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A sinus rhythm is any cardiac rhythm in which depolarisation of the cardiac muscle begins at the sinus node. [1] It is necessary, but not sufficient, for normal electrical activity within the heart. [2] On the electrocardiogram (ECG), a sinus rhythm is characterised by the presence of P waves that are normal in morphology. [2]
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 is more than 0.12 seconds (120 milliseconds). Additionally, P waves are typically mono-form and in a pattern consistent with atrial activation originating ...
Bigeminy is a cardiac arrhythmia in which there is a single ectopic beat, or irregular heartbeat, following each regular heartbeat. Most often this is due to ectopic beats occurring so frequently that there is one after each sinus beat, or normal heartbeat. The two beats are figuratively similar to two twins (hence bi-+ gemini).
Rhythm interpretation is an important part of healthcare in Emergency Medical Services . Trained medical personnel can determine different treatment options based on the cardiac rhythm of a patient. There are many common heart rhythms that are part of a few different categories, sinus arrhythmia, atrial arrhythmia, ventricular arrhythmia.
Any rhythm beyond these limits is abnormal and classed as a fetal arrhythmia. These are mainly the result of premature atrial contractions, usually give no symptoms, and have little consequence. However, around one percent of these will be the result of significant structural damage to the heart.
Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior fascicular block. Conduction to the ventricle would therefore be via the remaining fascicle. The ECG will show typical features of RBBB plus either left or right axis deviation. [7] [8]
The heart rhythm must originate above the ventricles (i.e., sinoatrial node, atria or atrioventricular node) to activate the conduction system at the correct point. The QRS duration must be more than 100 ms (incomplete block) or more than 120 ms (complete block). [9]
However, a sinus arrest is caused by a failure to form impulses. A third degree block is caused by failure to conduct them. The rhythm is irregular and either normal or slow. It is followed by a long pause that is not a multiple of the P-R interval. The pause ends with a P wave, instead of a junctional escape beat the way a sinus arrest would.