Sinus rhythm of the heart on the ECG - what does it mean and what can it tell about. Sinus rhythm irregular what it is Sinus rhythm non-specific heart rate deviation 62a

The human heart is a kind of trigger for the productive work of the whole organism. Thanks to the pulses of this organ, which are issued on a regular basis, the blood has the ability to circulate throughout the body, saturating the body with vital 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 has suspicions that something is not right with his heart, then he sends the patient to an ECG. Sinus rhythm on the ECG is a very important indicator and clearly gives data on the real state of the human heart muscle. What exactly can be determined by looking at the cardiogram, it is worth considering in more detail.

What is sinus rhythm

In the concept of medical staff, the sinus rhythm of the cardiogram is the norm for the human body. If there are identical gaps between the teeth depicted on the cardiogram, the height of these columns is also the same, then there are no deviations in the work of the main organ.

So, the sinus rhythm on the cardiogram is the following:

graphic representation of human pulse jumps;
a set of teeth of different lengths, between which there are different intervals, showing a 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 work of the heart and its individual valves.

Normal sinus rhythm is only present when the heart rate is between 60 and 80 beats per minute. It is this rhythm that is considered normal for the human body. and on the cardiogram it is displayed by teeth of the same size, located at the same distance from each other.

If the sinus rhythm of the cardiogram of the heart deviates from the norm, then the medical specialist will prescribe a number of additional studies to the patient, including tests

It is clearly worth remembering that the results of the 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, which means that it will definitely not be possible to obtain a reliable result about the state of human health.

What are the criteria for deciphering the result of the ECG

It is performed by doctors according to a special scheme. Medical specialists have a clear idea of which marks on the cardiogram are the norm and which are deviations. The conclusion of the ECG will be set only after the calculation of the results, which were displayed in a schematic form. The doctor, when examining the patient's cardiogram, in order to correctly and accurately decipher it, will pay special attention to a number of such indicators:

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

A doctor who knows what each of these schematic marks means, carefully studies them and can clearly orient himself in what kind of diagnosis should be made. The cardiograms of children and adults are deciphered according to the same principle, but the norm indicators for people of different age categories cannot be the same.

What sinus rhythm problems can be seen on an ECG

Electrocardiogram readings can indicate clear signs of problems in the functioning of the heart muscles. With the help of this study, you can see if there is a weakness of the sinus node, and what kind of health problems this causes. Considering the indicators of the cardiogram 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 rhythm of contractions, 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 contracts less than 60 times in one minute;
the presence of too small an interval between the teeth of the cardiogram, which means a violation in the sinus node.

ECG can easily determine the presence of sinus tachycardia, arrhythmia or bradycardia

Sinus bradycardia is a common abnormality, especially when it comes to the health of the child. This diagnosis can be explained by many factors, among which physiological defects or simply a factor of chronic fatigue may be hidden.

The deviation of the EOS to the left also indicates that the work of the vital organ is not set up correctly. Having determined such deviations, the doctor will send the patient for an additional examination and ask him to pass a number of necessary tests.

If the vertical position of the EOS is observed, then 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 a horizontal position of the EOS is observed, then this cannot immediately be considered a pathological condition. Such axis indicators are observed in people who are short in stature, but have rather 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 increase in the left or right ventricles. Axial misalignment may indicate that there is damage to certain valves. 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 to the right. Such a deviation can also tell about anomalies in the development of the heart muscle.

What can be said about the indicators of the norm

On the ECG, the sinus rhythm is always and without fail compared with certain indicators of the norm. Only knowing these indicators completely, the doctor will be able to deal with the patient's cardiogram and give the correct conclusion.

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

in children from birth to the first year of life, the orientation 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 old have a mostly vertical orientation of the axis, but it can also be horizontal, without indicating deviations from the norm. Heart rate from 95 to 128;
children from seven years old and adolescents on the cardiogram should have a normal or vertical axis position, the heart should contract from 65 to 90 beats per minute;
adults should have a normal direction of the axis on the cardiogram, the heart contracts at a frequency of 60 to 90 times per minute.

Normal heart rate in children is higher than in adults

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

Because of what, ECG readings may deviate from the norm

Irregular heart rate can be triggered not only by serious pathological abnormalities, but also by factors more familiar to everyday life.

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

a person regularly consumes alcoholic beverages;
the patient smokes cigarettes for quite a long time on a regular basis;
a person is regularly exposed to various kinds of stressful situations;
the patient often uses antiarrhythmic drugs;
a person has problems with the functioning of the thyroid gland.

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

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 the exact cause of all deviations and will be able to offer the patient competent treatment.

Why should a person undergo an ECG study?

The sinus rhythm, which is displayed on the ECG, clearly indicates whether there are deviations in the work of the heart and in which directions the problem is observed. Regularly undergo such a study is necessary not only for adults, but also for children. The results of the performed cardiogram will help a person get the following information:

whether he has pathologies and diseases of a congenital nature;
due to what pathologies in the body heart problems begin;
whether a person's way of life can become a cause of disturbances in the work of the main organ;
whether the heart is in the correct position and whether its valves work correctly.

Normal sinus rhythm on the ECG is displayed in the form of teeth of the same size and shape, while the distance between them is also the same. If any deviations from this norm are observed, then the person will have to be additionally examined.

Any violations 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 nevertheless noticed something like that, then he should calm down and go through the procedure again in order to accurately obtain 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 the 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 its 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 areas

If the sinus rhythm is within the normal range, then you will not have to take additional tests and undergo repeated studies. Normal work of the heart, as well as pathological deviations, is always recorded by a cardiogram.

The sinus rhythm on the ECG should be even 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 the reason for doctors to perform additional studies and prescribe tests. Only after additional examinations can the exact cause of the deviations be understood and treatment can begin. A normal sinus rhythm displays a clear and even cardiogram in terms of the location of the lines. Additional attention will have to be paid to the location of the axis, with respect to the parameters of which medical standards are also established.

To make a diagnosis of a normal ECG, normal sinus rhythm must be established. The heart rate that originates from the sinus node is called sinus rhythm. Healthy people have a sinus rhythm. However, in patients with heart disease, sinus rhythm is also often determined. Its frequency in healthy people varies with age.

In newborns, it is 60 - 150 in 1 min. Gradually slowing down, the rhythm by the age of 6 approaches the frequency of the rhythm of adults. In most healthy adults, it is 60 - 80 per 1 min.

The diagnosis of normal sinus rhythm is based on the following criteria:

the presence of a P wave of sinus origin, constantly preceding the QRS complex;

constant and normal distance PQ (0.12 - 0.20 s);
constant shape of the P wave in all leads;
rhythm frequency 60 - 80 per 1 min;
constant P–R or R–R distance.

Diagnostic criteria for normal sinus rhythm

The P wave of sinus origin must be positive in standard lead II and negative in lead aVR. In other leads from the extremities (I, III, aVL and aVF), the shape of the P wave may be different depending on the direction of the electric axis of the P wave (see below). In most cases in sinus rhythm, P waves are also positive in leads I and aVF.

In leads V1, V2, the P wave in normal sinus rhythm is usually biphasic (+-) or sometimes predominantly positive or negative. In the remaining chest leads V3 - V6, the P wave in normal sinus rhythm is usually positive, although differences are possible depending on the electrical axis of the P wave.

Constant and normal PQ interval. In normal sinus rhythm, each P wave should be followed by a QRS complex and a T wave. In this case, the PQ interval should; be equal in adults to 0.12 - 0.20 s.

"Guide to electrocardiography", V.N. Orlov

Determination of the rhythm frequency

ECG with sinus arrhythmia. Atrial escape rhythms

sinus arrhythmia expressed in periodic changes in the intervals R - R for more than 0.10 sec. and most often depends on the phases of respiration. An essential electrocardiographic sign of sinus arrhythmia is a gradual change in the duration of the interval R - R: in this case, after the shortest interval, the longest rarely follows.

Just like when sinus tachycardia and bradycardia, a decrease and an increase in the R-R interval occurs mainly at the expense of the T-P interval. There are slight changes in the P-Q and Q-T intervals.

ECG of a healthy 30 year old woman. The duration of the interval R - R ranges from 0.75 to 1.20 seconds. The average rhythm frequency (0.75 + 1.20 sec. / 2 = 0.975 sec.) is about 60 per 1 min. Interval P - Q = 0.15 - 0.16 sec. Q - T \u003d 0.38 - 0.40 sec. PI,II,III,V6 positive. Complex

QRSI,II,III,V6 type RS. RI>RI>rIII

Conclusion. sinus arrhythmia. S-type ECG. probably the norm.

in a healthy heart ectopic centers of automatism, including those located in the atria, have a lower rate of diastolic depolarization and, accordingly, a lower impulse frequency than the sinus node. In this regard, the sinus impulse, propagating through the heart, excites both the contractile myocardium and the fibers of the specialized tissue of the heart, interrupting the diastolic depolarization of the cells of the ectopic centers of automatism.

Thus, sinus rhythm prevents the manifestation of automatism of ectopic centers. Specialized automatic fibers are grouped in the right atrium in its upper part in front, in the lateral wall of the middle part and in the lower part of the atrium near the right atrioventricular opening. In the left atrium, automatic centers are located in the upper posterior and lower posterior (near the atrioventricular opening) areas. In addition, there are automatic cells in the region of the mouth of the coronary sinus in the lower left part of the right atrium.

Atrial automatism(and the automatism of other ectopic centers) can manifest itself in three cases: 1) when the automatism of the sinus node decreases below the automatism of the ectopic center; 2) with an increase in the automatism of the ectopic center in the atria; 3) with sinoatrial blockade or in other cases of large pauses in atrial excitation.

atrial rhythm can be persistent, observed for several days, months and even years. It can be transient, sometimes short-lived, if, for example, it appears in long cycle intervals with sinus arrhythmia, sinoatrial blockade and other arrhythmias.

A characteristic sign of atrial rhythm is a change in the shape, direction and amplitude of the P wave. The latter changes differently depending on the localization of the ectopic source of the rhythm and the direction of propagation of the excitation wave in the atria. In atrial rhythm, the P wave is located in front of the QRS complex. In most variations of this rhythm, the P wave differs from the P wave in sinus rhythm in polarity (up or down from the isoline), amplitude, or shape in several leads.

Exception makes up the rhythm from the upper part of the right atrium (the P wave is similar to the sinus one). Important is the difference between the atrial rhythm, which has replaced the sinus rhythm in the same person in terms of heart rate, the duration of P - Q and greater regularity. The QRS complex is supraventricular, but may be aberrant when combined with bundle branch block. Heart rate from 40 to 65 in 1 min. With an accelerated atrial rhythm, the heart rate is 66 - 100 per 1 min. (high heart rate is referred to as tachycardia).

Sinus rhythm is the normal rhythm of the heart that is generated by the sinoatrial node. Normal heart rate per minute ranges from 60 to 90 beats. The sinus rhythm is considered correct, in which each complex on the cardiogram is at an equidistant distance from the other. If the distance between beats exceeds 10% of the average, the rhythm is called irregular.

Signs of sinus rhythm are positive P waves in lead II and negative P waves in avR. Each atrial wave is followed by a ventricular complex. These are the main signs of sinus rhythm.

Regular sinus rhythm indicates normal heart function.

Violation of sinus rhythm can be observed in healthy adults as a reaction to emotional experiences. However, more often rhythm changes indicate the following conditions:

acquired heart defects;
cardiomyopathy;
myocarditis;
alcoholic heart disease;
thyrotoxicosis.

Overdose of antiarrhythmic drugs or other drugs.

There are situations when, in addition to regular heartbeats, extraordinary impulses of the heart occur. They are called extrasystoles. Quite often, extrasystoles are attributed to violations of the normal rhythm and its regularity. However, in a small amount, extrasystoles can also occur in normal healthy people. The number of supraventricular extrasystoles normally depends on the age of the person.

Irregular sinus rhythm of the heart can be observed in the form of attacks of paroxysmal supraventricular tachycardia in pregnant women. Typically, such attacks are rare and disturb the woman only with palpitations. Hemodynamics does not change. However, in rare cases, such an attack can mean the development of significant disorders in the work of the heart. Therefore, any change in rhythm in a pregnant woman must be carefully diagnosed.

Clinical picture

The main complaint in violation of the rhythm in most cases is a feeling of palpitations. In addition, a person may be concerned about:

excessive sweating;
flushes of heat;
dizziness;
weakness.

Irregular sinus rhythm can be detected using a conventional ECG or Holter monitoring. The results of the study can be evaluated either by a cardiologist or a doctor of functional diagnostics.

In childhood

Irregular sinus rhythm in a child can also be both a manifestation of the norm and pathology.

Normally, instability of the sinus rhythm of the heart can occur with excessive emotional excitement. In adolescent children, such a change in rhythm often occurs as a manifestation of respiratory arrhythmia. Diagnosing it is quite simple - during the ECG procedure, after recording a standard cardiogram, the child is asked to hold his breath. If at the same time the rhythm returns to normal, doctors talk about the development of respiratory arrhythmia. If, after holding the breath, the rhythm does not become normal, additional studies are necessary.

In young children, unstable sinus rhythm may be one of the manifestations of congenital heart defects. In older children, changes in sinus rhythm may be the first manifestation of acquired heart defects, cardiomyopathies, and myocarditis. To exclude these conditions, it is necessary to conduct a thorough diagnosis.

Any violation of the rhythm requires a full diagnosis to determine the cause of its development. In order to make a diagnosis of physiological arrhythmia, it is necessary to exclude pathological factors.

An electrocardiogram is ordered to a patient when the doctor suspects the development of a disease related to the 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 prescribed before each surgical operation, regardless of the damaged organs and the alleged disease. The results of the electrocardiogram have certain marks of the normal activity of the heart muscle. Cardiogram of the heart, sinus rhythm, what is it?

Norm indicators

The sinus ECG rhythm indicates the absence of any abnormalities in the work of the heart muscle in the patient's body. These are certain oscillations, upon the appearance of which, electronic impulses are first formed in the sinus node, and only then they diverge at the final points - in the ventricular and precardiac departments of the organ. In general, this whole process makes the human heart beat, saturating the limbs with blood.

The correct result is displayed in the cardiogram if the patient who has been scheduled for the examination does not need to worry and be nervous about any issues. He should not be afraid, it is better to relax and not think about anything.

What does sinus rhythm mean? When a cardiologist puts a certain mark on the cardiogram, he shows that the P peak in the whole QRS complex is constant, the main beat interval is 65-85 beats per 60 seconds, and the shown P-P, R-R distances are similar. As a result, it becomes clear that in the examination methodology, great importance is given to the localization of the driver's rhythm in the sinus center. For a reliable analysis, the following factors are checked:

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

When all these ECG signs of a sinus beat are 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 departments of the second order: the ventricles, the atrium, or the atrioventricular node.

Deciphering the cardiogram - the 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 the patient's chest.

In special cases, the organ is in planes - horizontal and semi-horizontal, as well as half vertical. It is worth noting that the heart can move in different directions 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 structural features of the patient's body.

Deviations from the norm

Unfortunately, not everyone is in good health. Often, the diagnosis reveals various deviations and disorders. A negative ECG indicator usually indicates blockades in the heart or arrhythmia.

Blockade 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.

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

To detect the development of pathology of the heart rhythm, a Holter examination is prescribed, and a drug test is also performed. This method is used to find out how stable, whether the regulation of the autonomic system has gone astray.

Signs of sinus rhythm disturbances on the ECG

Weakness Syndrome (SSS) is damage to the causative agent of impulses that 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 an arrhythmia in a patient.

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

The main thing is that at the same time the frequency of strokes of the heart muscle within one minute does not exceed 90-100 contractions. To calculate the desired mark, you must divide 60 by the length of the R-R armhole, displayed in a second scale.

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

Causes of heart rate jumps

To The most well-known causes of heart failure include:

Excessive alcohol consumption;
Heart muscle disorders - defects, acquired or congenital;
tobacco smoking;
Long-term use of antiarrhythmic drugs, glucosides;
Protrusion of the mitral valve, which is full or partial;
Bright heart failure;
A strong surge in the production of thyroid hormones.

Some factors that affect the increase in heart rate can eliminate rhythm deviations in the work of the respiratory system.

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

The heart is the main organ that provides blood to all organs and tissues; the degree of oxygenation and the function of the whole organism depend on its rhythmic and consistent work. For muscle contraction, a push is needed - an impulse coming from special cells of the conducting 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 (SN)

The sinus node (SN) is located under the inner shell of the right atrium, it is well supplied with blood, receiving blood directly from the coronary arteries, richly supplied with fibers of the autonomic nervous system, both sections 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, have a spindle shape. Their contractile function is extremely weak, but the ability to form an electrical impulse is akin to nerve fibers. The main node is associated with the atrioventricular junction, which transmits signals for further excitation of the myocardium.

The sinus node is called the main pacemaker, because it is it that provides the heart rate that provides the organs with adequate blood supply, therefore maintaining a regular sinus rhythm is extremely important for assessing the work of the heart in case of its lesions.

SU generates pulses of the highest frequency compared to other parts of the conductive system, and then transmits them at a high speed further. The frequency of the formation of impulses by the sinus node lies ranging from 60 to 90 per minute, which corresponds to the normal heart rate, when they occur at the expense of the main pacemaker.

Electrocardiography is the main method that allows you to quickly and painlessly determine where the heart receives impulses from, what is their frequency and rhythm. ECG has firmly entered 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 a heart rate of 75" should not disturb, this is the norm, and if the specialist writes about non-sinus, increased heart rate (tachycardia) or slowdown (bradycardia), then It's time to go for an examination.

Rhythm from the sinus node (SN) - sinus rhythm - normal (left) and pathological non-sinus rhythms. The points of origin of the impulse are indicated

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

Sinus rhythm is normal

Often, patients who find sinus rhythm in the ECG report begin to worry if everything is in order, because the term is not known to everyone, which means it can talk about pathology. However, they can be reassured: sinus rhythm is the norm, which indicates the active work of the sinus node.

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

The impact on the sinus node of the vagus nerve and the fibers of the sympathetic nervous system often causes a change in its function towards a greater or lesser 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 the norm and pathology, that is, with a heart rate of 58 beats per minute, it is too early to talk about bradycardia, as well as about tachycardia in excess an indicator of 90. All these parameters should be assessed comprehensively, with the obligatory consideration of the general condition of the patient, the characteristics of his metabolism, the type of activity, and even what he was doing immediately before the study.

Determining the source of the rhythm in the analysis of the ECG is a fundamental point, while the indicators of sinus rhythm are:

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

In the conclusion of the ECG, the subject can find: "sinus rhythm with a heart rate of 85, the normal position of the electrical axis." We consider this to be the norm. Another option: "the rhythm is non-sinus with a frequency of 54, ectopic." This result should alert, since a serious pathology of the myocardium 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 SU - in the fibers of the ventricular muscle, the atrioventricular node, etc. Impulsation 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 the heart rhythm can be made by studying long-term ECG recordings, since in the process of life in all healthy people there is a change in the frequency of heartbeats: one pulse at night, another during the day. However, even shorter intervals of fixation of ECG signs demonstrate the irregularity of the pulse associated with the peculiarities of the autonomic innervation and the work of the whole organism as a whole. Evaluation of the pulse is assisted by specially developed mathematical processing programs, statistical analysis - cardiointervalography, histography.

In order for the ECG result to be the most correct, all possible causes of changes in the activity of the heart should be excluded. Smoking, fast climbing stairs or running, a cup of strong coffee can change the parameters of cardiac activity. The rhythm will, of course, 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

Again, we recall that sinus rhythm corresponds to a frequency of 60 - 90 per minute. But what to do if the parameter goes beyond the set limits while maintaining its "sine"? 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:

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

Such physiological tachycardia is reflected in the ECG data:

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

Tachycardia with a preserved sinus rhythm under physiological conditions is aimed at providing blood to tissues that, for various reasons, have become more in need of it - 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 a 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 variant of the heart's work - slowing down its contractions (), which also does not always indicate pathology.

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

sleep state;
Professional sports;
Individual constitutional features;
Wearing clothes with a tight collar, a tightly tightened tie.

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

During sleep, there is a significant decrease in heart rate - by about a third of the "daily norm", which is associated with the predominance of the tone of the vagus nerve, which suppresses the activity of the sinus node. ECG is more often recorded in awake subjects, so this bradycardia is not recorded in conventional mass studies, but it can be seen with 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 especially worried patients.

In addition, it was noted that about 25% of young men have a rarer pulse within 50-60, while 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 where the heart rate slows below 60, but impulses in the heart continue to be generated by the main node. People with this condition may faint, 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.

The signs of sinus bradycardia on the ECG will be the lengthening of the intervals between the atrial teeth and the complexes of ventricular contractions, however, all indicators of the “sinusity” of the rhythm are preserved - the P wave still precedes the QRS and has a constant size and shape.

Thus, sinus rhythm is a 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, if there are no indications of other changes (ischemia, for example).

When should you worry?

Cause for concern should be the findings of cardiography, speaking of pathological sinus tachycardia, bradycardia, or with instability and irregularity of the rhythm.

With tachy- and bradyforms, the doctor quickly establishes the deviation of the pulse from the norm up or down, finds out complaints and sends for additional examinations - ultrasound of the heart, holter, blood tests for hormones, etc. Having found out the cause, you can start 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 msec. This is almost always a sign of pathology, so the patient is not left unattended and the cause of instability in the work of the sinus node is found out.

The fact that the heart beats with an irregular sinus rhythm will also be indicated by electrocardiography. The irregularity of contractions can be caused by structural changes in the myocardium - scarring, inflammation, as well as heart defects, heart failure, general hypoxia, anemia, smoking, endocrine pathology, abuse of certain groups of drugs and many other reasons.

Irregular sinus rhythm comes from the main pacemaker, but the frequency of the organ beats at the same time either increases or decreases, losing its constancy and regularity. In this case, we speak of sinus arrhythmia.

Features of the rhythm in children

Children are a very special part of people who have many parameters that 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 in babies of the first years and, especially, newborns, the pulse is much more frequent than in adults.

Sinus rhythm should be recorded in all children, without exception, if we are not talking about heart damage. Age-related tachycardia is associated with the small size of the heart, which should provide the growing body with the necessary amount of blood. The smaller the child, the more often his pulse, reaching 140-160 per minute during the neonatal period and gradually decreasing to the “adult” norm by 8 years of age.

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

At the same time, 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 associated with breathing, which is often observed in childhood. It is also necessary to take into account the conditions for taking an ECG: if the baby was laid on a cold couch, he was frightened or confused, then the reflex holding of the 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, the pathology of sinus rhythm is more often diagnosed in premature infants affected by intrauterine children, with increased intracranial pressure in newborns. It can be provoked by rickets, rapid growth,. As the nervous system matures, the regulation of the rhythm improves, and the disturbances can go away on their own.

A third of sinus arrhythmias in children are pathological and are caused by hereditary factors, infection with high fever, rheumatism, myocarditis, and heart defects.

Sport with respiratory arrhythmia is not contraindicated for a child, but only under the condition of constant dynamic monitoring and ECG recording. If the cause of unstable sinus rhythm is not physiological, then the cardiologist will be forced to limit the child's sports activities.

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

If the instability of the 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 true cause of the arrhythmia.