Definition of sinus bradycardiaSinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute. ECG criteria follows: Show
Normal (physiological) causes of sinus bradycardiaSinus bradycardia (SB) is considered a normal finding in the following circumstances:
Abnormal (pathological) causes of sinus bradycardiaIn all other situations, sinus bradycardia should be regarded as a pathological finding. There are numerous pathological conditions that cause sinus bradycardia. The most important causes are as follows:
ECG example of sinus bradycardiaFigure 1 shows sinus bradycardia at paper speed 25 mm/s. Treatment of sinus bradycardia: general aspects of managementBenign causes of sinus bradycardia (SB) do not require treatment. In all other situations it is necessary to find the underlying cause and direct treatments towards it. The most common causes are sinus node dysfunction, side effects of medications or acute myocardial ischemia/infarction. When the bradycardia causes hemodynamic symptoms it should be treated. Note that sinus bradycardia due to ischemia located to the inferior wall of the left ventricle is typically temporary and resolves within 1–2 weeks (sinus bradycardia due to infarction/ischemia is discussed separately). Benign (physiological) causes of bradycardia (e.g vasovagal reaction, well-trained athletes) need not be treated. When in doubt whether the bradycardia is physiological, it is useful to perform a Holter ECG (ambulatory recording). If drug side effects are believed to be the cause, it is fundamental to judge the risk of terminating drug therapy as compared with implementing an artificial pacemaker in order to be able to continue drug therapy. It is very common that patients with bradycardia have a strong indication for drugs that aggravate or even cause the bradycardia; in such scenarios, it is generally considered to be evidence based to implement an artificial pacemaker that will allow for drug therapy to continue. Sick sinus syndrome (sinus node dysfunction), which is a common cause of bradycardia, is also discussed separately. Algorithm for acute management of bradycardia
Patients with bradycardia due to myocardial ischemia/infarction only demand treatment if cardiac output is compromised or if the bradycardia predisposes to more malign arrhythmias (the algorithm above applies to this situation as well). Note, however, that bradycardias due to inferior wall ischemia/infarction is transient in most cases and rarely necessitate permanent pacemaker. Anterior wall infarctions, on the other hand, generally leave permanent bradycardia and thus demand permanent pacemaker. Learn more about conduction defects caused by ischemia and infarction. Permanent (long-term) treatment of bradycardiaPermanent symptomatic bradycardias are treated with artificial pacemakers. Note that patients with chronotropic incompetence may require pacemaker to increase exercise capacity and reduce symptoms. Patients with tachy-brady syndrome may also necessitate rate controlling drugs (e.g beta-blockers) and anticoagulation (if atrial fibrillation or flutter can be verified). Next chapterChronotropic incompetence Normal automaticity and pacemaker cells in the heart Mechanisms of cardiac arrhythmias Normal sinus rhythm Sinus tachycardia & Inappropriate Sinus Tachycardia Management (Treatment) of Bradycardias View all chapters in Cardiac Arrhythmias. What are the causes of sinus bradycardia?What are the most common causes of this symptom?
What is the treatment for sinus bradycardia?Treatment of sinus bradycardia: general aspects of management
What does sinus bradycardia look like on an ECG?See below: Sinus bradycardia is usually defined as a heart beat of less than 60 beats per minute. Iit by itself does not indicate a heart problem. Ecg: It looks like a normal ECG but with fewer ECG complexes because the heart rate is less than 60bpm., of course sinus bradycardia can also be seen assoc ...
What are the causes of sinus arrhythmia?The causes of sinus arrhythmia are very diverse:
What is sinus bradycardia with sinus arrhythmia?Sometimes, sinus arrhythmia occurs with another condition called sinus bradycardia. Bradycardia, or a slow heartbeat, is diagnosed when your heart's natural rhythm is below 60 beats per minute. If the low heart rate produces lengthy pauses between beats, you may have sinus bradycardia with sinus arrhythmia.
Should I be worried about sinus arrhythmia?Is sinus arrhythmia dangerous? No. Respiratory sinus arrhythmia is actually a sign of a healthy heart.
Is sinus arrhythmia normal ECG?Sinus arrhythmia is a common finding on telemetry. It is considered to be a normal variation found in healthy young adults. Upon confirming the diagnosis of sinus arrhythmia on EKG, there are no further recommendations regarding treatment.
What does sinus rhythm with sinus arrhythmia mean on an EKG?The rate in NSR is generally regular but will vary depending on autonomic inputs into the sinus node. When there is irregularity in the sinus rate, it is termed "sinus arrhythmia." A sinus rhythm faster than the normal range is called a sinus tachycardia, while a slower rate is called a sinus bradycardia.
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