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The first finding is that junctional rhythms are regular rhythms. This means that the time interval between beats stays constant. The next normal finding is a normal QRS. Since the impulse still travels down the bundle of His, the QRS will not be wide. Junctional rhythms can present with either bradycardia, a normal heart rate, or tachycardia. [9]
In a normal heart, the heart rate is the rate at which the sinoatrial node depolarizes since it is the source of depolarization of the heart. Heart rate, like other vital signs such as blood pressure and respiratory rate, change with age. In adults, a normal heart rate is between 60 and 100 bpm (normocardic), whereas it is higher in children. [57]
In normal adults, T wave inversions from V2 to V3 are less commonly found but can be normal. [4] The depth of the T wave also becomes progressively shallow from one to the next lead. [ 5 ] The height of the T wave should not exceed 5 mm in limb leads and more than 10 mm in precordial leads.
For example, taking normal QTc ≤ 0.42 s, QT would be expected to be 0.42 s or less at a heart rate of 60 bpm. For a heart rate of 70 bpm, QT would roughly be expected to be equal to or below 0.40 s. Likewise, for 80 bpm, QT would roughly be expected to be equal to or below 0.38 s. [13]
Normal heart rate (classically 60 to 100 beats per minute for an adult). Regular rhythm, with less than 0.16-second variation in the shortest and longest durations between successive P waves The sinus node should pace the heart – therefore, P waves must be round, all the same shape, and present before every QRS complex in a ratio of 1:1.
Schematic representation of a normal sinus rhythm ECG wave. Diagram showing how the polarity of the QRS complex in leads I, II, and III can be used to estimate the heart's electrical axis in the frontal plane. The QRS complex is the combination of three of the graphical deflections seen on a typical electrocardiogram (ECG or EKG). It is usually ...
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If lead I is positive (translating to 0° on the hexaxial reference system) and lead II is positive (translating to 60°), the electrical heart axis is estimated to fall in the left lower quadrant within the normal range. On the other hand, as shown in Figure 2, if lead I is negative (translating to 180°) and lead II is positive, the ...