Overview.
Atrioventricular junctional preterm contraction is also known as premature beats in the atrioventricular junction zone (JPBs), abbreviated as junctional preterm beats or junctional preterm beats and so on. It is an excitation that occurs in the atrioventricular (AV) junction region before sinus excitation. It can be seen in normal healthy people, but also in patients with organic heart disease. Patients mainly present with palpitations and panic with intermittent.
Etiology
The etiology is similar to atrial pre-systole. It can be seen in both normal healthy people and patients with organic heart disease. Examples include rheumatic heart disease, myocarditis, cardiomyopathy, coronary artery disease and other heart failure. It can also occur in patients with pulmonary heart disease. Treatment with digitalis is effective, but digitalis intoxication can also cause hypokalemia, which can disappear after potassium supplementation. When junctional pre-systole is accompanied by atrial pre-systole or ventricular pre-systole, it suggests myocardial damage. If appeared in acute myocardial infarction, severe myocardial ischemia myocardial injury suggests that the prognosis is more serious.
Symptoms
Patients with atrioventricular junctional pre-systole are mainly characterized by palpitations and panic attacks with intermittent intervals. If the number of pre-systolic contractions is too many, the patient feels that the heartbeat is very chaotic, and there may be chest tightness, discomfort in the precordial area, dizziness, and fatigue.
Auscultation during physical examination reveals arrhythmia with an early onset of heartbeat followed by a longer intermittent pause. The intensity of the 1st heart sound may change and vary in strength due to atrioventricular separation caused by junctional regional pre-systole.
Examination
Typical electrocardiographic features of atrioventricular junctional pre-systole
1. Early appearance of QRS wave: its morphology is the same as that of sinus beat.
2. There may be retrograde P′ waves before and after the QRS wave, or no retrograde P′ waves. If the P′ wave is before the QRS wave, the P-R interval is <0.12s; if the P is after the QRS wave, the R-P interval is <0.20s.
3. The compensatory intervals are usually complete compensatory intervals or incomplete compensatory intervals.
4. PII, PIII and PaVF are inverted, PV5 and PV6 are inverted, and PaVR, PaVL and PV1 are upright.
Diagnosis
A correct diagnosis can usually be made on the basis of clinical signs and ECG characteristics.
Treatment
1. Actively treat the primary disease and eliminate the causes of preterm systole, such as correcting electrolyte disorders, improving myocardial blood supply, improving cardiac function, etc.; prevent colds and flu; and take medication correctly and on time.
2. Avoid mental stress, maintain optimism, emotional stability; regularity, do not overwork; quit smoking and alcohol, to reduce the triggering factors of the disease; dietary discipline, less fat, sweet and greasy food.
3. Actively engage in physical exercise, weight control.
Questions you may be concerned about
How to treat atrioventricular junctional pre-systole?
Atrioventricular junctional preterm systole has different treatments according to different causes. It may be caused by organic heart disease, electrolyte disorders, anemia, etc., and can usually be treated with medication.
1. Organic heart disease: you can use antithrombotic drugs under the guidance of a doctor, such as aspirin, clopidogrel, etc., which can reduce myocardial oxygen consumption, you can also use beta-blockers, angina relief drugs, such as isosorbide mononitrate, with lipid regulation, plaque stabilization effect.
2. Electrolyte disorders: Concentrated sodium chloride, concentrated potassium chloride, magnesium sulfate, calcium gluconate, phosphate and other drugs can be used under the guidance of the doctor to correct the extracellular fluid hypotonic state and replenish blood volume.
3. Anemia: drugs such as iron dextrose, ferrous gluconate, iron sorbitol, ferrous fumarate, etc. can be used under doctor’s guidance, which can supplement the elements or factors needed for hematopoiesis.
The symptoms of atrioventricular junctional pre-systole, it is recommended to do further examination under the guidance of a doctor, to clarify the cause of the disease and active treatment, and the use of drugs need to follow the doctor’s instructions.