What is atrial pacemaker migration

Symptoms are caused by the source of the disease pacemaker migration. In a healthy person, migration episodes are asymptomatic.

VVD (vegetative-vascular dystonia) with hypotensionRare myocardial contractions;
Low index Blood pressure (blood pressure);
Increased sweating;
High saliva production.
sick sinus syndromeHeadache, sometimes severe;
· Head spinning;
Increased fatigue of the body;
Low frequency of myocardial contraction;
· Low memory indicator;
· Change of mood;
Chest pain
Arrhythmia in the work of the myocardium;
Shortness of breath.
myocardial ischemia, supraventricular tachycardiaPressing chest pain;
Baking pain in the sternum;
· Pain that ricochets in the arm, neck, and also under the left shoulder blade.
myocarditisChest pain in fits;
· Head spinning;
Increased heart rate
Shortness of breath
Swelling of the extremities.
mitral valve stenosisShortness of breath
Swelling of the extremities;
Edema of the peritoneum;
Oversized liver;
Pain in the area of ​​the heart muscle.
mitral valve insufficiency· coughing;
Chest pain – aching;
Discomfort in the sternum;
Pain in the hypochondrium.
Tricuspid valve stenosis (narrowing)Swelling
· Weakness of the whole organism;
· Increased contraction of the heart muscle (increased pulse);
Pain in the stomach and intestines;
Nausea, sometimes severe;
Painful feelings of the right hypochondrium;
· Low blood pressure index;
· coughing;
· Yellowness of the skin;
· A blue tint under the eyes.
tricuspid valve insufficiency· Low blood pressure index;
Supraventricular tachycardia;
Myocardial flutter;
Sensation of a heart popping out of the chest;
· Head spinning;
Fainting state;
Swelling of the face;
· The size of the liver is greatly increased;
· Heaviness in the hypochondrium on the right side;
Nausea, which turns into vomiting;
· Weakness of the body;
· A strong cough, in a severe case with bloody clots during expectoration.

In children with pacemaker migration, mental and vascular diseases are established. If a teenager has insomnia, overexcitability of the nervous system, then during examination on an ECG in a child, pacemaker migration is detected.

More than half of cases of heart rhythm disorders caused by driver migration appear in healthy people against the background of psychoemotional agitation, with drug intoxication, smoking, alcohol, and athletes who do not follow the training regimen. Some types of arrhythmias are asymptomatic and are detected only with an ECG of the heart.

If migration was caused by pathology, then the following symptoms may be observed:

  • Ischemic heart disease. General weakness, pain localized behind the sternum, irradiation under the scapula, neck, shoulder. Changes in heart rhythm are periodically observed, which is accompanied by nausea, profuse sweat.
  • Sick sinus syndrome. Sinus arrhythmia is prone to bradycardia, in which the brain suffers from a lack of oxygen. The patient has dizziness, headaches, fainting, increased irritability, nervousness, a feeling of sinking heart, pain in the heart – burning, pulling.
  • Myocarditis. There is dull pain in the region of the heart, the heart rhythm changes, there is a heartbeat, cold sweat. Blood pressure decreases, fainting is possible.
  • Mitral valve insufficiency. There is shortness of breath with minor physical exertion, pain in the heart, a sense of anxiety, anxiety.
  • Mitral valve stenosis. A heart rhythm disorder manifests itself in the form of atrial fibrillation, during the attack there is general weakness, shortness of breath, palpitations. Perhaps the development of thromboembolism.
  • Tricuspid stenosis. The episodes of atrial fibrillation with tachycardia are characteristic. The patient feels a chaotic heartbeat, sweating, weakness, trembling. At the end of the attack, the patient has increased urination.
  • Tricuspid valve insufficiency. The patient is disturbed by shortness of breath, weakness, frequent attacks of supraventricular tachycardia, palpitations, a feeling of “fluttering”, sinking hearts, fainting conditions.

In healthy people, this type of arrhythmia is asymptomatic. In other cases, the symptomatology is caused by a disease, against the background of which a pacemaker migration has developed.

Here are the symptoms that are characteristic of various situations:

  • In the presence of neurocirculatory dystonia, the leading symptoms will be reduced vascular pressure, decreased pulsation, hyperhidrosis, cold hands and increased salivation.
  • A person with a pacemaker weakness syndrome feels dizzy, pains in the head and chest, disturbances in cardiac activity. Also, such patients quickly become tired, irritable, their mood often changes. In addition, they have shortness of breath, memory loss.
  • Migration of the pacemaker, provoked by coronary disease, is accompanied by pain attacks that extend to the left arm, shoulder and jaw.
  • Patients with myocardial inflammation most often complain of paroxysmal pain in the heart area, interruptions in the heart rhythm, shortness of breath, dizziness, and a feeling of “irregular” pulsation.
  • Mitral valve stenosis is the cause of symptoms such as swelling of the extremities, abdomen, dyspnea, enlarged liver, hoarseness and a sensation of pain in the area of ​​the heart.
  • In patients with mitral valve insufficiency, there is a tendency to swelling, unpleasant or painful sensations in the area under the right ribs, cough, dyspnea, aching pains in the heart area.
  • The presence of stenosis of a tricuspid valve in a person has such manifestations as pain in the stomach, right hypochondrium, tachycardia, yellowish skin tone, weak state, nausea, low blood pressure, belching after eating, bluish mucous membranes, swelling.
  • In case of tricuspid valve insufficiency, patients have cough, in some cases with blood, vomiting, nausea, weak condition, swelling of the face, enlarged liver, a feeling of heaviness under the right ribs, paroxysmal supraventricular tachycardia – a feeling of increased pulsation, “jumping out” of the heart and dizziness sometimes flowing into a swoon.

Attention. In small patients with pacemaker migration syndrome, psycho-vegetative disturbances, a slowdown in sexual development and a decrease in motor activity are noted.


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.

Diagnosing the migration of a pacemaker begins with the collection and study of an anamnesis. Thus, they find out whether a person feels a violation of the heart, a weak state, reduced working capacity, and whether he feels pain in the zone of the heart and right hypochondrium.

It is also necessary to find out what chronic diseases the patient is concerned about, what operations and injuries have occurred in his life. In addition, the doctor carefully examines the family history.

To diagnose pacemaker migration, an external examination of the person is required to determine the frequency of respiratory movements, the presence of noise in the heart.

The patient must undergo general blood and urine tests, as well as a biochemical blood test to calculate the concentration of cholesterol, the amount of glucose and potassium in the blood.

Hardware methods for diagnosing migration:

  • Electrocardiographic examination (ECG);
  • HMECG: an electrocardiogram is recorded in two to three days. This method allows not only to establish the presence of pacemaker migration, but also to calculate the duration of such a migration, the time of occurrence, and also the causes of the disease.
  • Echocardiography. Allows to detect pathologies in the structures of the heart.

The typical migration of the pacemaker through the atria to the ECG (electrocardiogram) becomes especially apparent. An ECG scan result is like a series of waves. The top of the wave indicates the contraction of the right atrium caused by the sinoatrial node. If the diagram shows an irregularity of such waves (changes in shape, size and location), then the doctor makes the diagnosis “pacemaker migration in the atria”.

How is the treatment carried out?

All treatment of driver rhythm migration is based on the eradication of the main cause of the development of pathology. Those who have a migration of the rhythm source must adhere to all the doctor’s mandatory recommendations, these are:

  • complete exclusion of mental and emotional stress, for example, any conflict situations and stresses;
  • good and proper sleep in sufficient quantity;
  • moderate and regular physical activity. Their strength and duration are determined by the attending doctor, based on the severity of the pathology;
  • complete cessation of smoking and alcohol;
  • mandatory use of metabolic therapy, that is, drugs prescribed by a doctor that improve the functioning of the heart muscle.

Periodically, the list of drugs can be adjusted. However, it depends on the course of the syndrome. All changes must be carried out necessarily if the doctor requires it.

Prevention of the syndrome includes maintaining a healthy lifestyle, which includes proper nutrition and the fight against bad habits.

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.
  • 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.
  • eliminate strong psychological stress (stressful conditions, etc.);
  • get enough sleep;
  • quit smoking and drinking alcohol;
  • moderate and regular exercise (as recommended by the attending physician);
  • take medications that improve metabolism in the heart (only after consulting a doctor). The most famous are “Hypoxene”, “Ubiquinone”, “Trimetazidine”, “Mildronate”;
  • adjust drug treatment by consulting a doctor.

With prolonged neglect of pathology and the absence of treatment, the patient may require surgical intervention with the installation of a pacemaker.

Risk Factors

This type of arrhythmia is diagnosed in people of all ages, but most often it is observed in elderly patients and young children. Migration is also often found in professional athletes and those who maintain their body in excellent physical shape. The causes of the anomaly remain unknown.

In most cases, doctors can not unambiguously answer what caused the migration of the pacemaker in the atria. Under specific circumstances, that is, quite rarely, this disorder appears after an overdose of cardiac glycosides used to treat certain cardiac diseases.

Specialist forecast

If the pacemaker migrates without pathology, then the prognosis is favorable.

If a pathology is detected in the cardiogram, then the prognosis depends on the progression of the provocative disease.

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

If the heart rhythm disorder is caused by organic pathology, the prognosis depends on the course of the disease, which was a provocateur of the development of this pathology.

In the event that the migration of a pacemaker occurred in a healthy person and is its individual feature, the prognosis is favorable. As a rule, this phenomenon is often found in young patients or adolescents and has no apparent reason. With age, this type of arrhythmia disappears by itself.

For reference. In the case when the migration of the pacemaker indicates the presence of any heart disease, the prognosis is conditionally favorable. It is possible to improve the patient’s condition only with the right treatment started on time.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.