Ectopic pacemaker

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Ectopic pacemaker
Synonyms	Ectopic focus, ectopic beat
Pronounce	N/A
Specialty	N/A
Symptoms	Palpitations, irregular heartbeat, dizziness, shortness of breath
Complications	Arrhythmia, heart failure
Onset	Can occur at any age
Duration	Variable, can be transient or persistent
Types	N/A
Causes	Ischemic heart disease, myocardial infarction, electrolyte imbalance, drug toxicity
Risks	Hypertension, smoking, alcohol use, stress
Diagnosis	Electrocardiogram (ECG), Holter monitor, event monitor
Differential diagnosis	Atrial fibrillation, ventricular tachycardia, supraventricular tachycardia
Prevention	Lifestyle modification, medication management
Treatment	Antiarrhythmic drugs, catheter ablation, pacemaker
Medication	N/A
Prognosis	Varies depending on underlying cause and treatment
Frequency	Common, especially in older adults
Deaths	N/A

An overview of ectopic pacemakers in the heart

An ectopic pacemaker is an abnormal cardiac pacemaker site located outside of the sinoatrial node (SA node), which is the natural pacemaker of the heart. Ectopic pacemakers can lead to irregular heart rhythms, known as arrhythmias, and can occur in various parts of the heart, including the atria, ventricles, and the atrioventricular node.

Causes

Ectopic pacemakers can be caused by a variety of factors, including:

• Ischemic heart disease
• Electrolyte imbalance
• Myocardial infarction
• Cardiomyopathy
• Drug toxicity, such as from digitalis or antiarrhythmic drugs

Mechanism

The mechanism of ectopic pacemaker activity involves the generation of electrical impulses from a site other than the SA node. This can occur due to increased automaticity, triggered activity, or reentry circuits within the heart tissue. These impulses can compete with or override the normal pacemaker activity of the SA node, leading to abnormal heart rhythms.

Types of Ectopic Pacemakers

Ectopic pacemakers can be classified based on their location within the heart:

Atrial Ectopic Pacemakers

These occur in the atria and can lead to conditions such as premature atrial contractions (PACs) or atrial fibrillation.

Junctional Ectopic Pacemakers

Located near the atrioventricular node, these can cause junctional rhythms, which may result in a slower heart rate than normal.

Ventricular Ectopic Pacemakers

These occur in the ventricles and can lead to premature ventricular contractions (PVCs) or more serious conditions like ventricular tachycardia or ventricular fibrillation.

Clinical Significance

Ectopic pacemakers can have significant clinical implications, as they may lead to symptoms such as palpitations, dizziness, syncope, or even sudden cardiac arrest in severe cases. The presence of ectopic pacemakers often requires medical evaluation and management, which may include medication, cardioversion, or ablation therapy.

See also

• Cardiac conduction system
• Arrhythmia
• Sinoatrial node
• Atrioventricular node
• Electrocardiography