Electrocardiogram sinus rhythm. Sinus rhythm: what is it, what does it look like on an ECG, possible disturbances ECG sinus rhythm with heart rate

Human heart is a kind of trigger for the productive work of the whole organism. Thanks to the impulses of this organ, which are issued in on a regular basis, blood has the ability to circulate throughout the body, saturating the body with vital important substances. If the heart is normal, then the whole body works as productively as possible, but sometimes you still have to face certain health problems.

If a person comes for an examination to a doctor and the specialist suspects that something is wrong with his heart, he will send the patient for an ECG. Sinus rhythm on an ECG is a very important indicator and clearly provides data on the real state of the human heart muscle. What exactly can be determined by looking at the cardiogram is worth considering in more detail.

What is sinus rhythm

In the concept of medical staff, sinus rhythm of the cardiogram is the norm for human body. If there are equal spaces between the teeth shown on the cardiogram, and the height of these columns is also the same, then there are no deviations in the functioning of the main organ.

This means that sinus rhythm on the cardiogram is as follows:

• graphical representation of human pulse fluctuations;
• set of teeth different lengths, between which there are different intervals showing the specific rhythm of heart impulses;
• schematic representation of the work of the heart muscle;
• an indicator of the presence or absence of abnormalities in the functioning of the heart and its individual valves.

Normal sinus rhythm is only present when the heart rate is at least 60 and no more than 80 beats per minute. This is the rhythm that is considered normal for the human body. and on the cardiogram it is displayed as teeth of the same size, located at the same distance from each other.

If the sinus rhythm of the heart cardiogram deviates from the norm, then medical specialist will prescribe a series of additional research, including analyzes

It is clearly worth remembering that the results of a cardiogram can be one hundred percent accurate only if the person is completely calm. Stressful situations and nervous tension contribute to the fact that the heart muscle begins to emit impulses faster, and therefore receive reliable result about the state of a person’s health will definitely not be possible.

What criteria are used to decipher the ECG result?

It is performed by doctors according to a special scheme. Medical specialists have a clear understanding of which marks on the cardiogram are normal and which are abnormal. The ECG conclusion will be issued only after calculating the results, which were displayed in schematic form. A doctor, when examining a patient’s cardiogram in order to correctly and accurately decipher it, will turn Special attention on a number of such indicators:

• the height of the bars displaying the rhythm of heart impulses;
• the distance between the teeth on the cardiogram;
• how sharply the indicators of the schematic image fluctuate;
• what specific distance is observed between the bars displaying the pulses.

A doctor who knows what each of these schematic marks means carefully studies them and can clearly determine what kind of diagnosis needs to be made. Cardiograms of children and adults are deciphered according to the same principle, but the normal indicators for people are different age categories cannot be the same.

What sinus rhythm problems can be seen on an ECG?

Electrocardiogram readings can indicate obvious signs problems in the functioning of the heart muscles. With the help of this study, you can notice whether there is weakness of the sinus node, and what kind of health problems this causes. By looking at the cardiogram readings of a particular patient, a medical specialist can decipher the presence of problems of the following nature:

• sinus tachycardia on the ECG, indicating an excess of the contraction rhythm, which is considered normal;
• sinus arrhythmia on the ECG, indicating that the interval between contractions of the heart muscles is too long;
• sinus bradycardia on the ECG, indicating that the heart beats less than 60 times in one minute;
• the presence of too small an interval between the teeth of the cardiogram, which means disturbances in the functioning of the sinus node.

Using an ECG it is easy to determine the presence sinus tachycardia, arrhythmias or bradycardia

Sinus bradycardia is a common abnormality, especially if we're talking about about the child's health. This diagnosis can be explained by many factors, among which may be physiological defects or simply a factor chronic fatigue.

Deviation of the EOS to the left also indicates that the work is vital important body not set up correctly. Having identified such deviations, the doctor will send the patient for additional examination and ask him to take a series of necessary tests.

If observed vertical position EOS, this means that the heart has a normal location and is in its place, there are no serious physiological abnormalities. This situation is an indicator of the norm, which is also indicated in the conclusion of the doctor who deciphered the cardiogram.

If observed horizontal position EOS, then this cannot immediately be considered a pathological condition. Such axis indicators are observed in people who are short in stature but have fairly broad shoulders. If the axis deviates to the left or right, and this is very noticeable, then such indicators may indicate a pathological condition of the organ, an enlargement of the left or right ventricles. Axial displacement may indicate that certain valves are affected. If the axis shifts to the left, then the person most likely has heart failure. If a person suffers from ischemia, then the axis shifts in right side. Such a deviation may also indicate abnormalities in the development of the heart muscle.

What can we say about normal indicators?

On ECG sinus the rhythm is always mandatory is compared with certain norm indicators. Only knowing these indicators completely will the doctor be able to understand the patient’s cardiogram and give the correct conclusion.

Normal indicators for children and adults are completely various factors. If we consider the norms for different age categories, they will be something like this:

• in children from birth to the first year of life, the direction of the axis is vertical, the heart beats with a heart rate of 60 to 150 beats per minute;
• children from one year to six years have a mainly vertical axis, but it can also be horizontal, without indicating deviations from the norm. Heart rate from 95 to 128;
• children from seven years of age and representatives adolescence on the cardiogram should have a normal or vertical position of the axis, the heart should contract from 65 to 90 beats per minute;
• adults should have a normal axis direction on the cardiogram, the heart contracts at a frequency of 60 to 90 times per minute.

Normal heart rate children have more than adults

The above indicators fall under the category of the established norm, but if they are slightly different, this does not always become a sign of the presence of some serious pathologies in the body.

Why ECG readings may deviate from the norm

Irregular heart rhythm can be provoked not only by serious pathological abnormalities, but also by more common ones. Everyday life human factors.

If the result of the electrocardiogram does not always correspond to the norm, this means that this state of the body could be provoked by the following factors:

• are regularly consumed by humans alcoholic drinks;
• the patient is quite long time smokes cigarettes on a regular basis;
• a person is regularly exposed to various types of stressful situations;
• the patient often uses antiarrhythmic drugs medications;
• a person has problems with the functioning of the thyroid gland.

Of course, accelerated heartbeat or too slow may indicate problems of a more serious nature. If the results of the cardiogram do not correspond to the norm, this may indicate acute heart failure, valve displacement, congenital defects hearts.

If the sinus rhythm is within the established norm, then the person should not worry, and the doctor will be able to make sure that his patient is healthy.

The sinus node regularly emits impulses that cause the heart muscles to contract correctly and carry the necessary signals throughout the body. If these impulses are given irregularly, which can be clearly recorded by a cardiogram, then the doctor will have every reason to assume that the person has health problems. After studying the heart rate, the doctor will determine exact reason all deviations and will be able to offer the patient competent treatment.

Why should a person undergo an ECG test?

The sinus rhythm, which is displayed on the ECG, clearly indicates whether there are deviations in the functioning of the heart and in which directions the problem is observed. Not only adults, but also children need to undergo such research regularly. The results of a completed cardiogram will help a person obtain the following information:

• does he have any congenital pathologies or diseases;
• What pathologies in the body cause heart problems;
• could a person’s way of life become the cause of disturbances in the functioning of the main organ;
• whether the heart is in the correct position and whether its valves are working correctly.

Normal sinus rhythm on an ECG is displayed as waves of the same size and shape, and the distance between them is also the same. If any deviations from this norm are observed, then the person will have to be further examined.

Any irregularities in the cardiogram sheet can also be observed due to the fact that at the time of the procedure the person was very agitated. If the patient does notice something like this, then he should calm down and go through the procedure again in order to definitely get a reliable result.

The sinus rhythm on the cardiogram must coincide with the established norm, and only in this case can a person be considered healthy. If impulses from the heart to other systems diverge too quickly or slowly, then this does not bode well. This means that doctors will have to further clarify the cause of the problem and deal with it. complex treatment. If an uneven rhythm is observed on a teenager’s cardiogram, then this cannot be considered a pathological deviation, because such a condition may be associated with hormonal changes and physiological maturation of the body.

Doing a cardiogram regularly and checking the rhythm of impulses is necessary for those who already have heart problems or work in certain fields

If the sinus rhythm is within normal limits, then take additional tests and you won’t have to undergo repeated tests. Normal heart function, as well as pathological abnormalities, are always recorded by a cardiogram.

The sinus rhythm on the ECG should be smooth and clear, without any broken lines, too long or short intervals. If the presented indicators are normal, then we can safely say that the person is completely healthy. Deviations in the cardiogram are a reason for doctors to perform additional studies and prescribe tests. Only after additional examinations can we understand the exact cause of the deviations and begin treatment. A normal sinus rhythm is reflected by a clear and evenly spaced cardiogram. Additional attention will have to be paid to the location of the axis, regarding the parameters of which medical standards have also been established.

An electrocardiogram is prescribed to a patient when the doctor suspects the development of a disease associated with cardiovascular system. With the help of such an examination, many factors can be identified: worsening of a previously detected pathology, the manifestation of new symptoms.

The procedure is mandatory before each surgery, regardless of damaged organs and suspected disease. The results of the electrocardiogram have certain marks of normal activity of the heart muscle. Cardiogram of the heart, sinus rhythm, what is it?

Normal indicators

The sinus ECG rhythm indicates the absence of any abnormalities in the functioning of the heart muscle in the patient’s body. These are certain oscillations, when they appear, electronic impulses are first formed in the sinus node, and only then diverge to their final destinations - to the ventricular and precardiac sections of the organ. In general, this whole process makes a person’s heart beat, saturating the limbs with blood.

The cardiogram displays correct result, if the patient who was prescribed the examination does not need to worry or be nervous about any issues. He shouldn't be afraid, it's better to relax and not think about anything.

What does sinus heart rhythm mean? When a cardiologist puts a certain mark on the cardiogram, he shows that the P peak in the entire QRS complex is constant, the main beat interval is 65–85 beats in 60 seconds, and the displayed distances P-P, R-R are similar. As a result, it becomes clear that the survey methodology great value focuses on localizing the driver's rhythm in the sinus center. For a reliable analysis, the following factors are checked:

• The P points should precede the QRS complexes;
• The P values ​​of the openings must be identical to each other and located in similar divisions;
• In the 2nd opening, point P should be in the positive spectrum.

When all the data ECG signs The sinus beat is found in full, this means that the excitatory impulses are correctly distributed in order from top to bottom. If they were not detected, the rhythm cannot be assessed as sinus.

This fact will indicate that the source is located in the second-order sections: the ventricles, atrium or atrioventricular node.

Interpretation of the cardiogram - vertical position of the ECG rhythm. It means that the central axis and stroke move according to the accepted norm. As a result, this method determines the closest position of the heart muscle in chest patient.

IN special cases the organ is located in planes - horizontal and semi-horizontal, as well as half vertical. It is worth noting that the heart can move in different sides relative to the axis: forward and backward, to the sides. This fact is not proof of the development of pathology, it only indicates the individual characteristics of the patient’s body structure.

Deviations from the norm

Unfortunately, not all people have good health. Often, during diagnosis, various deviations and disorders are revealed. ECG indicator negative character, usually speaks of blockades in the heart or arrhythmia.

The blockage is usually caused by abnormal, unusual transmission of electrical impulses from the CNS (central nervous system) to the heart muscle itself. For example, an overestimated number of pulse beats indicates that with the usual systematics, as well as the standard sequence of organ compression, the oscillations are slightly accelerated and increased.

When talking about deviations in beat, it is usually caused by any differences between the sequence, frequency and regularity of beats. The size of the differences between the distances of points on the ECG reflects the irregularity of sinus rhythm. As a rule, this indicates a weak node.

To identify the development of heart rhythm pathology, a Holter examination is prescribed, and a medication test is also performed. This method is used to determine how stable the regulation of the autonomic system is and whether it has gone astray.

Signs of sinus rhythm disturbances on the ECG

Weakness syndrome (SSWS) is damage to the exciter impulses, which can be detected using electrocardiographic examination and clinical methods.

It is important to know what the normal ECG examination looks like in order to diagnose the presence of arrhythmia in a patient.

It was already indicated above that the disease is characterized by P waves located in the positive zone and similar in size. They must also be at the same distance from each other (approximately from 0.1 to 0.2 seconds), and must be in front of the QRS indicator.

The main thing is that the frequency of heart muscle beats within one minute does not exceed 90–100 contractions. To calculate the desired mark, you need to divide 60 by the length of the armhole R-R, displayed on the second scale.

Another method is to multiply the QRS mark obtained over a 3-second interval (approximately 15 centimeters on the tape) by 20. An ECG examination of sinus rhythm may show the following abnormalities:

Causes of heart rate surges

TO most known reasons disorders of the heart include:

1. Excessive alcohol consumption;
2. Cardiac muscle disorders - defects, acquired or congenital;
3. Tobacco smoking;
4. Long-term use of antiarrhythmic medications, glucosides;
5. Bulging mitral valve, having a full or partial nature;
6. Vivid heart failure;
7. A strong surge in the production of thyroid hormones.

Some factors that influence an increase in heart rate can eliminate rhythm deviations during respiratory function.

• Basic ECG parameters
• Sinus rhythm abnormalities on ECG
• Classification of arrhythmia
• Clinical picture of sinus rhythm disorders

Also in his conclusion, the cardiologist can indicate the stability or instability of the heart rhythm. This indicator is also determined by the length of the intercomplex intervals. In this case, there are two extreme variants of pathology: and.

In the first case, there is too frequent (more than 100 times per minute) generation of contractions by the sinoatrial node. In the case of bradycardia, a small number of heart contractions per unit of time is observed. Clinicians consider the minimum limit of normal, taking into account physiological characteristics, to be 50 beats per minute.

At the same time, both variants of the pathology carry quite significant grounds for immediate rhythm correction, since they equally have a detrimental effect on the functioning of the heart.

If we talk about instability of sinus rhythm, or, then this problem is identified by cardiologists as a separate group of heart diseases.

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Classification of arrhythmia

They involve the allocation large quantity various types of arrhythmias.

The extreme variants of development are complete dysfunction of the sinoatrial node with the formation of atrial fibrillation and flutter.

In such cases, the heart rate exceeds 250-500 beats per minute, the waves on the ECG are practically not tracked, and the formation of single sawtooth waves f on the isoline is noted.

In cardiology, atrial fibrillation is also called atrial fibrillation.

In cases where the sinus rhythm driver loses its functions, the formation of non-sinus rhythms develops. IN clinical picture this is reflected in the form of various types of arrhythmias.

Thus, when analyzing sinus rhythm, there are three main pathological conditions:

1. - in this case, the correct one is observed, the frequency of contractions is more than 110 per minute. Among the causes of sinus tachycardia, clinicians highlight increased activity sympathetic division vegetative nervous system(this can be a variety of emotional or physical overload, decreased activity vagus nerve, lesions of the sinoatrial node, various intoxications, infectious diseases or the effects of certain medications).
2. - an option in which it takes place correct rhythm, generated by the sinoatrial node, with a frequency of less than 50 beats per minute. The causes of bradycardia are opposite to the previous condition. These include an increase in the activity of the vagus nerve, a decrease in the influence of the sympathetic nervous system, different kinds hypoxia, extensive myocardial infarction, the influence of antiarrhythmics and cardiac glycosides, hypothyroidism, some infectious diseases.
3. Sinus arrhythmia - characterized by the fact that the rhythm is formed by the sinus driver, but the contraction frequency varies within limits exceeding 0.16 seconds. In this case, depending on the presence or absence of a clearly visible connection between heart rate intervals and the duration of respiratory cycles, we can talk about respiratory and non-respiratory sinus arrhythmia. The first, as a rule, characterizes the presence of an imbalance in the functioning of parts of the autonomic nervous system. The second variant of arrhythmia indicates an organic lesion of the pacemaker itself. It could be ischemic disease heart, various inflammatory changes in the myocardium, toxic effects of cardiac glycosides.

Sinus rhythm is one of the most important indicators normal operation heart, which indicates that the source of contractions comes from the main, sinus, node of the organ. This parameter is one of the first in the ECG conclusion, and patients who have undergone the study are eager to find out what it means and whether they should worry.

Heart - main body, which supplies all organs and tissues with blood, the degree of oxygenation and the function of the entire organism depend on its rhythmic and consistent work. To contract a muscle, you need a push - an impulse emanating from special cells of the conduction system. The characteristics of the rhythm depend on where this signal comes from and what its frequency is.

the cardiac cycle is normal, the primary impulse comes from the sinus node (SU)

The sinus node (SU) is located under the inner lining of the right atrium, it is well supplied with blood, receiving blood directly from the coronary arteries, and is richly supplied with fibers of the autonomic nervous system, both parts of which influence it, contributing to both an increase and a decrease in the frequency of impulse generation.

The cells of the sinus node are grouped into bundles; they are smaller than ordinary cardiomyocytes and have a spindle-shaped shape. Their contractile function is extremely weak, but their ability to form an electrical impulse is akin to nerve fibers. The main node is connected to the atrioventricular junction, to which it transmits signals for further excitation of the myocardium.

The sinus node is called the main pacemaker, because it is the one that provides the frequency of heart contractions that gives the organs adequate blood supply, therefore maintaining a regular sinus rhythm is extremely important for assessing the work of the heart when it is damaged.

The control system generates pulses of the highest frequency compared to other parts of the conduction system, and then transmits them with high speed Further. The frequency of impulse formation by the sinus node is ranging from 60 to 90 per minute, which corresponds to the normal heart rate, when they occur due to the main pacemaker.

Electrocardiography is the main method that allows you to quickly and painlessly determine where the heart receives impulses, what their frequency and rhythm are. ECG has become firmly established in the practice of therapists and cardiologists due to its accessibility, ease of implementation and high information content.

Having received the result of electrocardiography, everyone will look at the conclusion left there by the doctor. The first of the indicators will be the assessment of the rhythm - sinus, if it comes from the main node, or non-sinus, indicating its specific source (AV node, atrial tissue, etc.). So, for example, the result “sinus rhythm with heart rate 75” should not bother you, this is the norm, but if a specialist writes about non-sinus, increased heart rate (tachycardia) or slowdown (bradycardia), then It's time to go for further examination.

Rhythm from the sinus node (SU) – sinus rhythm – normal (left) and pathological non-sinus rhythms. The pulse origination points are indicated

Also, in conclusion, the patient can find information about the position of the EOS ( electrical axis hearts). Normally, it can be either vertical or semi-vertical, or horizontal or semi-horizontal, depending on individual characteristics person. Deviations of the EOS to the left or right, in turn, usually indicate organic pathology of the heart. The EOS and its position options are described in more detail in.

Sinus rhythm is normal

Often, patients who detect sinus rhythm in the ECG report begin to worry whether everything is in order, because the term is not known to everyone, and therefore may indicate pathology. However, you can calm them down: Sinus rhythm is the norm, which indicates the active functioning of the sinus node.

On the other hand, even with preserved activity of the main pacemaker, some deviations are possible, but they do not always serve as an indicator of pathology. Rhythm fluctuations occur at different physiological conditions, not called pathological process in the myocardium.

The impact of the vagus nerve and fibers of the sympathetic nervous system on the sinus node often causes a change in its function towards a higher or lower frequency of formation of nerve signals. This is reflected in the heart rate, which is calculated on the same cardiogram.

Normally, the frequency of sinus rhythm lies in the range from 60 to 90 beats per minute, but experts note that there is no clear boundary for determining normality and pathology, that is, with a heart rate of 58 beats per minute, it is too early to talk about bradycardia, as well as tachycardia if it exceeds indicator of 90. All these parameters must be assessed comprehensively with mandatory consideration general condition the patient, the characteristics of his exchange, type of activity, and even what he was doing immediately before the study.

Determining the source of rhythm when analyzing an ECG is a fundamental point, while the following are considered indicators of sinus rhythm:

• Identification of P waves before each ventricular complex;
• Constant configuration of atrial waves in the same lead;
• Constant value of the interval between the P and Q waves (up to 200 ms);
• The P wave is always positive (directed upward) in the second standard lead and negative in aVR.

At the conclusion of the ECG, the subject can find: “sinus rhythm with heart rate 85, normal position of the electrical axis.” We consider this conclusion to be the norm. Another option: “non-sinus rhythm with a frequency of 54, ectopic.” This result should be alarming, since serious myocardial pathology is possible.

The characteristics listed above on the cardiogram indicate the presence of sinus rhythm, which means that the impulse goes from the main node down to the ventricles, which contract after the atria. In all other cases, the rhythm is considered non-sinus, and its source lies outside the sinus system - in the fibers of the ventricular muscle, atrioventricular node, etc. Pulsation is possible from two places of the conduction system at once, in this case we are also talking about arrhythmia.

Correct conclusions about the regulation of heart rhythm can be made by studying long-term ECG recordings, since in the course of life everyone healthy people There is a change in the frequency of heartbeats: at night the pulse is one, during the day - another. However, even shorter periods of recording ECG signs demonstrate pulse unevenness associated with the peculiarities of autonomic innervation and the functioning of the whole organism as a whole. Pulse assessment is helped by specially developed mathematical processing programs, statistical analysis- cardiointervalography, histography.

For the ECG result to be most accurate, all possible reasons changes in heart activity. Smoking, quickly climbing stairs or running, or drinking a cup of strong coffee can change cardiac parameters. The rhythm, of course, will remain sinus if the node is working correctly, but at least tachycardia will be recorded. In this regard, before the study you need to calm down, eliminate stress and anxiety, as well as physical activity - everything that directly or indirectly affects the result.

Sinus rhythm and tachycardia

Let us remember again that sinus rhythm corresponds to a frequency of 60–90 per minute. But what to do if the parameter goes beyond the established limits while maintaining its “sinus”? It is known that such fluctuations do not always indicate pathology, so there is no need to panic prematurely.

Accelerated sinus rhythm of the heart (), which is not an indicator of pathology, is recorded when:

1. Emotional experiences, stress, fear;
2. Strong physical activity- in the gym, during heavy physical labor etc.;
3. After eating too much, drinking strong coffee or tea.

Such physiological tachycardia reflected in ECG data:

• The length of the gap between the P waves and the RR interval decreases, the duration of which, with appropriate calculations, allows us to determine exact figure Heart rate;
• The P wave remains in its normal place - in front of the ventricular complex, which, in turn, has the correct configuration;
• According to calculations, the heart rate exceeds 90-100 per minute.

Tachycardia with preserved sinus rhythm in physiological conditions is aimed at providing blood to tissues, which various reasons They began to need it more - playing sports, jogging, for example. It cannot be considered a violation, and in a short period of time the heart itself restores the sinus rhythm to normal frequency.

If, in the absence of any diseases, the subject encounters tachycardia with sinus rhythm on the cardiogram, you should immediately remember how the study took place - whether he was worried, whether he rushed headlong to the cardiography room, or maybe he smoked on the stairs of the clinic just before taking an ECG.

Sinus rhythm and bradycardia

The opposite of sinus tachycardia is the slowing down of its contractions (), which also does not always indicate pathology.

Physiological bradycardia with a decrease in the frequency of impulses from the sinus node to less than 60 per minute can occur with:

1. State of sleep;
2. Professional sports;
3. Individual constitutional characteristics;
4. Wearing clothes with a tight collar and a tightly tightened tie.

It is worth noting that bradycardia more often than an increase in heart rate indicates pathology, so close attention is usually paid to it. With organic lesions of the heart muscle, bradycardia, even if the “sinus” rhythm is maintained, can become a diagnosis requiring drug treatment.

During sleep, there is a significant decrease in heart rate - about a third of “ daily value", which is associated with the predominance of the tone of the vagus nerve, suppressing the activity of the sinus node. ECG is more often recorded in awake subjects, so such bradycardia is not recorded in routine mass studies, but it can be seen in daily monitoring. If in the conclusion of Holter monitoring there is an indication of a decrease in sinus rhythm during sleep, then it is likely that the indicator will fit into the norm, which the cardiologist will explain to particularly worried patients.

In addition, it was noted that about 25% of men young have a rarer pulse in the range of 50-60, and the rhythm is sinus and regular, there are no symptoms of trouble, that is, this is a variant of the norm. Professional athletes are also prone to bradycardia due to systematic physical activity.

Sinus bradycardia is a condition when the pulse decreases to less than 60, but impulses in the heart continue to be generated by the main node. People with this condition may faint or experience dizziness; often this anomaly accompanies vagotonia (a variant of vegetative-vascular dystonia). Sinus rhythm with bradycardia should be a reason to exclude serious changes in the myocardium or other organs.

Signs of sinus bradycardia on the ECG will be lengthening of the intervals between the atrial waves and complexes ventricular contractions, however, all indicators of “sinus” rhythm are preserved - the P wave still precedes the QRS and has constant value and shape.

Thus, sinus rhythm is normal indicator on the ECG, indicating the preserved activity of the main pacemaker, and with normosystole the rhythm is both sinus and normal frequency - between 60 and 90 beats. In this case, there should be no cause for concern unless there are indications of other changes (ischemia, for example).

When should you worry?

Cardiography findings indicating pathological sinus tachycardia, bradycardia, or rhythm instability and irregularity should be a cause for concern.

In case of tachy- and bradyforms, the doctor quickly determines whether the pulse deviates from the norm to a greater or lesser extent, clarifies complaints and refers to additional examinations- Ultrasound of the heart, Holter, blood tests for hormones, etc. Having found out the cause, you can begin treatment.

Unstable sinus rhythm on the ECG is manifested by unequal intervals between the main teeth of the ventricular complexes, the fluctuations of which exceed 150-160 ms. This is almost always a sign of pathology, so the patient is not ignored and the cause of instability in the sinus node is found out.

Electrocardiography will also indicate that the heart beats with an irregular sinus rhythm. Irregular contractions may be caused by structural changes in the myocardium - scar, inflammation, as well as heart defects, heart failure, general hypoxia, anemia, smoking, endocrine pathology, abuse of certain groups of drugs and many other reasons.

An irregular sinus rhythm comes from the main pacemaker, but the frequency of the organ’s beats either increases or decreases, losing its constancy and regularity. In this case, they talk about sinus arrhythmia.

Features of rhythm in children

Children are a very special part of people whose many parameters are very different from adults. So, any mother will tell you how often the heart of a newborn baby beats, but at the same time she will not worry, because it is known that babies of the first years and, especially newborns, have a pulse much faster than adults.

Sinus rhythm should be recorded in all children without exception, unless there is heart damage. Age-related tachycardia is associated with small in size heart, which must provide a growing organism required quantity blood. How smaller child- the faster his pulse, reaching 140-160 seconds per minute during the newborn period and gradually decreasing to the “adult” norm by the age of 8 years.

An ECG in children records the same signs of sinus origin of the rhythm - P waves before ventricular contractions of the same size and shape, while tachycardia must fit into age parameters. The lack of activity of the sinus node, when the cardiologist indicates instability of the rhythm or ectopia of its driver, is a reason for serious concern for doctors and parents and a search for the cause, which in childhood most often becomes a congenital defect.

At the same time, when reading the indication of sinus arrhythmia according to the ECG data, the mother should not immediately panic and faint. It is likely that sinus arrhythmia is related to breathing, which is often observed in childhood. It is also necessary to take into account the conditions for taking an ECG: if the baby is laid on a cold couch, he is scared or confused, then a reflexive holding of breath will increase the manifestations of respiratory arrhythmia, which does not indicate a serious illness.

However, sinus arrhythmia should not be considered normal until its physiological nature is clearly proven. Thus, sinus rhythm pathology is more often diagnosed in premature babies affected by intrauterine children, with increased intracranial pressure in newborns. It can be provoked by rickets, rapid growth,... As the nervous system matures, rhythm regulation improves, and disturbances may go away on their own.

Third sinus arrhythmias children wear pathological character and called hereditary factors, infection with high fever, rheumatism, myocarditis, heart defects.

Sports for children with respiratory arrhythmia are not contraindicated, but only under the condition of constant dynamic monitoring and ECG recording. If the cause of unstable sinus rhythm turns out to be non-physiological, then the cardiologist will be forced to limit the child’s sports activities.

It is clear that parents are concerned important question: what to do if the sinus rhythm on the ECG is incorrect or an arrhythmia is recorded? First, you need to go to a cardiologist and give your child another cardiogram. If the physiological changes are proven, then observation and an ECG 2 times a year are sufficient.

If the instability of sinus rhythm does not fit into the normal variant, is not caused by breathing or functional reasons, then the cardiologist will prescribe treatment in accordance with the real reason arrhythmias.

The heart is an organ that works rhythmically. Normally, the heart rhythm is set by the sinus node. That is, the sinus rhythm of the heart is the normal heart rhythm. The sinus node is a natural impulse generator located in the right atrium. The impulse moves from top to bottom. First comes to right atrium, then to the left. The impulse then travels through the atrioventricular junction to the ventricles. As a result, the heart alternates between contracting and relaxing, thanks to which it performs its main function of pumping blood throughout the body.

What does sinus rhythm mean? This means that on the electrocardiogram the P waves are of a constant shape, distance R-R or R-R is the same, contraction frequency is 60-80 beats per minute. The heart is fine and works clearly and stably. If the rhythm is unstable, the height of the P waves and the distance between them are not the same on the cardiogram, then there is weakness of the sinus node or the pacemaker is another node of the heart. Further special diagnostics will help determine what the reason is: the pathology of the sinus node itself or problems in its autonomic system. So, if the doctor, when deciphering your cardiogram, writes: “Sinus rhythm: normal,” then your heart is fine.

If your sinus rhythm is abnormal, you may have heart blocks and arrhythmias. Any disturbance in the regularity, consistency and frequency of heartbeats is called arrhythmia. Heart blocks occur when there is a disturbance in the transmission of impulses from nerve centers to the heart muscle. At accelerated rhythm they talk about tachycardia, when slow - bradycardia. A heart rate of less than 50 and more than 90 beats per minute is a signal that you need to see a doctor.

Common causes of sinus rhythm disturbance?

• Heart defects
• Cardiomyopathies
• Infective endocarditis
• Overload, both physical, psychological and emotional.

These disorders can occur at any age. Quite common in children. Although in many cases, heart rhythm disturbances do not affect their well-being in any way and are detected by chance, it can cause more serious abnormalities (bradycardia, tachycardia, arrhythmia). A child's sinus rhythm may be disrupted from birth, or perhaps as he grows up. Often such deviations occur in adolescence, this is due to an imbalance in the development of the body and internal organs. If a child faints, complains of pain in the heart area, weakness, dizziness, you need to check the functioning of his heart. The main way is to do an electrocardiogram.

Causes of heart rhythm disturbances in children?

• Congenital defects associated with unfavorable pregnancy and childbirth
• Nervous system diseases
• Endocrine diseases
• Intoxication (including overdose or individual intolerance to drugs)
• Deficiency of microelements, in particular magnesium and selenium

After examinations and finding out the causes of deviations, the cardiologist will suggest necessary measures, sometimes it is enough to provide the child with an appropriate regime of study and rest, proper nutrition and the heart returns to normal. At serious problems A more detailed examination and treatment is prescribed.

The functioning of the heart in pregnant women has its own peculiarities. Sinus rhythm during pregnancy accelerates by an average of 10 beats per minute, and tachycardia and arrhythmia occur in half of pregnant women. This could be a relapse existing disease, or may be the result of the process of a woman’s body getting used to pregnancy. The body needs additional nutrition, and the heart increases the frequency and force of contractions. Physiological features The course of pregnancy can also cause the sinus rhythm of the heart to be disturbed.

If you feel any changes in the functioning of your heart, discomfort, or increased fatigue, it is better not to delay, but to go see a doctor, have an electrocardiogram done and, if necessary, provide support for your heart.