Sinus arrhythmia in a 6-year-old child. Sinus arrhythmia in children. Sinus heart rhythm in children: normal

in children - a fairly common disease characterized by a violation heart rate. For the most part, this disease does not cause discomfort to the child and does not affect his well-being in any way. But this does not mean at all that you can give up on the disease.

How to treat sinus arrhythmia?

For the most part, sinus arrhythmia does not require treatment. However, in some cases, medical intervention is necessary only to ensure that the disease does not develop complications and develop into a more serious pathology.

Today there are several main types of treatment:

However, before introducing certain restrictions into a child’s life, you need to think seriously and consult with a doctor: perhaps arrhythmia is a temporary phenomenon, and it will go away as the baby grows up.

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How can arrhythmia be dangerous?

Untreated arrhythmia in a child does not always go away completely without a trace. In some cases, it may not manifest itself in any way until a certain moment, but over time it will lead to quite serious consequences, such as:

• thrombosis;
• risk of developing myocardial infarction;
• stroke.

All these factors will not make themselves felt immediately, but only after many years. However, it is definitely worth thinking about these consequences if the child has just become aware of them. Its symptoms manifest themselves almost immediately, which allows the parent to quickly take appropriate measures:

1. The child complains of a lack of air and is haunted by a feeling of suffocation. With minor physical exertion, the baby may experience shortness of breath, regardless of how intense the exercise was.
2. With arrhythmia, there may be discomfort in the area of ​​the heart. Rapid heartbeat can occur without any reason, and sometimes, on the contrary, it will seem as if it is freezing.
3. Dizziness, frequent headaches. Unpleasant symptoms may occur when sudden movements: raising the head, lifting, jumping or tense muscles. Most parents mistakenly attribute these symptoms to pressure surges, thereby giving the disease the opportunity to progress.

Having noticed changes in a child’s behavior and well-being, you should question him in detail, asking him to indicate all the disturbing symptoms.

Having collected the full clinical picture, you can safely contact your doctor for additional advice. At the same time, it is important to remember that for children this is not a death sentence, but only temporary difficulties that, when the right approach They can be easily eliminated without causing any consequences.

Many, even the most banal studies, which are carried out in the clinic during a medical examination, help to suspect and diagnose various serious violations health. Therefore, doctors strongly recommend not to neglect annual examinations with primary specialists, as well as systematically conduct basic research. An electrocardiogram is considered to be one of the important and at the same time simple diagnostic manipulations. Having received the result of such a study in their hands, many patients pay attention to the indicated sinus rhythm of the heart. Let's talk about the term sinus rhythm of the heart, what is the norm in adults and children.

Probably every person knows that the heart is an organ that performs work rhythmically. U healthy person The heartbeat rhythm is determined by the sinus node. Accordingly, we can conclude that the sinus rhythm of the heart is precisely the normal heart rhythm.

The sinus node is a natural impulse generator and is located inside the right atrium. The impulse moves from bottom to top. First it reaches the right atrium, and then the left. The impulse then passes through the atrioventricular junction towards the ventricles. Its effect causes the heart to contract and relax rhythmically, thus performing its main functions - pumping blood throughout the body.

Sinus rhythm hearts - what does this mean on a cardiogram?

With normal sinus rhythm on the cardiogram, all P waves have a constant shape, and distance R-R or R-R is the same. The heart rate ranges from sixty to eighty beats per minute. Accordingly, with such indicators, the heart is in order and functions with stability and clarity.

If the sinus rhythm is unstable, then the cardiogram shows that the height of the P waves, as well as the distance between them, are not the same. Observing such a picture, the doctor can conclude that the sinus node is weak or that another heart node has become the pacemaker. In this case, the patient is advised to undergo special diagnostics. Such studies will already help to find out what exactly caused the sinus rhythm disturbance: pathology of the sinus node itself or problems in its autonomic system.

Thus, if the doctor wrote in the cardiogram that sinus rhythm is normal, we can conclude that the patient’s heart is functioning normally. Violation of this indicator often indicates heart block or arrhythmias. In general, all violations of systematicity, consistency or heart rate can be called arrhythmias. Heart blocks develop when there is a disruption in the transmission of impulses from nerve center to the heart muscle. An acceleration of the rhythm indicates the development of tachycardia, and a slowdown indicates bradycardia. A decrease in heart rate to fifty or less, or an increase in this indicator to ninety or more is serious reason For immediate appeal to the doctor. And the editors of the site www.!

What is the normal sinus rhythm in adults and children?

Normal sinus rhythm in an adult is characterized by a frequency of sixty to eighty beats per minute, as well as a regular rhythm and a constant interval between beats, which is 0.12-0.22 seconds.

Children's hearts beat completely differently depending on their age. So in the very first month of life, the sinus rhythm should be approximately one hundred and forty beats per minute, and from the age of one month of life to one year - one hundred and thirty-two beats per minute. Then the sinus rhythm gradually becomes slower. So, from the age of one to two, this figure is equal to one hundred and twenty-four beats per minute, and from two to six – one hundred and fifteen beats. In schoolchildren from six to eight years of age, sinus rhythm decreases to one hundred and six beats per minute, and from eight to ten years of age - to eighty-eight beats per minute. Over the next two years (from ten to twelve years) the indicators decrease to eighty beats per minute. For children between the ages of twelve and fifteen, a sinus rhythm of seventy-five beats per minute is considered normal.

Are all sinus rhythm disorders dangerous to health?

In fact, in some cases, sinus rhythm disturbances should not be considered a symptom. So sometimes this phenomenon is associated with breathing - immaturity respiratory system, a banal jog or fast walk before the study, excessive body weight, a period of active growth in children, ICP, prematurity, etc.

What else can cause sinus rhythm disturbances?

Sometimes such a problem indicates the presence of heart defects, cardiomyopathy and infective endocarditis. In children it can also be provoked birth defects which are associated with an insufficiently favorable course of pregnancy or childbirth, various ailments nervous and endocrine system. In some cases, sinus rhythm disturbances are a consequence of intoxication (even the result of an overdose of medications or their individual intolerance) and deficiency of microelements, most often magnesium and selenium.

Quite often, sinus rhythm disturbances do not make themselves felt and are diagnosed only when next examination. Therefore, it is extremely important to regularly visit a cardiologist for preventive ECGs.

• In the first month of life, physiological normal indicators will be 140-160 beats/minute,
• In the first year of life, physiological normal indicators will be 132-135 beats/minute,
• Per year, physiological normal indicators will be 120-132 beats/minute,
• From one to two years, physiologically normal indicators will be 110-125 beats/minute,
• From 2 to 3 years – 115 beats/minute,
• From 6 to 8 years – 90-105 beats/minute,
• From 10 to 12 – 80-85 beats/minute,
• From twelve and more – 75 beats/minute.

- one of many variants of disturbances in the rhythm of cardiac activity, the morphological substrate of which is a violation of the contractility of the heart muscle not at regular intervals, with an unchanged sequence of contractions of the chambers of the heart.

There are several types of this arrhythmia:

1. Non-respiratory types of sinus arrhythmia:
   • Sinus tachycardia,
   • Sinus bradycardia,
2. Actually respiratory sinus arrhythmia:
   • – one of the varieties of sinus arrhythmia, the morphological substrate of which is an increase in the number of heart contractions of more than ninety beats per minute, with a norm of sixty to eighty beats per minute.
   • Sinus bradycardia– one of the varieties of sinus arrhythmia, the morphological substrate of which is a decrease in the number of heartbeats less than sixty.
   • Respiratory arrhythmia– also one of the varieties of sinus arrhythmia, the morphological substrate of which is an increase in the number of heart contractions during inhalation and a decrease during exhalation.
   • Not dangerous species arrhythmias- This physiological species sinus arrhythmias, as well as in preschool children.
   • Dangerous types of arrhythmias– these are those types of arrhythmias that are characterized by heart disease, endocrine disorders and others.
   • Moderate sinus arrhythmia in children– most often appears in children, the essence of which lies in mild symptoms, or complete absence symptoms,
   • Severe sinus arrhythmia– more often manifests itself in older people, and is a sign of organic damage to the heart (rheumatism, myocarditis, endocarditis and others),
   • Severe arrhythmia in children– appears after physical activity stress, fear, anxiety.

Symptoms of sinus arrhythmia

Older children experience the following symptoms:

Children in the first year of life may experience:

• Sleep disorder, insomnia,
• Pulsations of the carotid (carotid) arteries,
• Pallor of the skin,
• Poor appetite
• Tearfulness,
• Minor weight gain.

Dangerous accompanying symptoms:

Such dangerous accompanying symptoms as pain in the heart, shortness of breath, cyanosis, edema, fainting and others indicate that, in addition to sinus arrhythmia, the child may have other more dangerous ones. accompanying illnesses.

Diagnosis of sinus arrhythmias

• In most cases(about 50%) sinus arrhythmias are detected by chance, according to data from visits to a doctor, during mandatory medical examinations by a pediatrician.
• Diagnosis is made based on complaints(tearfulness, rapid or slow heartbeat, sleep disturbance, insomnia, paleness skin, poor appetite, cold sweat, dyspeptic disorders).
• Physical examination methods– auscultation, palpation, percussion, and pulse measurement. When measuring pulse, it is necessary to take into account age-specific heart rate indicators. Laboratory methods examinations such as general analysis urine, general blood test, biochemical analysis blood.
• Of course, the gold standard for diagnosis are instrumental methods examinations - such as electrocardiography (arrhythmia is recorded both at rest and during light physical exertion; it allows identifying rhythm disturbances associated with disorders nervous system).

Signs of sinus arrhythmia on the electrocardiogram will be as follows:

1. The pacemaker is the sinus node,
2. The distance between the RR and TP teeth is different,
3. Sequence and shape of P waves, QRS complex, T,

Ultrasound examination of the heart, echocardiography and stress tests or tests (), Holter monitoring, allow you to diagnose any types and forms of arrhythmias.

Transesophageal electrocardiography, the essence of which is to record sinus arrhythmia through the esophagus. If the child has concomitant diseases of the central or peripheral nervous system, electroencephalography, rheoencephalography, and consultation with a pediatric neurologist are additionally prescribed.

Etiology of the disease

The cause of the disease may be associated with activity in the conduction system of the heart, a disturbance in transformation, in the conduction of nerve impulses. The reason is also related to structural changes in cardiac tissue (developmental defects), disorders nervous regulation hearts.

This arrhythmia is observed when various states of the body, both physiological and pathological:

• Physiological conditions most often include physical activity and stressful situations.
• If this arrhythmia occurs while the patient is at rest, then you should think about the presence of any pathological condition body.
  It could be a disease of cardio-vascular system, namely:
  • coronary heart disease (myocardial infarction),
  • arterial hypertension,
  • bacterial endocarditis,
  • pericarditis,
  • endomyocarditis,
  • heart defects (stenosis and insufficiency of the heart valve apparatus),
  • diseases of the endocrine system (diffuse toxic goiter, adrenal tumor, hyperthyroidism, hyperparathyroidism, blood diseases such as anemia, diseases of the nervous system (neuroses),
  • neuro-circulatory dystonia (asthenia),
  • respiratory diseases (pneumonia, bronchitis, tonsillitis),
  • hyperthermia,
  • increased tone of the sympathetic nervous system,
  • diseases of the digestive system ( intestinal infection), which lead to electrolyte imbalance.

Treatment of sinus arrhythmia in children

• There is no need to treat physiological or functional types of arrhythmias. Parents with functional types of arrhythmias should pay attention to the child’s daily routine, correct, balanced, fractional meals, reducing physical activity and time spent at the computer and TV.
• In the treatment of clinically significant sinus arrhythmia use medicinal, conservative and surgical methods treatment. You should also take into account various concomitant pathologies of organs that can cause sinus arrhythmia, and, if necessary, carry out complex therapy.
• Traditional treatment arrhythmias involves the use of antiarrhythmic drugs or antiarrhythmic drugs(AAP), the essence of which is to reduce cardiac activity or increase cardiac conductivity.

Procainamide or procainamide:

1. Inside: initial dose 15-50 mg/kg/day in 4-8 doses, maximum dose up to 4 g/day,
2. Intramuscular: initial dose – 20-30 mg/kg/day in 4-6 doses, maximum dose 4 g/day,
3. Intravenously: 3-6 mg/kg/day, but not more than 100 mg for five minutes, maintenance dose 40-80 mg/kg/day, maximum dose 2 g/day.

Propranolol (AAP beta blocker):

1. Inside: 1/2-1 mg/kg/day in 3-4 doses, maximum dose 14-16 mg/kg/day,
2. Intravenously: 10-100 mg/kg/day slowly over 10 minutes.

• Analogues of the drugs anaprilin and novocainamide are also used.
• Verpamil, amiodarone,
• Quinidine: orally at a dose of 6 mg/kg 5 times a day.
• Potassium and magnesium preparations to restore electrolyte imbalance, Magne B6 (a source of magnesium is indicated for children from 6 years of age, 4-5 tablets per day), asparkam for potassium deficiency, dosage depends on the age of the child.
• For disturbances in the conduction system of the heart, drugs such as atropine and adrenaline are used.

When treating sinus arrhythmia with drugs, you should pay attention to the dosage, contraindications, and unwanted effects drugs.

Minimally invasive surgical intervention is also used– implantation of a pacemaker under the skin in the area (subclavicularis), the essence of which is as follows: the electrode subclavian vein is injected into the right side of the heart, where the pacemaker is located; if there is a disturbance in the conduction system of the heart, the pacemaker registers these disturbances and corrects them.

Radiofrequency ablation or cryo-ablation: essence this method consists in the destruction of destruction or destruction (by energy high frequency or freezing) of that part of the cardiac conduction system that is the source of sinus arrhythmia.

Take vitamins for the heart: such as ( ascorbic acid(C), pyridoxine (B6) polyunsaturated fatty acid(F). This group Vitamins help strengthen the walls of blood vessels and the heart, and also prevent the development of ischemia and promote the removal of cholesterol.

Vitamins, providing muscle elasticity and vascular wall, such as thiamine (vitamin B1) prevents rhythm disturbances, rutin - this (vitamin P) - helps increase elasticity, strengthening, strength of the vascular wall, silicon and others.

The so-called reflex method takes place in treatment., the essence of which is reflex stimulation of the central nervous system on the activity of the heart (pressure on eyeballs fingertips and hold for 5 minutes, massage the side surfaces of the neck).

Traditional methods of treatment

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Sinus respiratory arrhythmia does not cause complications.

Non-respiratory types of sinus arrhythmias can cause disturbances in the blood supply to the brain, namely oxygen starvation or cerebral hypoxia, which is characterized by sudden losses consciousness, dizziness.

With such a long course, sinus arrhythmia can progress and heart failure may occur.

The main thing is to lead healthy image life:

• Do exercises every morning,
• Go swimming,
• Skiing, light jogging,
• Balanced, small, frequent meals,
• Take vitamins for your heart
• Avoid fried, spicy foods,
• Avoiding heavy physical activity
• To prevent sinus arrhythmia, it is necessary to do an electrocardiogram 4 times a year,
• If you notice the first signs of illness, you should consult a doctor,

Prevention is the best “cure” for a disease.

Arrhythmia and sports

In many cases, the child's parents who has been diagnosed with sinus arrhythmia, they try to completely limit him from any physical activity. There is no need for this, since light physical activity is even good for health.

This refers to the respiratory form of sinus arrhythmia, in which there are no contraindications even for sending a child to sports clubs, but still the child must be monitored by a cardiologist and undergo an electrocardiogram 4 times a year.

Normal heart function is very important for overall health child's body Therefore, any dysfunction of this organ is perceived by parents with anxiety and concern. Enough common problem V childhood sinus arrhythmia appears. Is it dangerous for babies, why can it occur and how to act if such a rhythm disorder is detected in a baby?

What is this

First of all, parents should know that sinus is called normal rhythm heartbeats, since it is formed due to the work of the sinus node, the second name of which is “pacemaker”, since it is he who sets the rhythm of heart contractions.

During normal operation of this node, the heart contracts at a frequency characteristic of a certain age, and the intervals between heartbeats are the same. For example, for newborns, a normal sinus rhythm will have a rate of about 140 beats per minute, and for children 7 years old - about 100 beats per minute.

With sinus arrhythmia, the child’s heart rhythm changes

If a child experiences sinus arrhythmia, there is either a change in the intervals between heartbeats or a change in the heart rate.

Causes

Depending on the factors provoking sinus arrhythmia, it is divided into respiratory and non-respiratory.

Respiratory

This is the name for sinus arrhythmia associated with the breathing process. When children with this arrhythmia inhale, their heart rate becomes higher, and when they exhale, heart contractions slow down.

The main cause of this variant of arrhythmia is an immature nervous system, therefore such rhythm disturbances are often diagnosed in babies with intracranial hypertension, encephalopathy, rickets, prematurity, as well as during periods of active growth of children (at 6-7 years and at 9-10 years). Gradually, the nervous system matures, and arrhythmia occurs less and less often in the child. As a rule, this type of sinus arrhythmia in itself does not pose a health risk.

Non-respiratory

It is noted in approximately 30% of children with sinus arrhythmia. This rhythm disturbance occurs in the form of attacks or manifests itself as a constant arrhythmia.

The reason may be:

• Hereditary predisposition.
• An infection whose symptoms include fever, dehydration and intoxication.
• Poisoning.
• Viral or bacterial myocarditis.
• Rheumatic disease.
• Cardiopsychoneurosis.
• Congenital heart defect.
• Tumor process in heart.
• Thyroid diseases.
• Taking certain medications.

Sinus arrhythmia can be respiratory or non-respiratory, depending on the cause

Forms

Sinus rhythm disturbances are divided into the following forms:

1. Sinus tachycardia. With such an arrhythmia, the sinus node sets a greater number of contractions than should be normal in a child of a certain age. This problem is caused by intoxication, oxygen deficiency, thyrotoxicosis, psychological agitation, physical activity, heart inflammation and other reasons.
2. Sinus bradycardia. This form of arrhythmia is characterized by a reduced number of heart beats per minute. It can be provoked by emotional excitement, poisoning, hypothyroidism, diseases of the nervous system, myocarditis, hypothermia and other factors.
3. Extrasystole. This form of arrhythmia is observed in every fifth child. In most cases, it does not affect the baby’s health in any way, but there are dangerous types of extrasystole, so in case of such a disorder, the child must be examined in detail.

In addition, depending on the severity of the rhythm disturbance, the following is diagnosed:

• Moderate sinus arrhythmia. This type of arrhythmia is most often observed in children. It is characterized by weak manifestation or absence clinical symptoms, and in many cases treatment is not required.
• Severe sinus arrhythmia in a child. It is more common in adults and is often provoked by rheumatism and other serious heart lesions. Such arrhythmia bothers the patient and requires treatment.

Symptoms

In many children, sinus arrhythmia does not cause any complaints, especially when it comes to its respiratory form. Some children feel that their heart is beating faster, and the mother can notice the increase in heart rate by measuring the child's pulse. As a rule, there will be no other complaints with harmless sinus arrhythmias.

If the baby complains that it is difficult for him to breathe, he becomes dizzy, he gets tired quickly, and a tugging or stabbing pains, you should consult a doctor, as these symptoms indicate more serious problems with heart. It is important to immediately show the child to a cardiologist if cyanosis of the skin, fainting, swelling or shortness of breath occurs.

Possible complications

If sinus respiratory arrhythmia in children poses virtually no danger, since it does not interfere with blood flow in the child’s heart, then non-respiratory forms can lead to complications such as fainting, chaotic contractions of the heart and ischemia of brain tissue.

Over time, children with such heart rhythm disturbances begin to develop heart failure.

Diagnostics

Most often, sinus arrhythmia is detected on an electrocardiogram by measuring the distance between the R waves, which represent the apexes of the ventricular complexes. You can also suspect a violation of the heartbeat rhythm during examination of the child and palpation of his large arteries (calculating heart rate).

You can assume that a child has sinus arrhythmia by palpating the child’s arteries

To confirm the presence of arrhythmia and find out its cause, the baby is referred to:

• Holter monitoring. A special device is attached to the baby’s body, which takes an ECG throughout the day.
• Echocardiography. Using ultrasound, the heart itself and large vessels are examined, which helps to identify defects and changes in the structure of the heart.
• Orthostatic test. The baby's heart rate and blood pressure are measured supine position, and then ask you to stand up and repeat the measurements. This test makes it possible to assess hemodynamics and cardiac activity.

What to do

If, during a routine examination or an ECG, after the child complains of pain or discomfort in the heart, sinus arrhythmia is detected, it is necessary to visit a cardiologist with the baby to examine him in more detail and determine the cause of this rhythm disturbance. If no other problems are found in the child other than changes in the heartbeat, the baby will simply need to visit the doctor every 6 months and perform a control ECG.

If the child is not at all bothered by isolated arrhythmia, it is not treated

Isolated arrhythmia that does not bother the child is not treated. If the cause of the change in the rhythm of heart contractions is any cardiac disease, the doctor will choose necessary treatment. Depending on the cause, glycosides, vitamins, antiarrhythmic drugs, diuretics, antibiotics and other drugs can be used in the treatment of sinus arrhythmia. If there are serious heart defects, the baby may require surgical correction.

Arrhythmia and sports

If a child has been diagnosed with sinus arrhythmia, then in order to play sports it is necessary to determine its form. If this is a respiratory arrhythmia, there will be no contraindications to visiting sports clubs, but the child should be regularly shown to a cardiologist and taken for an ECG to prevent such a rhythm disorder from becoming more severe. Non-respiratory forms of arrhythmia are a reason to limit physical activity, depending on the cause of heart rhythm disturbances.

Prevention

To prevent rhythm disturbances in children, it is recommended:

• Set up optimal mode days with full sleep.
• Balance your child's diet by including enough plant food, rich in magnesium and potassium. Fried and fatty foods, as well as sweets in the child’s menu should be limited.
• Avoid overwork and excessive fatigue.
• Include moderate physical activity in your baby’s life, such as exercise or swimming.
• Walk often.
• Avoid stress.
• Visit your pediatrician regularly, even if you have no complaints.
• Strengthen the child's immunity.

In the next video, the doctor gives parents of children with arrhythmia useful tips that will help support normal work child's heart.

Sinus arrhythmia in children is a manifestation of age-related changes in the body or a complication of any disease. According to research, it is diagnosed in childhood in 0.5% of cases.

The danger of arrhythmia is determined by the reasons for its occurrence and the nature of its manifestations. In most cases this state is only temporary, associated with the development and growth of the body. In others - as a consequence pathological processes in the heart and blood vessels.

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What is sinus arrhythmia?

The heart, like a pump, pumps blood throughout the body, pulsating at a certain frequency. This is possible due to electrical signals emanating from the pacemakers. Their main source is sinus rhythm. If for some reason the impulse is advanced or delayed, a failure of heart contractions is provoked.

The diagnosis of sinus arrhythmia in a child is made based on the results of electrocardiography. This condition is mainly caused by rapid growth and hormonal changes in organism. Only rarely is the cause serious pathology hearts.



Classification

Sinus arrhythmia is divided according to heart rate (HR) into 3 types:

• normal - the number of beats per minute is maintained;
• tachyarrhythmia - increases;
• bradyarrhythmia decreases.

By origin they are distinguished:

• hereditary;
• congenital;
• acquired.

Classification is also carried out according to severity:

1. 1. Moderate. It is a harmless form of arrhythmia with mild symptoms. In most cases, it is diagnosed during routine ECGs.
2. 2. Expressed. Accompanies pathologies of the heart and blood vessels, has obvious Clinical signs.

Sinus arrhythmia is divided into 2 types according to its manifestation:

• respiratory;
• non-respiratory.

The first type of arrhythmia is characterized by a reflex increase in heart rate during inhalation and a decrease during exhalation. The second form of sinus rhythm disorder can be paroxysmal or permanent. These types of arrhythmia are provoked by different reasons.

In order to determine heart rhythm disturbances in your child, you can use a table with normal heart rate indicators for different ages.

Age, years	Heart rate, beats per minute
First month of life	140
1 month - 1 year	135
1-2	125
2-5	115
6-8	105
8-10	88
10-12	80
12-15	75



Causes

Respiratory arrhythmia occurs due to the immaturity of the child’s nervous system. The younger he is, the more easily he may have seizures. Children at risk are:

• with postnatal encephalopathy;
• premature;
• with intracranial hypertension syndrome;
• with rickets, which changes the excitability of the nervous system;
• overweight;
• between the ages of 6 and 10 years, when rapid growth occurs and vegetative system does not have time to adapt to the body's requirements.

Once the autonomic nervous system has fully developed, attacks of respiratory sinus arrhythmia will disappear on their own.

Non-respiratory sinus arrhythmia manifests itself paroxysmally or is constant. It can occur several times a year or bother the child every day. This is caused by the fact that there are changes in the conduction system of the heart or its cells (cardiocytes) that lead to disruption of the correct rhythm. In most cases, this is not due to diseases, but to some pathological conditions.

In almost 30% of cases, sinus arrhythmia occurs against the background of cardiac changes. Main causes of the disease:

1. 1. Hereditary predisposition. There is no 100% dependence on the transmission of the pathological condition from parents to children. But in most cases, sinus arrhythmia of non-respiratory origin also occurs in children if the parents were exposed to it.
2. 2. Infectious diseases leading to intoxication, dehydration or fever. Nerve impulses to heart contractions travel along muscle fibers. This process is highly dependent on the presence of potassium, chlorine and sodium in them. If any reasons lead to a change in the water-electrolyte balance, then a rhythm disturbance is provoked.
3. 3. Vegetovascular dystonia (neurocirculatory). If the ability of blood vessels to adequately change the lumen depending on the oxygen needs of tissues is impaired, arrhythmia may occur.
4. 4. Myocarditis. Inflammatory process in the cardiac muscle of a bacterial or viral nature causes sinus arrhythmia or other disorders (atrial fibrillation, heart block, extrasystole). Associated symptoms infectious lesions myocardium: dullness of heart sounds, pain in the heart area, fever, swelling, shortness of breath.
5. 5. Rheumatism is a disease that can cause endocarditis or myocarditis and affects the valvular apparatus of the heart. Provokes him previous sore throat. Accompanied by inflammation of large joints, fever and heart pain.
6. 6. Congenital heart defects.
7. 7. Tumors.



Risk factors

Regardless of the type of sinus arrhythmia, the likelihood of its occurrence is higher during certain periods of a child’s life. This is due to physiological characteristics. More susceptible to disease infants from 4 to 8 months. Preschoolers - from 4 to 5 years old. Also, sinus arrhythmia often occurs in children aged 6 to 8 years and older than 12 years.

Arrhythmia and sports

Often, when a child who participates in sports is diagnosed with sinus arrhythmia, parents wonder about the appropriateness of sports in the life of their child. Most of all they are interested in whether physical activity is to blame for the development of pathology.

Without a physiological predisposition to the development of heart rhythm disturbances, even professional sports cannot provoke it in children. If the child had grounds for the appearance of sinus arrhythmia, then any physical activity can become an impetus for its development.

Regardless of the severity of the disease, sports are not contraindicated in case of respiratory arrhythmia. But the child must be periodically observed by a cardiologist; he needs constant monitoring and electrocardiographic examinations. This is necessary to prevent the development of more severe heart rhythm disturbances.

For children involved in professional sports, mandatory ECG examinations every three months and Holter monitoring are indicated. The decision on the advisability of physical activity for respiratory arrhythmia is determined by the doctor individually. If a child is diagnosed with a non-respiratory form of pathology, then he is strictly prohibited from playing sports.

Symptoms

The danger of this pathological condition is that it can occur without characteristic symptoms. But in some cases, the child still exhibits certain clinical signs.

In a newborn baby, sinus arrhythmia can be recognized by:

• constant crying at night and poor sleep;
• changes in skin color;
• noticeable shortness of breath;
• poor appetite;
• causeless worries.

In older children and adolescence The following symptoms are possible:

• fainting conditions;
• poor tolerance to even minor physical activity;
• fast fatiguability;
• sensations of interruptions in the work of the heart.

If clinical signs are not observed, then sinus arrhythmia can be recognized by ECG readings. Tachycardia and bradycardia are distinguished by the RR interval, which decreases or lengthens respectively. On electrocardiograph readings, the presence in front of the QRS complex P wave, which represents electrical excitation. For myocardial contraction, impulses must travel from the atria to the ventricles. Their passage time is characterized by the length of the PQ interval.

Treatment

If sinus arrhythmia in children is caused by dysregulation of the autonomic nervous system, then they are not prescribed drug treatment. Dr. Komarovsky recommends preventive actions aimed at reducing the likelihood of seizures. To normalize the heart rate, the child needs:

• Healthy food;
• do exercises in the morning;
• be physically active;
• spend more time in the fresh air;
• avoid stressful situations and excessive emotional stress.

If a child has a non-respiratory arrhythmia with severe clinical symptoms, that is, there are two treatment options:

• medicinal;
• surgical.

First of all, actions are aimed at eliminating the factors that provoke heart rhythm disturbances:

• treat the underlying heart or vascular disease;
• remove foci of chronic infections;
• discontinue medications that negatively affect heart contractions.

Drug therapy consists of using a complex of medications:

1. 1. Antiarrhythmic for recovery normal frequency heartbeats. The most effective: Novocainamide, Verapamil, Obzidan.
2. 2. Means for improving the metabolism of heart tissue: Cocarboxylase, Riboxin.
3. 3. Medicines to stabilize the balance of electrolytes: Panangin, Potassium Orotate, Asparkam.

If drug treatment does not work, then minimally invasive surgical techniques are used to restore normal heart rhythm. With help radiofrequency ablation eliminate pockets of excess nerve impulses. If it is ineffective, the child is implanted with a pacemaker, which normalizes the heart rhythm.