Sinus bradycardia with sinus arrhythmia otherwise normal ecg
Definition of sinus bradycardia
Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute. ECG criteria follows:
- Regular rhythm with ventricular rate slower than 50 beats per minute.
- P-waves with constant morphology preceding every QRS complex.
- P-wave is positiv in limb lead II.
Normal (physiological) causes of sinus bradycardia
Sinus bradycardia (SB) is considered a normal finding in the following circumstances:
- During sleep.
- Well-trained individuals display SB at rest due to high vagal tone. These individuals have developed a highly efficient left ventricle, capable of
generating sufficient cardiac output at low heart rates.
- During vasovagal syncope (e.g during intense emotional stress)
- During vagal maneuvers (Valsalva maneuver, carotid sinus [baroreceptor] stimulation).
- Its not uncommon to discover SB in healthy young individuals who are not well-trained. This is also a normal finding.
Abnormal (pathological) causes of sinus bradycardia
In 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:
- Myocardial
ischemia/infarction – Particularly ischemia or infarction located to the inferior wall of the left ventricle. This type of bradycardia is due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects (e.g second-degree AV block) as a result of ischemia/infarction.
- Sinus Node Dysfunction (SND) – Sinus node dysfunction
implies that the cells of the sinoatrial node are defect and fail to generate electrical impulses.
- Side effects of drugs (notably beta blockers, digitalis, verapamil, diltiazem, amiodarone, klonidin) – These drugs affect the pacemaker cells in the sinoatrial node. They may also induce conduction defects (e.g AV block).
- Increased
intracranial pressure (manifests with sinus bradycardia and hypertension).
- Hypothyroidism.
- Hypothermia.
- Hyperkalemia.
ECG example of sinus bradycardia
Figure 1 shows sinus bradycardia at paper speed 25 mm/s.
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What is the treatment for sinus bradycardia?
Treatment of sinus bradycardia: general aspects of management
- Algorithm for acute management of bradycardia. Terminate or adjust any medications that cause or aggravate the bradycardia. It can be repeated if necessary.
- Permanent (long-term) treatment of bradycardia. Permanent symptomatic bradycardias are treated with artificial pacemakers. ...
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- Related chapters. View all chapters in Cardiac Arrhythmias.
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:
- neurocircular dystonia;
- lack of magnesium or potassium in the blood;
- osteochondrosis;
- amyloid dystrophy;
- supercooling;
- oxygen starvation;
- failures in the thyroid gland;
- hypertension;
- hormonal disorders;
- anemia;
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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.