Normal Sinus Rhythm
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Normal Sinus Rhythm
A sinus rhythm is any cardiac rhythm in which depolarisation of the cardiac muscle begins at the sinus node. It is characterised by the presence of correctly oriented P waves on the electrocardiogram (ECG). Sinus rhythm is necessary, but not sufficient, for normal electrical activity within the heart. The term normal sinus rhythm (NSR) is sometimes used to denote a specific type of sinus rhythm where all other measurements on the ECG also fall within designated normal limits, giving rise to the characteristic appearance of the ECG when the electrical conduction system of the heart is functioning normally; however, other sinus rhythms can be entirely normal in particular patient groups and clinical contexts, so the term is sometimes considered a misnomer and its use is sometimes discouraged. Other types of sinus rhythm that can be normal include sinus tachycardia, sinus bradycardia, and sinus arrhythmia. Sinus rhythms may be present together with various other cardiac arrhythmi ...
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Sinus Bradycardia
Sinus bradycardia is a sinus node dysfunction giving a heart rate that is lower than the normal 60–100 beats per minute (bpm) in humans. Bradycardia is generally defined to be a heart rate of under 60 bpm. Signs and symptoms The decreased heart rate can cause a decreased cardiac output resulting in symptoms such as lightheadedness, dizziness, hypotension, vertigo, and syncope. The slow heart rate may also lead to atrial, junctional, or ventricular ectopic rhythms. Bradycardia is not necessarily problematic. People who practice sports may have sinus bradycardia, because their trained hearts can pump enough blood in each contraction to allow a low resting heart rate. Sinus bradycardia can also be an adaptive advantage; for example, diving seals may have a heart rate as low as 12 beats per minute, helping them to conserve oxygen during long dives. Sinus bradycardia is a common condition found in both healthy individuals and those who are considered well-conditioned athletes. ...
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PR Interval
In electrocardiography, the PR interval is the period, measured in milliseconds, that extends from the beginning of the P wave (the onset of atrial depolarization) until the beginning of the QRS complex (the onset of ventricular depolarization); it is normally between 120 and 200 ms in duration. The PR interval is sometimes termed the PQ interval. Interpretation Variations in the PQ interval can be associated with certain medical conditions: * Duration ** A long PR interval (of over 200 ms) indicates a slowing of conduction between the atria and ventricles, usually due to slow conduction through the atrioventricular node (AV node). This is known as first degree heart block. Prolongation can be associated with fibrosis of the AV node, high vagal tone, medications that slow the AV node such as beta-blockers, hypokalemia, acute rheumatic fever, or carditis associated with Lyme disease. ** A short PR interval (of less than 120ms) may be associated with a Pre-excitation syndromes ...
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QRS Complex
The QRS complex is the combination of three of the graphical deflections seen on a typical electrocardiogram (ECG or EKG). It is usually the central and most visually obvious part of the tracing. It corresponds to the depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. In adults, the QRS complex normally lasts ; in children it may be shorter. The Q, R, and S waves occur in rapid succession, do not all appear in all leads, and reflect a single event and thus are usually considered together. A Q wave is any downward deflection immediately following the P wave. An R wave follows as an upward deflection, and the S wave is any downward deflection after the R wave. The T wave follows the S wave, and in some cases, an additional U wave follows the T wave. To measure the QRS interval start at the end of the PR interval (or beginning of the Q wave) to the end of the S wave. Normally this interval is 0.08 to 0.10 seconds. When ...
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Artificial Pacemaker
An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart either the upper atria, or lower ventricles to cause the targeted chambers to contract and pump blood. By doing so, the pacemaker regulates the function of the electrical conduction system of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a cardiologist, particularly a cardiac electrophysiologist, to select the optimal pacing modes for individual patients. Most pacemakers are on demand, in which the stimulation of the heart is based on the dynamic demand of the circulatory system. Others send out a fixed rate of ...
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Complete Heart Block
Third-degree atrioventricular block (AV block) is a medical condition in which the electrical impulse generated in the sinoatrial node (SA node) in the atrium of the heart can not propagate to the ventricles. Because the impulse is blocked, an accessory pacemaker in the lower chambers will typically activate the ventricles. This is known as an ''escape rhythm''. Since this accessory pacemaker also activates independently of the impulse generated at the SA node, two independent rhythms can be noted on the electrocardiogram (ECG). * The P waves with a regular P-to-P interval (in other words, a sinus rhythm) represent the first rhythm. * The QRS complexes with a regular R-to-R interval represent the second rhythm. The PR interval will be variable, as the hallmark of complete heart block is the lack of any apparent relationship between P waves and QRS complexes. Presentation People with third-degree AV block typically experience severe bradycardia (an abnormally low measured heart ...
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Euclidean Vector
In mathematics, physics, and engineering, a Euclidean vector or simply a vector (sometimes called a geometric vector or spatial vector) is a geometric object that has magnitude (or length) and direction. Vectors can be added to other vectors according to vector algebra. A Euclidean vector is frequently represented by a '' directed line segment'', or graphically as an arrow connecting an ''initial point'' ''A'' with a ''terminal point'' ''B'', and denoted by \overrightarrow . A vector is what is needed to "carry" the point ''A'' to the point ''B''; the Latin word ''vector'' means "carrier". It was first used by 18th century astronomers investigating planetary revolution around the Sun. The magnitude of the vector is the distance between the two points, and the direction refers to the direction of displacement from ''A'' to ''B''. Many algebraic operations on real numbers such as addition, subtraction, multiplication, and negation have close analogues for vectors, operations whic ...
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Cardiac Arrhythmia
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death. Arrhythmias are often categorized into four groups: extra beats, supraventricular tachycardias, ventricular arrhythmias and bradyarrhythmias. Extra beats include premature atrial contractions, premature ventricular contra ...
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Sinus Arrhythmia
Sinus arrhythmia is a commonly encountered variation of ''normal'' sinus rhythm. Sinus arrhythmia characteristically presents with an irregular rate in which the variation in the R-R interval vary by more than 0.12 seconds (120 milliseconds). Additionally, P waves are typically mono-form and in a pattern consistent with atrial activation originating from the sinus node. Respiratory sinus arrhythmia During respiration, the intermittent vagus nerve activation occurs, which results in beat to beat variations in the resting heart rate. During inspiration vagal tone is slowed down and the heart rate goes up (being maximal at the peak of inspiration), while during expiration vagal tone is increased and heart rate decreases, being slowest at end-inspiration. When present, respiratory sinus arrhythmia typically indicates good cardiovascular health and is more commonly seen in young healthy people, especially those with enhanced vagal tone or slower heart rates. Text was copied from thi ...
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Sinus Tachycardia
Sinus tachycardia is an elevated sinus rhythm characterized by an increase in the rate of electrical impulses arising from the sinoatrial node. In adults, sinus tachycardia is defined as a heart rate greater than 100 beats per minute (bpm). The normal resting heart rate is 60–90 bpm in an average adult. Normal heart rates vary with age and level of fitness, from infants having faster heart rates (110-150 bpm) and the elderly having slower heart rates. Sinus tachycardia is a normal response to physical exercise, when the heart rate increases to meet the body's higher demand for energy and oxygen, but sinus tachycardia can also indicate a health problem. Thus, sinus tachycardia is a medical finding that can be either physiological or pathological. Signs and symptoms Tachycardia is often asymptomatic. It is often a resulting symptom of a primary disease state and can be an indication of the severity of a disease. If the heart rate is too high, cardiac output may fall due to the ma ...
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Cardiac Rhythm
The cardiac conduction system (CCS) (also called the electrical conduction system of the heart) transmits the signals generated by the sinoatrial node – the heart's pacemaker, to cause the heart muscle to contract, and pump blood through the body's circulatory system. The pacemaking signal travels through the right atrium to the atrioventricular node, along the bundle of His, and through the bundle branches to Purkinje fibers in the walls of the ventricles. The Purkinje fibers transmit the signals more rapidly to stimulate contraction of the ventricles. The conduction system consists of specialized heart muscle cells, situated within the myocardium. There is a skeleton of fibrous tissue that surrounds the conduction system which can be seen on an ECG. Dysfunction of the conduction system can cause irregular heart rhythms including rhythms that are too fast or too slow. Structure Electrical signals arising in the SA node (located in the right atrium) stimulate the atria ...
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