The term ectopic means ‘‘out of place” or ‘‘abnormal position” and, in relation to the heart, refers to an early heartbeat, whose origin is from a focus other than the sinus node. Atrial ectopics originate from an irritable focus in that chamber and clinically they may be asymptomatic or described by the patient as an ‘‘extra” beat or irregular pulse. The term ectopy is synonymous with ectopic, but it also helps identify combinations of ectopics, such as an atrial bigeminy or couplets.
Atrial ectopic, premature atrial complex, atrial premature depolarisation, electrocardiography, ventricular aberration
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Atrial ectopics can be generated from irritable foci anywhere in the atria, although most arise from characteristic sites of anatomic heterogeneity. They increase in frequency with age and are generally innocent, unless there is an underlying cause. The ECG footprints of atrial ectopy are prematurity and a non-sinus P wave morphology. Additionally, variable AV conduction, post-ectopic compensatory (or otherwise) pauses and QRS widening due to aberrant conduction may all be observed and all should be considered, when interpreting this common electrophysiology phenomenon.
In 49+ years as a practicing cardiologist, Assoc Prof Harry Mond has published 260+ published manuscripts & books. A co-founder of Cardiac Monitoring Service, he remains Medical Director and oversees 500K+ heart studies each year.
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