after the birth of a child, the symptoms of arrhythmia go away without treatment.

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Most often, the pathology does not have pronounced signs. However, the following symptoms may occur:

  • heart rhythm disturbance;
  • constant fatigue;
  • headache;
  • discomfort and heaviness in the chest area;
  • fatigue;
  • dizziness;
  • the occurrence of cold sweat;
  • soreness in the heart zone;
  • dyspnea;
  • general weakness.

Signs on the ECG are manifested in the form of displacements:

  • within the sinus node (this condition is called migration of the sinus rhythm, it is difficult to diagnose);
  • in the atria (pacemaker migration in the atria);
  • in the atrioventricular node.

On the electrocardiogram, there is also a change in the P-wave and the duration of the atrioventricular interval (its shortening and gradual lengthening, or vice versa).

When signs of pathology appear, additional research methods are prescribed to establish the root cause.

Signs on an ECG

What do the teeth on the ECG mean:

  • tooth P characterizes the state of the atria;
  • PQ – time of atrial ventricular conduction;
  • QRS – reflects the electrical activity of the ventricular complex;
LocalizationType of arrhythmiaECG signs
Atrial Ventricular Node – AV ConnectionVentricular extrasystole
  • Expansion and distortion of the ventricular complex QRS.
  • Before extrasystole there is no tooth R.
  • Omnidirectionality of the same teeth with respect to the isoelectric line.
  • The onset after systole of a full compensatory pause.
Atrioventricular nodeParoxysmal tachycardia
  • A series of consecutive extrasystoles is recorded on the ECG.
  • The P wave is absent either as a result of a merger with the QRS complex, or when
  • The pulse does not pass when it is generated in the middle sections of the node.
Sinus node, SSSUAtrial fibrillation according to bradysystolic type
  • The sinus rhythm disappears cyclically – the migration of the pacemaker through the atria is established.
  • Bradyarrhythmia.
  • The absence of the P wave in all standard and most additional leads.
  • Unstable (increase or decrease) indicators of RR intervals.
Sinus nodeSupraventricular or supraventricular tachycardia
  • Several consecutive ectopic teeth of R.
  • Truncated ventricular QRS complexes.
  • Increased rhythm frequency.

Manifestations of pathology in children and adolescents

In children, the causes of the ailment are the same as in adults. They are extracardiac and cardiac. Pathology develops against the background of ischemia, rheumatism of the heart, with myocarditis, congenital malformations of the organ.

Infectious diseases (especially tonsillitis) and vegetovascular dystonia often provoke the disease. A development factor is also considered stress. In many cases, the violation affects the sinus node.

In a child, symptoms can manifest as increased fatigue, lethargy and moodiness, loss of strength, and poor appetite. He may complain of pressing pain in the heart, shortness of breath, weakness and soreness in the muscles.

Rarely, various disorders occur from the gastrointestinal tract, urinary system.

Sometimes pressure may increase, dizziness and fainting may occur. With pathology in children, a deviation in physical and mental development (delay) is observed. Often there is insomnia and hypersensitivity to any change in weather.

In a teenager, this condition provokes endocrine or neurovegetative disorders.

Doctors say that sometimes no symptoms are observed in children, and pathology is detected only with electrocardiography.

Migration of a pacemaker: what is it, causes and symptoms, treatment and consequences

The coordination of the work of the heart is provided by a group of nerve cells, which is called the “conducting system”.

They are responsible for the correct sequential contraction of the heart muscle to create a constant and sufficient flow of blood to the internal organs: the brain, kidneys, lungs, etc.

One of the disturbances in the conductive system is the migration of the pacemaker (pacemaker). How to suspect this condition and treat it successfully is described in this article.

A conductive system consists of two main components:

  • Rhythm drivers are groups of cells that set the pace of the heart and support its constant functioning. There are only four of them:
Heart pacemakerPace, sets the driver (in a calm state of a person), heartbeats / minlocation
Sinus node60 – 95At the top of the right atrium.
Sinoatrial node40 – 59On the border between the ventricles and atria in the interatrial septum, it is somewhat displaced up.
The initial section of the bundle of His20 – 39In the initial ventricle, in the atrial septum.
Purkinje Fibers15 – 19Branched in the muscle tissue of the ventricles.
  • Conducting bundles / pathways: atrial bundle; 3 sinoatrial bundles; 2 legs of branch block, dividing into branches.

Normally, the main driver of the heart rhythm is the sinus node – only it is able to provide the necessary frequency and sequence of activation of muscle tissue for sufficient “pushing” of blood into the vessels.

When it is damaged and / or increased electrical activity (moving a true pacemaker) of other groups of nerve cells, heart control is intercepted at the sinus node. If this process is realized before the pulse passes through the atrioventricular node, the pacemaker migrates through the atria with supraventricular arrhythmias.

Pathology groupDiseaseWhat it is?
Diseases and injuries of the cardiovascular systemCoronary heart disease – IHD abbreviatedIt occurs due to blockage of the cardiac arteries and the development of energy and oxygen deficiency in the tissues of the body (insufficient flow of blood and nutrients). IHD includes a heart attack, muscle replacement with connective tissue fibers (cardiosclerosis), the appearance of periodic pressing pains behind the sternum (angina pectoris), and a number of other pathologies.
CardiomyopathyGenetically determined changes in the normal structure of the heart. They can be manifested by excessive expansion of its cavities, an increase in wall thickness, a decrease in the total volume of an organ, and a group of specific arrhythmias.
MyocarditisInflammatory processes in the middle (myocarditis) or outer (pericarditis) membranes of the heart, which can be caused by the action of microbes and toxins, as well as autoimmune reactions (immunity cells attack healthy tissues).
Violation of the structure of the heart valvesIncomplete closure (insufficiency) or opening (stenosis) of the valves develops due to bacterial endocarditis or a violation of intrauterine development (defects). Migration of the pacemaker through the atria of a child often occurs due to valvular defects.
NNST (connective tissue dysplasia)Congenital pathology leading to a violation of the normal structure of connective tissue fibers. Migration of the pacemaker in children is often associated with NNST, as this condition is one of the causes of valvular pathology.
Carried out operations on the heart muscleAny mechanical intervention on the organ (blow to the chest area, cardiac surgery, wounds, etc.) carries the risk of damage to the structures of the conduction system of the heart.
Heart injuries
Hormonal disordersHyperthyroidismHyperthyroidism (hyperthyroidism) or a tumor of the adrenal gland, leading to an increase in the concentration of catecholamine hormones in the blood (pheochromocytoma) stimulate the heart and increase the frequency, strength of the heartbeat. Due to excessive organ activation, the risk of arrhythmia is high.
Adrenal insufficiencyA change in the balance of potassium, sodium ions in the body leads to disruption of the functioning of the conductive system.
Active aldosteroma (Conn syndrome)
Taking certain drugs, toxins
  • nitro-containing drugs (Nitroglycerin, isosorbide dinitrate and mononitrate);
  • some anticancer pharmacological products (Doxorubicin, Dactinomycin);
  • potassium preparations;
  • a number of antiarrhythmic drugs (“Quinidine”, “Morazizin”, “Etatsizin”, etc.).

In the absence of a visible reason, after a comprehensive examination of the patient, it is permissible to use the term “idiopathic rhythm disturbance”. It means that at this stage it is not possible to identify a specific mechanism for the development of the disease and treatment will be carried out on the basis of existing symptoms.

Migration of the supraventricular pacemaker (from the sinus node) can have 3 variants of the clinical course:

    Asymptomatic. Arrhythmia is detected during a routine examination when taking an electrocardiogram, while the patient does not show any complaints.

ECG picture of sinus arrhythmia

  • The development of parkosmal / non-paroxysmal tachycardia. This option is manifested by a persistent increase in heart rate and contractions of the heart (paroxysmal form) or periodic bouts of increase in the rate of “pumping” of blood throughout the body. In addition to the feeling of “heartbeat”, a person may be disturbed by poor tolerance of mental and physical stress, decreased working capacity and great fatigue during the day, discomfort in the heart and spontaneous attacks of unpleasant emotions, in particular fear.
  • The development of bradyarrhythmia. Even with a significant increase in the number / speed of generated pulses in the atrium, the heart rate (HR) may not exceed 60 beats per minute. This is due to the slowing down effect of other pacemakers, which are located below the point of formation of the electrical impulse.
  • Bradycardia is rarely felt by a person. More often there are complaints of drowsiness, episodes of “turbidity” and even loss of consciousness, distraction and fatigue.

    It should be noted that the violation of the pacemaker in the asymptomatic variant can progress and eventually manifest itself with the above symptoms. Therefore, when revealing a pathology on the ECG, the diagnosis and treatment of the disease should not be postponed until the state of health worsens.

    The number of rhythm disturbances in childhood is progressively increasing – over the past 10 years there has been a threefold increase in these pathologies. Parents should be on their guard and pay attention to the detected episodes of too frequent / slow heartbeats, do not forget about the passage of preventive examinations.

    Often, violations detected in childhood are inherited from the father or mother and are of a genetic nature. Therefore, if parents from a young age suffer from arrhythmias, the risk of having this disease in the child increases.

    Among the features of the clinical picture, it should be noted that the migration of the pacemaker in children often has an asymptomatic, asymptomatic course. It can not manifest itself in any way and is determined solely on the ECG or manifest itself with the following signs:

    • episodes of heart palpitations;
    • persistent bradycardia;
    • fatigue and constant drowsiness of the child;
    • rapid breathing.

    Diseases of the cardiovascular system are different in type, characteristics and risks of fatal results.

    Many do not bring visible discomfort until a certain point; they are discovered by chance during a thorough diagnosis. In approximately 60% of cases, we are talking about acquired pathological processes.

    These include the described condition. Migration of a pacemaker is a deviation during which a spontaneous movement of electrical activity from the right atrium to other areas of the muscular organ is noted. But in the ventricles – extremely rare.

    Treatment is carried out under the supervision of specialized specialists; lifelong maintenance therapy is possible. The bottom line is to eliminate the root cause, but it is not always possible to radically affect the etiological factor.

    Despite the menacing name, deviation in itself carries minimal danger. It is necessary to evaluate what is behind it and then to predict the outcome.

    Development mechanism

    A pacemaker is a dense cluster of active cardiomyocyte cells that can spontaneously become excited.

    Their main function is to generate a bioelectric pulse that passes through the entire muscular organ and causes myocardial contractions.

    Without this, there can be no normal blood circulation, as soon as the process weakens, generalized hemodynamic disturbances occur, fraught with imminent death. Another name is the sinus node. It is located in the upper segment of the right atrium.

    If the cardiac structures are disturbed by the type of pacemaker migration, the signal source moves to other chambers, including the involvement of the ventricle, atrioventricular node (this anatomical structure enters the “game” when the sinus node is disturbed, as an auxiliary element, in the normal position he is responsible for the distribution of momentum).

    In contrast to atrial fibrillation, when the signal is chaotic and occurs immediately in many parts of the heart, migration is accompanied by regular contractions and the only source of impulse, albeit displaced.

    In this case, the intensity of the produced stimulus may be insufficient for the full functioning of the myocardium.

    In such a situation, there is a significant risk of fibrillation, flutter, atrial extrasystole, and other dangerous arrhythmias, fraught with cardiac arrest.

    Types of Violation

    The migration classification criterion is based on the localization of the bioelectrical activity site.

    Accordingly, they talk about three options:

    • The signal is generated in the left atrium. Relatively frequent type. It occurs in 90% of cases or so. It is accompanied by minimal symptoms. Migration is unstable, at some point the cardiac structures again change places.
    • The impulse is produced in the ventricles. It is much more dangerous, since there is a risk of spontaneous cardiac arrest without preliminary symptoms.
    • There is an alternating wandering movement of the active site. For a short period of time. In such a situation, the signal spontaneously moves from one camera to another. This type also carries enormous danger.

    ECG signs

    Methods of diagnosis

    The examination begins first with a medical history and physical examination of the patient. After that, additional methods are applied.

    Diagnose pathology help:

    • electrocardiography (ECG);
    • echocardiography;
    • Ultrasound of the heart;
    • Holter monitoring.

    In addition, the patient is required to undergo laboratory examinations:

    • general blood test;
    • biochemical blood test;
    • Analysis of urine.

    Other methods of investigation may be prescribed to make an accurate diagnosis. With this pathology, a consultation with a cardiologist and therapist is necessary.

    First of all, treatment is aimed at eliminating the root cause that triggered the ailment. For example, in inflammatory and infectious diseases, antibiotic therapy and anti-inflammatory drugs are prescribed.

    Specialists often prescribe medications to patients that improve metabolic processes in the heart muscle.

    During therapy, the following recommendations must be observed:

    1. Get enough sleep and relax.
    2. Exclude physical and psycho-emotional overstrain.
    3. Stop smoking and drinking alcohol.

    In the case of a severe course of the disease, cardiac surgical methods of treatment are prescribed. Often, with a surgical intervention on the heart, a pacemaker is used.

    After treatment, the patient should lead a healthy lifestyle to prevent the re-development of pathology.

    If signs of rhythm disturbance are detected on electrocardiography, the following examination methods are prescribed to clarify the diagnosis:

    • General blood test – according to indicators, you can judge the presence of inflammation.
    • A biochemical blood test reveals a violation in the mineral, protein, lipid and carbohydrate metabolism.
    • A chest x-ray detects a change in the size and shape of the heart.
    • Echocardiography is an ultrasound diagnostic method used to study the structural and functional lesions of the valvular apparatus of the heart and myocardium.
    • Phonocardiography complements auscultation. On inhalation and exhalation, the device records heart murmurs at the time of myocardial contraction.
    • Holter ECG monitoring evaluates myocardial activity, records cardiac abnormalities that are not detected during routine electrocardiography.

    Possible complications and prognosis

    With this ailment, dangerous consequences usually do not develop. However, the underlying disease can cause complications.

    Most often, the following occurs:

    • heart failure;
    • myocardial infarction;
    • heart block.

    If migration manifests itself as an individual characteristic of a person, is detected by chance during an ECG and does not need treatment, this means that the prognosis is favorable.

    If the heart rhythm disorder is caused by organic pathology, then the prognosis depends on the course of the disease, which was a provocateur of the development of this pathology. Everything here individually and in advance cannot be said.

    In this article, you will learn how doctors detect pacemaker migration, why it occurs, and whether it is dangerous. How can she bother a person? Is it possible to get rid of her?

    The author of the article: Victoria Stoyanova, category 2 doctor, head of the laboratory at the diagnostic and treatment center (2015–2016).

    Migration of a pacemaker is the movement of a source of impulse that makes the heart beat from one place to another. Normally, the pulse should always be formed in the sinus node. It is located at the top of the right atrium. When the impulse begins to be generated by different parts of the atria, we are talking about the migration of the pacemaker.

    Normal pulse formation in the sinus node

    Migration of a pacemaker is dangerous because it can be a sign of cardiovascular disease. Also, with it, the tendency to atrial arrhythmias, for example, atrial flutter, increases.

    If you have detected this feature on an ECG, consult a cardiologist or arrhythmologist.

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    If the pacemaker’s migration was caused by a disease, then it can be eliminated only after the underlying disease has been completely cured. If it is not accompanied by any pathologies, it can disappear on its own with age.

    If the migration of the pacemaker is not caused by diseases, but is your individual feature, then the prognosis is favorable. Usually, the causeless migration of the pacemaker is detected in adolescents and young people. With age, it can pass.

    If this ECG abnormality was caused by diseases of the cardiovascular system, the prognosis is conditionally favorable. Improving the condition is possible only with the timely and proper treatment of the causative disease.

    Types of Violation

    Accurate identification of the type of process is necessary for the development of therapy tactics, along with the identification of the origin of the deviation from the norm.

    Migration of the supraventricular pacemaker is an arrhythmia in which the impulse moves from the sinus node to the atrioventricular.

    It occurs in 5-10% of all cases, but carries a great danger, since the signal ceases to be distributed in the correct sequence.

    The result is a symptomatic complex that resembles the blockade of the legs of the bundle of His and carries the same threats.

    Cardiac causes

    Development factors are not always cardiac. They account for only 60% of clinical cases. Many neurogenic moments, some situations the patient causes himself.

    The causes in children, adolescents and adults are the same:

    • Myocarditis. Inflammation of the muscle layer of the organ. Presented by a group of clinical options. The main one is infectious, provoked by viruses, less often bacteria.

    Always secondary to other pathologies. It can cause inflammation, including tonsillitis, caries, and others. Urgent in-patient treatment with antibiotics is required.

    Detoxification therapy is indicated in any case to alleviate the condition and reduce the likelihood of cardiac arrest.

    The second clinical option is an autoimmune process. It occurs against the background of current rheumatism and other diseases of this kind. It is stopped by immunosuppressants in shock dosages.

    If you do not help in a timely manner, there is a risk of atrial destruction. Complex prosthetics without guarantees of effect will be required. Migration of the pacemaker is due to the destruction of active cells. This is a compensatory mechanism.

    • Heart defects, both congenital and acquired. The aorta most often suffers, valve stenosis (including mitral) is observed, and other options.

    With genetic abnormalities, violations of a mixed plan are possible. Not only cardiac structures suffer, but also other systems.

    Many conditions go unnoticed for years, the process is detected at peak periods: puberty, physical overload, emotional shock, and other moments play the largest role.

    With stubborn ignoring of symptoms, the diagnosis is made during an autopsy.

    • Inflammation of the pericardial sac – pericardium. There is a compression of the organ, which ends with the ectopia (shift) of the pacemaker.
    • Rheumatism. Autoimmune pathology. The exact origin is not known. It is assumed that all viral infections are to blame. A complete cure is not possible. The migration of the pacemaker cannot be eliminated radically either. But there are good chances to translate the process into a stable remission.
    • Cardiomyopathy The growth of the muscle layer of the organ, also the expansion of the chambers. The likelihood of developing an ectopy of the site of electrical activity is approximately 20%. It may be higher with a mixed etiology of the process.
    • Coronary artery disease. Disorders of the functionally active tissues of the coronary arteries. Sooner or later, leads to acute necrosis or cell death.
    • Postponed heart attack. Accompanied by migration almost always, the intensity of the violation is higher, the more extensive was myocardial damage.
    • Sick sinus syndrome. The result of previous diseases or an innate feature of the body. It consists in the inability of the natural pacemaker to produce a signal of sufficient strength to fully reduce the myocardium. As a compensation, the body activates other cardiomyocytes.

    In addition to strictly hearty moments, there are other reasons of an objective nature that do not depend on the patient’s behavior and habits:

    • Vegetovascular dystonia. Or VSD. Contrary to the claims of many experts, a diagnosis is not considered. This is a symptomatic complex.

    It is inherent in patients with past or current pathologies of the central nervous system, brain appendages. It can also be triggered by a violation of the hormonal background.

    In this case, the deviation is associated with the activation of the vagus nerve. It requires urgent identification of the origin, then relief of symptoms and the prevention of repeated attacks are indicated.

    • Viral and infectious inflammatory pathologies. From a simple cold and SARS to tuberculosis, other conditions of a dangerous nature. As treatment progresses, the result is different. In the absence of gross defects, a complete restoration is likely.
    • Endocrine Disorders Hyperthyroidism, excessive synthesis of hormones of the adrenal cortex, excess of specific substances of the pituitary gland, androgens, angiotensin, aldosterone, renin.

    The treatment is to normalize the background. As you achieve this goal, well-being improves. But if there are defects in the development of the heart, as an option, cardiomyopathy, full compensation can not be expected.

    External Factors

    Other points are related to the behavior of the person himself:

    • Long-term use of drugs to stimulate the work of the muscle layer of the organ – cardiac glycosides. These are dangerous pharmaceuticals. They are prescribed according to indications, they are not suitable for long-term self-administration. At the end of the application, improvement is possible.
    • Intense stress. Resistance to nervous tension is different for everyone. Persons with a weak, inert type of central nervous system are more susceptible to psychosomatic pathologies. Including with the migration of a pacemaker without organic reasons.
    • Physical activity, not adequate to the level of human development. Overload yourself with activity is not worth it, especially if the preparation is insufficient. There is not only migration of the pacemaker, but also the formation of additional abnormal foci of electrical activity in the atria and ventricles. It ends in failure: fibrillation, organ shutdown, death.
    • Lack of trace elements, including potassium, magnesium, iron (to a lesser extent). Metabolic deficiency processes occur in patients with malnutrition, cachexia, anorexia, taking diuretics on a regular basis.

    The reasons must be determined by the exclusion method.

    Out of touch with a specific organic defect, they speak of an idiopathic, that is, an unidentified form. When the fact is there, and the reason for the origin cannot be determined.


    The study of manifestations will not bring a significant effect if you look for strictly specific signs. There are none. The clinical picture corresponds to the main process. Several groups of symptoms can be distinguished.

    Actually cardiac pathology. Accompanied by such components:

    • Chest pain of varying degrees of intensity. Patients usually do not pay attention to them, because episodes of discomfort are short-lived, from a few seconds to a couple of minutes. Everything is attributed to fatigue, change of weather or stomach problems. The nature of the sensation is pressing, burning.
    • Dyspnea. Against the background of intense physical activity. As the pathological process progresses, it is at rest.
    • Cough. Dry, without sputum. For a long time. Strengthens at night and in a horizontal position, which indicates its cardiac origin.
    • Arrhythmia. The most characteristic feature. It usually manifests itself in the form of an increase in the frequency of contraction (tachycardia). The reverse process is less often observed. Dangerous types, such as fibrillation, are found in complex or advanced cases. Requires compulsory surgical treatment.
    • Increased sweating, especially at night.
    • Pallor of the skin, cyanosis of the nasolabial triangle. Not always.

    Possible swelling of the extremities, face, pain in the liver, decreased blood pressure, dizziness, cephalgia, nausea and vomiting. Depending on the underlying diagnosis.

    The complete clinical picture is most typical of tricuspid valve malformations.

    • Decrease in heart rate.
    • Excessive saliva production.
    • Cold feeling in limbs.
    • Drop in blood pressure.
    • Fainting.

    This is a symptomatic complex of vegetovascular dystonia. Manifestations are not always present. Occur at the time of the attack.

    How is the treatment carried out?

    If research methods have not revealed organic damage to the heart, then only observation is recommended.

    With cardiovascular causes of arrhythmias, the main rule is the treatment of the underlying disease.

    Name of the diseaseTherapies
    Coronary heart diseaseConservative therapy:
    • Thrombosis prophylaxis: Aspirin, Cardiomagnyl.
    • Means that reduce myocardial oxygen demand: Metoprolol, Atenolol, Bisoprolol.
    • Statins – drugs that lower blood cholesterol: Simvastatin, Atorvastatin.
    • Vascular spasm prevention – ACE inhibitors: enalapril, lisinopril.
    • Anti-ischemic drugs: calcium channel antagonists (Verapamil), nitrates (Nitroglycerin).
    • Surgery
    • Coronary Angioplasty
    • Coronary artery bypass grafting.
    Syndrome of weakness of the sinus nodeArtificial pacemaker.Myocarditis
    • Etiological treatment: antibiotics, antiviral drugs.
    • Pathogenetic therapy.
    • Antiarrhythmic drugs prevent the development of atrial and atrial fibrillation: Coronal, Propafenone.
    • Anticoagulants: Warfarin.
    • Blood clot prophylaxis: Aspirin, Trombonyl.
    • Anti-ischemic drugs: Mexico.
    Heart defects
    • In the initial stages – conservative therapy.
    • Diuretics: Hypothiazide, Furosemide.
    • ACE inhibitors: Captopril, Enalapril.
    • B-blockers: Losartan, Loviten.
    • Cardiac glycosides: Digitoxin, Celanide.
    • With the development of heart failure – surgery to replace the valve.
    Hypotonic vegetative-vascular dystonia
    • Sedative medicines: Novo-passit, Persen.
    • Tranquilizers: Seduxen.
    • Drugs that improve cerebral circulation: Vinpocetine, Nimodipine.
    • Balanced diet.
    • The mode of work and rest.
    • Dosed physical activity.

    Preventive measures

    To prevent the occurrence of this pathological condition, doctors advise to adhere to such rules:

    • eat fully (do not overeat, reduce the consumption of animal fats, add fresh fruits, vegetables, greens to the diet);
    • refuse to drink alcohol;
    • quit smoking;
    • engage in moderate exercise;
    • control weight (avoid obesity);
    • avoid conflict and stressful situations.

    In addition, it is important to follow the recommendations for the prevention of angina, a complication of which is damage to the muscle fiber of the heart.

    Also, the prevention of an ailment is considered the passage of planned medical examinations and timely treatment of various diseases.

    Consultation with a doctor is required

    Kushakovsky M.S. Arrhythmias of the heart. S-P .: Tome, 2007. Chazov E.I., Golitsin S.P. et al. Guide to heart rhythm disturbances. Geotar Media, 2008

    • Choose a suitable cardiologist
    • To pass analyzes
    • Get a treatment regimen from a doctor
    • Follow all recommendations

    Why does pacemaker migrate?

    In order to imagine what the pacemaker migration is, you need to understand how the conduction system of the heart is arranged and what ensures the normal functioning of the entire cardiovascular system.

    A complex of heart structures consisting of muscle fibers is responsible for the automatic function of the main organ. The main part of this conductive department is the sinus node, as well as the antiveventricular connection, since it is from there that the electrical impulse originates.

    The sinus node is located in the right atrium and consists of interwoven muscle fibers and nerve endings, which is the pacemaker.

    Another pacemaker is the antrioventricular node, which is located in the area located between the ventricle and the atrium, and it begins to act in case of violations in the sinus node.

    Migration of a pacemaker: what is it and what consequences can turn around, only people with special education know.

    In fact, pathology is considered a type of arrhythmia and occurs against the background of a disorder in the sequence and speed of contractions of the organ, at which the rhythm driver changes periodically.

    Impulses of nerve fibers are directed from the site of the sinus node to some areas of the atria, and then to the antrioventricular junction.

    When a person’s physiology is disturbed, electrical signals cease to flow normally into the region of the main organ, the heart rhythm changes, arrhythmia develops, a variety of which are disorders such as an increase in heart rate (tachycardia) or a decrease in this indicator (bradycardia). More often, such a disease can affect an adult, but such pathologies are not excluded in a child. Migration of the pacemaker through the atrial zone is considered the most common form of the disease.

    Arrhythmia is a fairly common disease in which complications rarely occur. Only atrial fibrillation and ventricular fibrillation can lead to deadly consequences.

    Timely examination and treatment will help to keep the disease under control and prevent the deterioration of human well-being. Often, pathology affects adolescents, and the reason for this is a change in the hormonal background.

    In this case, panic is not worth it, usually cardiac activity is restored and comes back to normal on its own.


    Doctors categorize symptoms as the migration of the supraventricular type pacemaker and the migration of the ventricular pacemaker, each of these types of diseases can have its own symptoms. The first type of disease is much more common than the second. Despite the fact that the ailment affects the main organ of the body, its manifestations may be completely absent for a long time or may have a character.

    Symptoms of supraventricular pacemaker migration:

    1. weakness, loss of strength;
    2. a feeling of interruption in the activity of the heart;
    3. chest pain;
    4. excessive sweating during an attack;
    5. dizziness.

    The disorder in the transmission of electrical signals from the atrial zone to the ventricular region provokes a slowdown in heart contractions, which causes more severe symptoms. Many do not immediately realize that there are problems with the main organ, and for a long time do not pay attention to it. Any ailment relating to this department requires diagnosis, and often treatment, therefore it cannot be ignored.

    Symptoms of ventricular pacemaker migration:

    • impaired consciousness;
    • increased blood pressure;
    • severe dizziness;
    • weakness, decreased performance;
    • loss of consciousness.

    Migration of the pacemaker in children causes more dangerous symptoms and serious consequences. Since arrhythmia can occur at any age of the child, infant or adolescent, it is necessary to regularly examine the baby and find out how well his cardiovascular system functions.

    In case of disturbances in the rhythm of the main organ, psycho-vegetative pathologies, delayed puberty and disorders of motor activity can develop. If arrhythmia occurs in children at a young age, then during teenage hormonal changes, the disease will manifest itself brightly.

    Symptoms in a child:

    1. respiratory failure, shortness of breath;
    2. blueness of some parts of the body, lips, fingertips;
    3. decreased or complete loss of appetite;
    4. sleep disturbance;
    5. the vessels of the neck noticeably pulsate;
    6. discomfort in the area of ​​the heart;
    7. playing sports and any physical activity is difficult;
    8. lowering blood pressure;
    9. loss of consciousness.

    Migration of the pacemaker and other types of arrhythmias often do not manifest themselves in children, but are detected only during ECG diagnosis. If complications of this disease appear, then the risk of sudden death in a child increases greatly.

    In adults, the progression of the disease can be accompanied by more severe symptoms in the form of muscle weakness, memory impairment and paresis. Normally, changes in the speed and sequence of heart contractions are observed in athletes. Such an order of work of an organ can accompany this person all his life and not be a pathology.


    Many factors can disrupt the activity of the sinus node, but such disorders are divided by doctors into congenital or acquired. In order to establish the work of the main organ, it is necessary first to eliminate the provoking moment, which led to the development of the disease.

    Name Description
    The first type is cardiac factorsThe disease occurs due to disorders in the cardiovascular system.
    The second variety is extracardiacThe disease appears against the background of extracardiac pathologies
    The third type of ailment – combinedIn this case, the reasons lie in the diseases of the main organ and other parts of the body together

    Often, a provoking factor leading to the development of pacemaker migration is neurocircular dystonia, in which the effect on the activity of the heart of the vagus nerve predominates. This disorder is usually detected in young people and disappears on its own after a while. During this period, the functions of the nervous system, as well as other body processes, are restored.

    Other causes that damage the pacemaker:

    1. Ailments of a psychosomatic nature.
    2. Infectious processes in the body.
    3. Viral pathology.
    4. Severe emotional upset.
    5. Disorders of the endocrine system.
    6. Heart diseases (cardiomyopathy, endocarditis, problems with coronary arteries, myocarditis, organ defects, rheumatic lesions).
    7. Excessive physical activity.
    8. Drug poisoning.

    Damage to the ventricular, supraventricular region, antioventricular and sinus nodes can occur due to tumor processes in the heart, organ ischemia, as well as heart attack and cardiosclerosis.

    These pathologies cause a violation of the functional properties of the entire cardiovascular system, including the migration of a pacemaker.

    In children, a similar condition is often provoked by problems in the perinatal period. It is possible to determine exactly the criteria that influenced the occurrence of the ailment only after a thorough diagnosis. This disease has an ICD-10 code (international classification of diseases), the numbers of which are 149.


    Migration of the pacemaker to the ECG in a child and adult is usually detected by chance, with a planned examination of a person. However, in other situations, when the disease proceeds with the presence of symptoms, people go to the doctor themselves.

    Despite the pathology detected and what the patient complains about, the diagnosis is always the same.

    First, the doctor conducts a survey of the patient, revealing all the deviations in well-being, then, it is necessary to examine the person, listening to the heart. During these events, the doctor examines the skin color of the patient, determines the presence of noise in the main organ and respiratory rate.

    • OAC (general blood count), as well as OAM (general urinalysis). It reveals the presence of inflammatory processes in the body.
    • LHC (biochemical blood test), is performed to determine the level of bad cholesterol, its excess in the blood is fraught with atherosclerosis. Among other things, glucose and potassium are measured.
    • An ECG (electrocardiogram) is needed to study heart rhythm. This method can be called the most important with a similar diagnosis.
    • Echocardiography (echocardiography) allows you to determine whether structural damage has appeared in the body, which is usually detected on the area of ​​the walls, partitions and valve apparatus.
    • HMECG, or daily monitoring of an electrocardiogram according to Holter. When conducting this diagnostic method, the patient is recorded a cardiogram for 1-3 days. This event helps doctors to establish the migration of the organ pacemaker and will reveal its duration, ways of manifestation and causes.
    • Consultations of some specialists, therapist, neurologist and others.

    When examining a patient, he is better off in a hospital. The doctor will suggest placing the patient in the ward, so that all diagnostic procedures are done at any time of the day, and the person is calm.


    Therapy of migration of the pacemaker of the main organ is carried out individually for each patient, depending on the causes of the disease. Medication methods include taking certain drugs to control the speed and frequency of the heartbeat.

    In addition to taking medication, the doctor will recommend that you follow some rules to improve the well-being of a person and accelerate therapy.

    • devote sufficient time to sleep and daytime rest;
    • remove all bad habits, cigarettes, alcohol;
    • proper nutrition, with the exception of fatty, salty, spicy foods;
    • avoid emotional overload;
    • physical activity should not be excessive;
    • follow all doctor’s recommendations regarding medication;
    • regular walks in the fresh air.

    If arrhythmia is not amenable to therapy, then it must be treated surgically. There is an artificial pacemaker, which is called a pacemaker or pacemaker. The cost of such devices is high, but such manipulations by doctors are necessary when the heart is not able to independently control its work.

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    Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.