What is sinus arrhythmia
The sinus node is a natural pacemaker that receives signals from the autonomic nervous system. When you inhale, the tone of the vagus nerve decreases and the pulse quickens; when you exhale, it increases, and the heart beats a little slower. On the ECG it looks like uneven distances between the complexes with the correct shape of the teeth. The younger a person is and the better trained his cardiovascular system is, the more noticeable these fluctuations are. If the difference in frequency is not related to breathing, it is referred to as non-respiratory sinus arrhythmia, which requires the attention of a physician.
- Respiratory - associated with the phases of breathing, a variant of the norm
- Non-respiratory - does not depend on breathing
- Mild, moderate and pronounced - according to the degree of fluctuation
- Combination with sinus bradycardia or tachycardia
Reasons
Respiratory sinus arrhythmia is a physiological phenomenon, so there is no need to talk about its cause as a disease. It is more pronounced in children, adolescents during periods of rapid growth, in athletes, as well as during sleep and during slow, deep breathing. Rhythm fluctuations can intensify with autonomic dysfunction, after infections, or with anxiety. Non-respiratory sinus arrhythmia is more often associated with age-related changes and heart disease, may accompany sick sinus syndrome, occur with increased intracranial pressure or against the background of drugs that affect the rhythm.
- Physiological influence of breathing on rhythm
- Childhood and adolescence
- High fitness
- Autonomic dysfunction
- Coronary heart disease and age-related changes
- Sick sinus syndrome
- Taking certain heart medications
Symptoms
Respiratory sinus arrhythmia is usually not felt and is detected only on an ECG. Sometimes, when counting the pulse, a person notices that the beats are uneven, and this causes concern. Complaints appear when there is severe arrhythmia, especially in combination with a rare pulse, or if another rhythm disorder is hidden behind it. Then there may be interruptions, dizziness, weakness, and less often fainting. Adolescents with autonomic dysfunction often simultaneously experience fatigue, sweating, headaches, and blood pressure fluctuations, which are not related to the heart, but to regulatory features.
- Usually no complaints
- Uneven pulse when counting
- Feeling interrupted
- Dizziness with severe arrhythmia
- Fatigue and sweating with autonomic dysfunction
What examinations are needed
To confirm the respiratory nature of the arrhythmia, the doctor compares the ECG during normal breathing and when holding the breath: with the respiratory form, the rhythm evens out. The rhythmogram allows you to evaluate in detail the fluctuations of the intervals. If there are complaints, a rare pulse, pauses or changes in the ECG, Holter monitoring, echocardiography are prescribed, and in children, if necessary, an ECG with physical activity. Thyroid hormones and electrolytes are also checked if symptoms occur. In children without complaints with normal development, additional studies are usually not required.
- ECG with breath-hold test
- ECG with rhythmogram
- Holter ECG monitoring
- Echocardiography - according to indications
- ECG with stress in children
- TSH and electrolytes for complaints
What to do and is treatment necessary?
Respiratory sinus arrhythmia does not require treatment or restrictions in physical education and sports, unless there are other changes. A child with such an ECG record does not need to be excused from classes or take medications “for the heart.” A healthy sleep schedule, sufficient physical activity, walking, and limiting energy drinks are helpful. Regular exercise and normalization of the regime help with autonomic dysfunction. Non-respiratory arrhythmia and arrhythmia with complaints require examination and treatment of the cause, which is prescribed by a cardiologist.
- Do not limit physical activity without indications
- Maintain a sleep schedule
- Regular physical activity
- Limit caffeine and energy drinks
- Do not take heart medications unless prescribed
- Repeat ECG if complaints occur
