What is sinus rhythm on ecg. Sinus rhythm of the heart Sinus rhythm 1100

An electrocardiogram is a diagnostic method that allows you to determine the functional state of the most important organ of the human body - the heart. Most people at least once in their lives have dealt with a similar procedure. But having received the ECG result in hand, not every person, unless he has a medical education, will be able to understand the terminology used in cardiograms.

What is cardiography

The essence of cardiography is the study of electrical currents that occur during the work of the heart muscle. The advantage of this method is its relative simplicity and availability. Strictly speaking, it is customary to call a cardiogram the result of measuring the electrical parameters of the heart, displayed in the form of a time graph.

The creation of electrocardiography in its modern form is associated with the name of the Dutch physiologist of the early 20th century, Willem Einthoven, who developed the basic methods of ECG and the terminology used by doctors to this day.

Thanks to the cardiogram, it is possible to obtain the following information about the heart muscle:

• Heart rate,
• Physical state of the heart
• The presence of arrhythmias
• The presence of acute or chronic damage to the myocardium,
• The presence of metabolic disorders in the heart muscle,
• The presence of violations of electrical conductivity,
• The position of the electrical axis of the heart.

Also, the electrocardiogram of the heart can be used to obtain information about some vascular diseases that are not related to the heart.

An ECG is usually performed in the following cases:

• Feeling an abnormal heartbeat;
• Attacks of shortness of breath, sudden weakness, fainting;
• Heartache;
• Murmurs in the heart;
• Deterioration of the condition of patients with cardiovascular diseases;
• Passage of medical examinations;
• Medical examination of people over 45 years old;
• Inspection before the operation.

• pregnancy;
• Endocrine pathologies;
• Nervous diseases;
• Changes in blood counts, especially with an increase in cholesterol;
• Over 40 years of age (once a year).

Where can I get a cardiogram?

If you suspect that your heart is not all right, then you can contact a general practitioner or cardiologist to give you a referral for an ECG. Also, on a paid basis, a cardiogram can be done at any clinic or hospital.

Procedure procedure

The ECG recording is usually performed in the supine position. To take a cardiogram, a stationary or portable device is used - an electrocardiograph. Stationary devices are installed in medical institutions, and portable ones are used by emergency teams. The device receives information about the electrical potentials on the surface of the skin. For this, electrodes are used, attached to the chest and limbs.

These electrodes are called leads. On the chest and limbs, 6 leads are usually installed. The chest leads are designated V1-V6, the leads on the limbs are called the main (I, II, III) and enhanced (aVL, aVR, aVF). All leads give a slightly different pattern of fluctuations, however, summing up the information from all the electrodes, you can find out the details of the work of the heart as a whole. Sometimes additional leads (D, A, I) are used.

Usually, the cardiogram is displayed as a graph on paper containing millimeter markings. Each lead-electrode has its own schedule. The standard belt speed is 5 cm/s, other speeds can be applied. In the cardiogram displayed on the tape, the main parameters, norm indicators and the conclusion generated automatically can also be indicated. Also, data can be recorded in memory and on electronic media.

After the procedure, it is usually required to decipher the cardiogram by an experienced cardiologist.

Holter monitoring

In addition to stationary devices, there are also portable devices for daily (Holter) monitoring. They are attached to the patient's body along with electrodes and record all the information received over a long period of time (usually within a day). This method gives much more complete information about the processes in the heart compared to a conventional cardiogram. So, for example, when taking a cardiogram in stationary conditions, the patient must be at rest. Meanwhile, some deviations from the norm can manifest themselves during physical exertion, in sleep, etc. Holter monitoring provides information about such phenomena.

Other types of procedures

There are several other methods of carrying out the procedure. For example, this is monitoring with physical activity. Abnormalities are usually more pronounced on the exercise ECG. The most common way to provide the body with the necessary physical activity is a treadmill. This method is useful in cases where pathologies can manifest themselves only in case of increased work of the heart, for example, if coronary disease is suspected.

With phonocardiography, not only the electrical potentials of the heart are recorded, but also the sounds that arise in the heart. The procedure is prescribed when it is necessary to clarify the occurrence of heart murmurs. This method is often used for suspected heart defects.

The patient must be calm during the procedure. Between physical activity and the procedure must pass a certain period of time. It is also not recommended to undergo the procedure after eating, drinking alcohol, caffeinated drinks or cigarettes.

Causes that can affect the ECG:

• Times of Day,
• electromagnetic background,
• Physical exercise,
• food intake,
• The position of the electrodes.

Prong types

First, let's talk a little about how the heart works. It has 4 chambers - two atria and two ventricles (left and right). The electrical impulse, due to which it is reduced, is formed, as a rule, in the upper part of the myocardium - in the sinus pacemaker - the nerve sinoatrial (sinus) node. The impulse propagates down the heart, first affecting the atria and causing them to contract, then it passes through the atrioventricular ganglion and another ganglion - the bundle of His, and reaches the ventricles. The main burden of pumping blood is taken by the ventricles, especially the left one, which is involved in the systemic circulation. This stage is called contraction of the heart or systole.

After the contraction of all parts of the heart, the time comes for their relaxation - diastole. Then the cycle repeats again and again - this process is called the heartbeat.

The state of the heart, in which there is no change in the propagation of impulses, is reflected on the ECG in the form of a straight horizontal line, called the isoline. The deviation of the graph from the isoline is called a tooth.

One heartbeat on an ECG contains six teeth: P, Q, R, S, T, U. The teeth can be directed both up and down. In the first case, they are considered positive, in the second - negative. The Q and S waves are always positive, and the R wave is always negative.

The teeth reflect the different phases of the contraction of the heart. P reflects the moment of contraction and relaxation of the atria, R - excitation of the ventricles, T - relaxation of the ventricles. Special designations are also used for segments (gaps between adjacent teeth) and intervals (sections of the graph, including segments and teeth), for example, PQ, QRST.

Correspondence of the stages of heart contraction and some elements of cardiograms:

• P - atrial contraction;
• PQ - horizontal line, the transition of the discharge from the atria through the atrioventricular node to the ventricles. The Q wave may be absent normally;
• QRS - ventricular complex, the element most often used in diagnostics;
• R - excitation of the ventricles;
• S - relaxation of the myocardium;
• T - relaxation of the ventricles;
• ST - horizontal line, myocardial recovery;
• U - may be absent in the norm. The reasons for the appearance of a tooth have not been clearly elucidated, however, the tooth is valuable for diagnosing certain diseases.

Below are some ECG abnormalities and their possible explanations. This information, of course, does not negate the fact that it is more expedient to entrust the decoding to a professional cardiologist who knows better all the nuances of deviations from the norms and related pathologies.

Major abnormalities and diagnosis

Table of cardiogram parameters in adults

The norm of the duration of the elements of the cardiogram in children

The norms indicated in the table may also depend on age.

Rhythm of contractions

Violation of the rhythm of contractions is called. Rhythm irregularity in arrhythmia is measured as a percentage. An irregular rhythm is indicated by a deviation of the distance between similar teeth by more than 10%. Sinus arrhythmia, that is, arrhythmia combined with sinus rhythm, may be a normal variant for adolescents and young adults, but in most cases indicates the onset of a pathological process.

A kind of arrhythmia is extrasystole. He is told to her in the case when extraordinary reductions are observed. Single extrasystoles (no more than 200 per day with Holter monitoring) can also be observed in healthy people. Frequent extrasystoles that appear on the cardiogram in the amount of several pieces may indicate ischemia, myocarditis, heart defects.

Heart rate

This option is the most simple and clear. It determines the number of contractions in one minute. The number of contractions may be higher than normal (tachycardia) or lower than normal (bradycardia). The normal heart rate for adults can range from 60 to 80 beats. However, the norm in this case is a relative concept, so bradycardia and tachycardia may not always be evidence of pathology. Bradycardia can occur during sleep or in trained people, and tachycardia can occur during stress, after physical exertion, or at elevated temperature.

Heart rate norms for children of different ages

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Types of heart rate

There are several types of heart rhythm, depending on where the nerve impulse begins to spread, leading to the contraction of the heart:

• sinus,
• atrial,
• atrioventricular,
• Ventricular.

Normally, the rhythm is always sinus. In this case, sinus rhythm can be combined with both a heart rate above normal and a heart rate below normal. All other types of rhythms are evidence of problems with the heart muscle.

atrial rhythm

Atrial rhythm also often appears on the cardiogram. Is the atrial rhythm normal or is it a kind of pathology? In most cases, the atrial rhythm on the ECG is not normal. However, this is a relatively mild degree of cardiac arrhythmias. It occurs in case of oppression or disruption of the sinus node. Possible causes are ischemia, hypertension, sick sinus syndrome, endocrine disorders. However, individual episodes of atrial contractions can be observed in healthy people. This type of rhythm can take on both the nature of bradycardia and the nature of tachycardia.

atrioventricular rhythm

Rhythm emanating from the atrioventricular node. In atrioventricular rhythm, the pulse rate usually drops to less than 60 beats per minute. Causes - weakness of the sinus node, atrioventricular blockade, taking certain drugs. Atrioventricular rhythm, combined with tachycardia, can occur during heart surgery, rheumatism, heart attack.

Ventricular rhythm

In ventricular rhythm, contractile impulses propagate from the ventricles. The contraction rate drops below 40 beats per minute. The most severe form of rhythm disturbance. Occurs in acute myocardial infarction, heart defects, cardiosclerosis, cardiac circulatory failure, in the preagonal state.

Electrical axis of the heart

Another important parameter is the electrical axis of the heart. It is measured in degrees and reflects the direction of propagation of electrical impulses. Normally, it should be somewhat inclined to the vertical and be 30-69º. At an angle of 0-30º, they talk about the horizontal location of the axis, at an angle of 70-90º - about the vertical. Axial deviation in one direction or another may indicate a disease, for example, hypertension or intracardiac blockades.

What do the conclusions on cardiograms mean?

Consider some of the terms that an ECG decoding may contain. They do not always indicate serious pathologies, however, in any case, they require a visit to a doctor for advice, and sometimes additional examinations.

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Atrioventricular block

It is reflected on the graph as an increase in the duration of the P-Q interval. 1 degree of the disease is reflected in the form of a simple prolongation of the interval. Grade 2 is accompanied by a deviation of the QRS parameters (loss of this complex). At grade 3, there is no connection between P and the ventricular complex, which means that the ventricles and atria work each in their own rhythm. The syndrome in stages 1 and 2 is not life-threatening, but requires treatment, as it can go into an extremely dangerous stage 3, in which the risk of cardiac arrest is high.

Ectopic rhythm

Any heart rhythm other than sinus. May indicate the presence of blockades, coronary heart disease, or be a variant of the norm. It can also appear as a result of an overdose of glycosides, neurocirculatory dystonia, hypertension.

Sinus bradycardia or tachycardia

Sinus rhythm on the ECG that is below (bradycardia) or above (tachycardia) the normal range. It can be both a variant of the norm and be a symptom of some pathologies. However, in the latter case, this symptom will most likely not be the only one indicated in the transcript of the cardiogram.

Nonspecific ST-T wave changes

What it is? This entry suggests that the reasons for the interval change are unclear and more research is needed. It may indicate a violation of metabolic processes in the body, for example, a change in the balance of potassium, magnesium, sodium ions, or endocrine disorders.

Conduction disorders within the ventricles

As a rule, they are associated with conduction disturbances inside the His nerve bundle. May affect the trunk of the beam or its legs. May lead to delayed contraction of one of the ventricles. Direct therapy for blockades of the His bundle is not carried out, only the disease that caused them is treated.

Incomplete blockade of the right leg of the bundle of His (RBBBB)

Widespread violation of ventricular conduction. In most cases, however, it does not lead to the development of pathologies and is not their consequence. If the patient does not have problems with the cardiovascular system, then this symptom does not require treatment.

Complete right bundle branch block (RBBBB)

This violation is more serious than an incomplete blockade. May indicate myocardial damage. It usually occurs in older and older people, it is rarely found in children and adolescents. Possible symptoms are shortness of breath, dizziness, general weakness and fatigue.

Blockade of the anterior branch of the left leg of the bundle of His (BPVLNPG)

Occurs in patients with hypertension who have had a heart attack. It may also indicate cardiomyopathy, cardiosclerosis, atrial septal defect, mitral valve insufficiency. Has no characteristic symptoms. It is observed mainly in the elderly (over 55 years).

Blockade of the posterior branch of the left leg of the bundle of His (B3VLNPG)

As a separate symptom, it is rare, as a rule, it is combined with blockade of the right bundle leg. May indicate a heart attack, cardiosclerosis, cardiomyopathy, calcification of the conduction system. The blockade is indicated by a deviation in the electrical axis of the heart to the right.

Metabolic changes

Reflect malnutrition of the heart muscle. First of all, it concerns the balance of potassium, magnesium, and sodium. The syndrome is not an independent disease, but indicates other pathologies. It can be observed with ischemia, cardiomyopathy, hypertension, rheumatism, cardiosclerosis.

Low voltage ECG

Electrodes installed on the patient's body capture currents of a certain voltage. If the voltage parameters are below normal, then they talk about low voltage. This indicates insufficient external electrical activity of the heart and may be the result of pericarditis or a number of other diseases.

Paroxysmal tachycardia

A rare condition that differs from normal (sinus) tachycardia, primarily in that it has a very high heart rate - more than 130 beats / s. In addition, the basis of paroxysmal tachycardia is the incorrect circulation of an electrical impulse in the heart.

Atrial fibrillation

At the heart of atrial fibrillation are atrial fibrillation or flutter. Arrhythmia caused by atrial fibrillation can also occur in the absence of heart pathologies, for example, with diabetes, intoxication, and also with smoking. Atrial flutter may be characteristic of cardiosclerosis, certain types of coronary disease, inflammatory processes of the myocardium.

Sinoatrial blockade

Difficulty in the output of the impulse from the sinus (sinoatrial) node. This syndrome is a type of sick sinus syndrome. It is rare, mostly in the elderly. Possible causes are rheumatism, cardiosclerosis, calcification, severe hypertension. May lead to severe bradycardia, syncope, convulsions, respiratory failure.

Hypertrophic conditions of the myocardium

They indicate an overload of certain parts of the heart. The body feels this situation and reacts to it by thickening the muscular walls of the corresponding department. In some cases, the causes of the condition may be hereditary.

Myocardial hypertrophy

General myocardial hypertrophy is a protective reaction, indicating an excessive load on the heart. May lead to arrhythmia or heart failure. Sometimes it is the result of a heart attack. A variation of the disease is hypertrophic cardiomyopathy - a hereditary disease that leads to an abnormal arrangement of heart fibers and carries the risk of sudden cardiac arrest.

Left ventricular hypertrophy

The most common symptom, which does not always indicate severe pathologies of the heart. May be characteristic of arterial hypertension, obesity, some heart defects. Sometimes it is also observed in trained people, people engaged in heavy physical labor.

Right ventricular hypertrophy

A rarer, but at the same time much more dangerous symptom than left ventricular hypertrophy. Indicates insufficiency of pulmonary circulation, severe pulmonary diseases, valvular defects or severe heart defects (tetralogy of Fallot, ventricular septal defect).

Left atrial hypertrophy

It is reflected in the form of a change in the P wave on the cardiogram. With this symptom, the tooth has a double top. It indicates mitral or aortic stenosis, hypertension, myocarditis, cardiomyopathies. Leads to chest pain, shortness of breath, increased fatigue, arrhythmias, fainting.

Right atrial hypertrophy

Less common than left atrial hypertrophy. It can have many causes - pulmonary pathologies, chronic bronchitis, arterial embolism, tricuspid valve defects. Sometimes seen during pregnancy. May lead to circulatory disorders, edema, shortness of breath.

Normocardia

Normocardia or normosystole refers to a normal heart rate. However, the presence of normosystole in itself is not evidence that the ECG is normal and everything is in order with the heart, since it may not exclude other pathologies, such as arrhythmias, conduction disorders, etc.

Nonspecific T wave changes

This symptom is typical for about 1% of people. A similar conclusion is made if it cannot be unambiguously associated with any other disease. Thus, with non-specific changes in the T wave, additional studies are needed. The symptom may be characteristic of hypertension, ischemia, anemia and some other diseases, and may also occur in healthy people.

tachysystole

Also often called tachycardia. This is the general name for a number of syndromes in which there is an increased frequency of contractions of various parts of the heart. There are ventricular, atrial, supraventricular tachysystoles. Such types of arrhythmias as paroxysmal tachycardia, atrial fibrillation and flutter also belong to tachysystoles. In most cases, tachysystoles are a dangerous symptom and require serious treatment.

ST depression of the heart

ST segment depression is common in high-frequency tachycardias. Often it indicates a lack of oxygen supply to the heart muscle and may be characteristic of coronary atherosclerosis. At the same time, the appearance of depression in healthy people is also noted.

Borderline ECG

This conclusion often frightens some patients who have found it on their cardiograms and are inclined to think that "borderline" means almost "mortal". In fact, such a conclusion is never given by a doctor, but is generated by a program that analyzes the parameters of the cardiogram on an automatic basis. Its meaning is that a number of parameters go beyond the norm, but it is impossible to unequivocally conclude that there is any pathology. Thus, the cardiogram is on the border between normal and pathological. Therefore, upon receipt of such a conclusion, a doctor's consultation is required, and, perhaps, everything is not so scary.

Pathological ECG

What it is? This is a cardiogram, which clearly showed some serious deviations from the norm. These can be arrhythmias, conduction disorders or nutrition of the heart muscle. Pathological changes require immediate consultation with a cardiologist, who must indicate the treatment strategy.

Ischemic changes on the ECG

Ischemic disease is caused by impaired blood circulation in the coronary vessels of the heart and can lead to such serious consequences as myocardial infarction. Therefore, the identification of ischemic signs on the ECG is a very important task. Ischemia at an early stage can be diagnosed by changes in the T wave (rise or fall). At a later stage, ST segment changes are observed, and at an acute stage, Q wave changes are observed.

Deciphering the ECG in children

In most cases, deciphering the cardiogram in children is simple. But the parameters of the norm and the nature of the violations may differ compared to those in adults. So, children normally have a much more frequent heartbeat. In addition, the sizes of teeth, intervals and segments are somewhat different.

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 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, 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 gives the organs an adequate blood supply, so 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 in a comprehensive manner, taking into account 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:

1. Emotional experiences, stress, fear;
2. Strong physical activity - in the gym, with heavy physical labor, etc .;
3. 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 was carried out - 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:

1. sleep state;
2. Professional sports;
3. Individual constitutional features;
4. 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.

A heart rhythm that originates from the sinus node and not from other areas is called sinus. It is determined in healthy people and in some patients suffering from heart disease.

Cardiac impulses appear in the sinus node, then diverge through the atria and ventricles, which causes the muscular organ to contract.

Sinus rhythm of the heart on the ECG - what does it mean and how to determine it? There are cells in the heart that create momentum due to a certain number of beats per minute. They are found in the sinus and atrioventricular nodes, as well as in the Purkinje fibers that make up the tissue of the heart ventricles.

Sinus rhythm on an electrocardiogram means that this the impulse is generated by the sinus node(norm - 50). If the numbers are different, then the impulse is generated by another node, which gives a different value for the number of beats.

Normally, a healthy sinus rhythm of the heart is regular with varying heart rates depending on age.

In newborns, the rhythm rate can be 60 - 150 per minute. With growing up, the rhythm frequency slows down and by the age of 6-7 it approaches adult rates. In healthy adults, the rate is 60 - 80 in 60 seconds.

Normal indicators in the cardiogram

What do you pay attention to when performing electrocardiography:

1. The P wave on the electrocardiogram necessarily precedes the QRS complex.
2. Distance PQ corresponds to 0.12 seconds - 0.2 seconds.
3. The shape of the P wave is constant in each lead.
4. In an adult, the rhythm frequency corresponds to 60 - 80.
5. The P–R distance is similar to the R–R distance.
6. The P wave in the normal state should be positive in the second standard lead, negative in lead aVR. In all other leads (this is I, III, aVL, aVF), its shape may vary depending on the direction of its electrical axis. Usually, P waves are positive in both lead I and aVF.
7. In leads V1 and V2, the P wave will be 2-phase, sometimes it can be predominantly positive or predominantly negative. In leads V3 to V6, the waveform is predominantly positive, although there may be exceptions depending on its electrical axis.
8. Normally, each P wave must be followed by a QRS complex, a T wave. The PQ interval in adults is 0.12 seconds - 0.2 seconds.

Sinus rhythm along with the vertical position of the electrical axis of the heart(EOS) shows that these parameters are within the normal range. The vertical axis shows the projection of the position of the organ in the chest. Also, the position of the body can be in semi-vertical, horizontal, semi-horizontal planes.

Rotations of the organ from the transverse axis can be determined, which indicate only the structural features of a particular organ.

When the ECG registers sinus rhythm, it means that the patient has no problems with the heart yet. Highly it is important not to worry and not be nervous during the examination so as not to get invalid data.

Do not check immediately after exercise or after the patient has gone up to the third or fifth floor on foot. You should also warn the patient that you should not smoke half an hour before the examination, so as not to get unreliable results.

Violations and criteria for their determination

If the description contains the phrase: sinus rhythm disorders, then registered blockade or arrhythmia. An arrhythmia is any failure in the rhythm sequence and frequency.

Blockades can be caused if the transmission of excitation from the nerve centers to the heart muscle is disturbed. For example, the acceleration of the rhythm shows that with a standard sequence of contractions, the heart's rhythms are accelerated.

If the phrase about an unstable rhythm appears in the conclusion, then this manifestation of a small or presence of sinus bradycardia. Bradycardia adversely affects the human condition, since the organs do not receive the amount of oxygen required for normal activity.

Unpleasant symptoms of this disease can be dizziness, pressure drops, discomfort, and even chest pain and shortness of breath.

If an accelerated sinus rhythm is recorded, then most likely this is a manifestation tachycardia. Such a diagnosis is made when the number of heart rhythm beats exceeds 110 beats.

Interpretation of results and diagnosis

In order to make a diagnosis of arrhythmia, to compare the obtained indicators with the indicators of the norm. Heart rate for 1 minute should not be more than 90. To determine this indicator, you need to divide 60 (seconds) by the duration of the R-R interval (also in seconds) or multiply the number of QRS complexes in 3 seconds (a section equal to 15 cm long tape) by 20.

Thus, the following deviations can be diagnosed:

1. - Heart rate / min is less than 60, sometimes an increase in the P-P interval up to 0.21 seconds is recorded.
2. Tachycardia– Heart rate increases to 90, although other signs of rhythm remain normal. Often there can be observed slanting depression of the PQ segment, and the ST segment is ascending. At a glance, it may look like an anchor. If the heart rate rises above 150 beats per minute, blockades of the 2nd tbsp occur.
3. Arrhythmia- this is an irregular and unstable sinus rhythm of the heart, when the R-R intervals differ more than 0.15 seconds, which is associated with changes in the number of inhalation and exhalation beats. Often found in children.
4. Rigid rhythm- excessive regularity of contractions. R-R differs by less than 0.05 sec. This may be due to a defect in the sinus node or a violation of its neurovegetative regulation.

Reasons for deviations

The most common causes of rhythm disturbances can be considered:

• excessive alcohol abuse;
• smoking;
• long-term use of glycosides and antiarrhythmic drugs;
• protrusion of the mitral valve;
• pathology of the functionality of the thyroid gland, including thyrotoxicosis;
• heart failure;
• infectious lesions of valves and other parts of the heart - his disease is quite specific);
• overload: emotional, psychological and physical.

Additional Research

If the doctor, when examining the results, sees that the length of the area between the P teeth, as well as their height, are unequal, then sinus rhythm is weak.

To determine the cause, the patient may be recommended to undergo additional diagnostics: the pathology of the node itself or problems of the nodal autonomic system can be detected.

An additional examination is prescribed when the rhythm is lower than 50 and stronger than 90.

For the smooth functioning of the heart to the body vitamin D is needed, which is found in parsley, chicken eggs, salmon, milk.

If you make a diet correctly, stick to the daily routine, you can achieve a long and uninterrupted work of the heart muscle and not worry about it until old age.

Finally, we suggest you watch a video with questions and answers about heart rhythm disorders:

Sinus node - This is a group of cells located in the right atrium, which have the ability to produce impulses, to transmit these impulses to other myocardial cells.

Normally, an impulse occurs in the sinus node of the right atrium, covers both atria, then through the atrioventricular node, which is the center of second-order automatism, the impulse is transmitted to the ventricles and covers them with excitation.

This is how the contraction of the heart occurs: first the atria, and then the ventricles. If, after conducting an ECG, the doctor made the conclusion “sinus, regular rhythm”, then this means that your heart is contracting normally, there are no pathological abnormalities in the conduction system. This means that the impulse that causes your heart to contract occurs where it is needed, namely in the sinus node of the right atrium.

1 ECG and sinus rhythm

The simplest and most accessible method for determining the heart rhythm is an ECG. This method allows you to determine the frequency and regularity of heart contractions, assess the nature of the rhythm and its source, diagnose acute or chronic damage to the myocardium. Conducting an ECG is mandatory for routine examination and medical examination. Any doctor and medical worker with a secondary medical education should be able to encrypt a cardiogram.

On the electrocardiogram, there is a P wave, which is responsible for the work of the atria, and there is a complex of QRS teeth, this complex shows the work of the ventricles. Since the atria normally contract first, then the ventricles, the P wave must always precede the QRS complex.

So, ECG signs of sinus rhythm:

1. Permanent shape of the P wave (duration 0.1 s, height 2-2.5 mm),
2. The same distance between the teeth P-P or R-R,
3. The P wave always precedes the QRS complex
4. The distance from the P wave to the next Q wave is the same and equal to 0.12-0.2 s,
5. Heart rate from 60 to 90 beats per minute.

If these criteria are met on the ECG, this means that the heart rhythm is normal.

2 What should a patient know before an ECG?

In order for the electrocardiogram data to be as accurate as possible, there are certain rules that the patient must follow before conducting this study. Firstly, try not to be nervous, do not drink alcohol, coffee, strong tea, do not smoke before the procedure, as the heart rate will increase, tachycardia will develop and the ECG data will not be correct. No need to overeat and do physical labor. If you follow all the above rules, then an ECG recording will allow you to accurately diagnose the work of your heart and determine its rhythm and frequency of contractions.

3 Heart rate in children

Heartbeat in newborn babies and toddlers is much more frequent than in an adult. If you put your hand on the chest of a small child, you can hear how often and loudly a tiny heart beats. The younger the child, the faster his heart beats. For example, the norm for a newborn baby is a heart rate of up to 140 beats per minute, and when feeding, screaming, it can reach 180 beats per minute.

This is due to the fact that the metabolism is more intense in babies and the fact that the heart is less affected by the vagus nerve, which slows down the heartbeat. By the age of two, the heart rate averages 120-125 per minute, by six - 100-105, and already at ten or twelve years, the heart rate in a child will correspond to an adult.

These physiological features, characteristic of childhood, should be taken into account by the parent, and do not panic if, when deciphering the cardiogram, the doctor writes a three-digit number, determining the heart rate for your child. Perhaps a rapid heartbeat is normal for his age. And if the intervals between heartbeats are the same, the P wave accompanies each set of ventricular contractions - this means sinus rhythm, and in this case there is no cause for concern.

4 When is sinus rhythm abnormal?

The sinoatrial node can produce impulses both with the same, constant frequency, and with periods of gradual increase and decrease. If the sinus rhythm is characterized by such periods of acceleration-decrease, we are talking about an abnormal sinus rhythm or arrhythmia. There are two forms of sinus arrhythmia: respiratory (cyclic) and not associated with breathing (non-cyclic).

Respiratory or cyclic arrhythmia is characterized by the fact that the heart rate increases on inhalation and slows down on exhalation, there is a clear connection with breathing. This condition occurs due to high activity of the vagus nerve. Respiratory arrhythmia is characteristic of young people, athletes, patients with neurocirculatory dystonia, neuroses, as well as adolescents during puberty.

ECG signs of respiratory arrhythmia:

1. Signs of sinus rhythm (P wave of normal shape and size, always precedes the QRS complex),
2. Increased heart rate on inspiration and decrease on expiration
3. The duration of R-R is not the same, but the runs are within 0.15 s.

A characteristic feature and diagnostic criterion is the following moment: respiratory arrhythmia disappears on the ECG when holding the breath, increases under the action of drugs of the group of b-blockers and disappears under the action of atropine. Sinus arrhythmia not associated with breathing is observed in the elderly, with various cardiac pathologies (cardiomyopathies, coronary artery disease, myocarditis).

If respiratory arrhythmia has a favorable prognosis and is a physiological feature, then non-cyclic arrhythmia has a more serious prognostic value and may mean certain disorders in the work of the heart.

ECG signs of non-cyclic arrhythmia:

1. Signs of sinus rhythm (P wave of normal shape and size, always precedes the QRS complex)
2. There is no connection of sinus arrhythmia with respiration,
3. Sinus arrhythmia persists when holding the breath,
4. The duration of R-R is not the same, the run-up is more than 0.15 s.

From the foregoing, we can conclude that sinus rhythm is a normal rhythm of heart contraction, but sinus rhythm does not exclude possible disturbances in the work of the heart. It is important that the rhythm is not just sinus, but also correct. Correct sinus rhythm means that your heart is beating regularly and rhythmically.

An electrocardiograph (ECG) is a device for assessing the electrical activity of the heart muscle. In cardiology, it is most in demand, as it allows you to detect any changes in the heartbeat, organic lesions and electrolyte imbalance. Sinus rhythm when deciphering the cardiogram is detected in the absence of pathological abnormalities. An experienced specialist is engaged in evaluating the final results. To a simple person, Latin letters and crooked lines will not say anything. They will help to independently deal with the decoding of generally accepted standards and definitions.

The sinus rhythm detected on the electrocardiogram is displayed with the same teeth at an equal time interval and indicates the correct functioning of the heart. The source of impulses is given by the natural pacemaker, the sinus (sinusoidal) node. It is localized in the corner of the right atrium and serves to generate signals that cause the sections of the heart muscle to contract in turn.

A feature of the sinus node is an abundant blood supply. The number of impulses sent to them is influenced by the departments (sympathetic, parasympathetic) of the autonomic nervous system. If their balance fails, the rhythm is disturbed, which is manifested by an increase (tachycardia) or slowing (bradycardia) of the heartbeat.

Normally, the number of generated pulses should not exceed 60-80 per minute.

Maintaining sinus rhythm is important for stable circulation. Under the influence of external and internal factors, a violation of the regulation or conduction of impulses can occur, which will lead to disruptions in hemodynamics and dysfunctions of internal organs. Against this background, the development of blockade of signals or the weakening of the sinusoidal node is possible. On the electrocardiogram, the resulting disorder is displayed as the presence of a focus of replacement (ectopic) impulses in a certain section of the heart muscle:

• atrioventricular node;
• atrium;
• ventricles.

When localizing the source of signals in any place other than the sinus node, we are talking about the pathology of the heart. The patient will have to undergo a series of examinations (24-hour ECG monitoring, stress tests, ultrasound) to identify the causative factor of the disorder. Treatment will focus on eliminating it and restoring sinus rhythm.

Deciphering the cardiogram of the heart: sinus rhythm

Panic at the discovery of a “sinus rhythm” record is characteristic of people unfamiliar with medical terms. Usually, a cardiologist prescribes a series of examinations, so it will be possible to get an appointment with him again only after receiving all the results. The patient has to wait patiently and get acquainted with publicly available sources of information.

In fact, sinus rhythm is the generally accepted norm, therefore, there is no point in worrying. Deviations are possible only in the heart rate (HR). It is affected by various physiological factors, the influence of the vagus nerve and autonomic failures. The number of heart beats per minute may become higher or lower than the allowable age norm, despite the sending of signals from the natural pacemaker.

The diagnosis of "tachycardia" or "bradycardia" of the sinus type is made only after a comprehensive assessment of all the nuances. The doctor will pay attention to the patient's condition and ask about the actions taken immediately before the study. If the decrease or increase in heart rate is insignificant and is associated with the influence of external factors, then the procedure will be repeated a little later or on another day.

The identification of a natural pacemaker during electrocardiography occurs according to generally accepted criteria:

• the presence of a positive P wave in the second lead;
• between the P and Q wave the same interval, not exceeding 0.2 seconds;
• negative P wave in lead aVR.

If the transcript indicates that the patient has sinus rhythm and the normal position of the electrical axis of the heart (EOS), then they are afraid of nothing. The rhythm is set by its natural driver, that is, it comes from the sinus node to the atria, and then to the atrioventricular node and ventricles, causing an alternate contraction.

Permissible norms

Whether the indicators of the cardiogram are normal can be determined by the position of the teeth. The rhythm of the heart is assessed by the interval between the R-R waves. They are the highest and normally should be the same. A slight deviation is acceptable, but not more than 10%. Otherwise, we are talking about a slowdown or increased heart rate.

For a healthy adult, the following criteria are characteristic:

• the P-Q interval varies within 0.12-0.2 sec;
• Heart rate is 60-80 beats per minute;
• the distance between the Q and S teeth remains in the range from 0.06 to 0.1 sec;
• the P wave is 0.1 sec;
• the Q-T interval varies from 0.4 to 0.45 sec.

In a child, the indicators are slightly different from adults, which is associated with the characteristics of the child's body:

• QRS interval does not exceed 0.1 sec.;
• Heart rate varies with age;
• the distance between the Q and T teeth is not more than 0.4 sec;
• P-Q interval 0.2 sec.
• P wave does not exceed 0.1 sec.

In adults, as in children, in the absence of pathologies, there should be a normal position of the electrical axis of the heart and sinus rhythm. You can get acquainted with the permissible frequency of reductions by age in the table:

Causes of deviation from the norm

Heart rate varies depending on the time of day, psycho-emotional state and other external and internal factors. To obtain reliable data, you need to take into account many nuances:

No less important is careful preparation for the procedure:

If it was not possible to comply with all the rules, then upon arrival at the diagnostic room, you should tell the specialist about it. He will take into account this nuance and, if necessary, appoint an examination for another day.

The general list of factors that can affect the frequency and rhythm of the heart rate is as follows:

• mental disorders;
• overwork (psycho-emotional, physical);
• malformations (congenital, acquired);
• taking medications with antiarrhythmic effect;
• violation of the valve apparatus (insufficiency, prolapse);
• dysfunction of the endocrine glands;
• advanced stage of heart failure;
• pathological changes in the myocardium;
• inflammatory heart disease.

About taking drugs, especially for stabilizing blood pressure (Meksaritma, Amidarone) and improving metabolic processes (Metonate, Adenosine), you must inform before the procedure. Many heart medications can slightly distort the results.

Features of decoding an electrocardiogram

Focusing on the electrocardiogram, the cardiologist will be able to assess the electrical potential of the heart muscle during systole (contraction) and diastole (relaxation). Displays data in 12 curves. Each of them demonstrates the passage of an impulse through a certain part of the heart. Curves are recorded on 12 leads:

• 6 leads on the arms and legs, designed to assess oscillations in the frontal plane.
• 6 leads in the chest area for recording potentials in the horizontal plane.

Each curve has its own elements:

• The teeth in appearance resemble bulges pointing up and down. They are designated in Latin letters.
• Segments are the distance between several adjacent teeth.
• An interval is a gap consisting of several teeth or segments.

General principles of decryption

Evaluation of an electrocardiogram is a complex process. The doctor conducts it in stages, so as not to miss the slightest changes:

For a better understanding of the information, it is advisable to familiarize yourself with the various options for the conclusions of specialists:

• A healthy person is characterized by sinus rhythm, 60-80 heartbeats per minute, EOS in a normal position and the absence of pathologies.
• With increased or decreased heart rate, sinus tachycardia or bradycardia is indicated in conclusion. The patient will be advised to undergo several more examinations or repeat the procedure on another day if the result was influenced by external factors.
• In elderly patients and people who do not lead a healthy lifestyle, pathological changes in the myocardium of a diffuse or metabolic nature are often detected.
• A record of the presence of non-specific changes in the ST-T interval indicates the need for additional examinations. Finding out the true cause only with the help of electrocardiography in this case is not possible.
• The revealed violation of repolarization indicates an incomplete recovery of the ventricles after contraction. Usually, various pathologies and hormonal disruptions affect the process. It will take a few more tests to find them.

Most of the conclusions are positive. Changes can be overcome with lifestyle changes and medications. An unfavorable prognosis is usually in the detection of coronary disease, proliferation (hypertrophy) of the chambers of the heart muscle, arrhythmias, and failures in the conduction of impulses.

Causes of deviations in sinus rhythm

An abnormal sinus rhythm appears under the influence of pathologies or physiological factors. The forms of failure differ depending on the frequency and rhythm of contractions:

Despite the correct source of signals, the problem should be dealt with. If no action is taken, a more severe form of arrhythmia may develop and dangerous symptoms of hemodynamic failures will appear.

Sinus tachycardia

The sinus form of tachycardia is pathological or physiological. In the first case, it occurs due to other diseases, and in the second - after stress and overwork. The electrocardiogram usually reveals an increase in the frequency of contractions from 100 to 220 per minute and a short RR interval.

For an attack of sinus tachycardia, the following symptoms are characteristic:

• feeling of heartbeat;
• lack of air;
• general weakness;
• dizziness;
• sleep disturbance;
• chest pain;
• noise in ears.

Attacks of sinus bradycardia, like tachycardia, occur as a symptom of other diseases or as a reaction to physiological factors. They are characterized by a decrease in heart rate to 60 or less beats per minute. On the electrocardiogram, an increase in the distance between the P-P teeth is noticeable.

In addition to slowing the heartbeat, during an attack of bradycardia, the following symptoms appear:

• dizziness;
• pre-fainting state;
• pain in the region of the heart;
• skin blanching;
• tinnitus;
• fast fatiguability.

sinus arrhythmia

The sinus type of arrhythmia is usually manifested by an irregular rhythm. The heart rate can increase or decrease sharply under the influence of various stimuli. The length of the RR interval changes.

An attack of sinus arrhythmia is characterized by the following symptoms:

Features of decoding ECG in children

Electrocardiography is performed in children in the same way as in adults. Problems can arise only with hyperactive babies. First they need to calm down and explain the importance of the procedure. The results differ only in heart rate. In the process of active growth, the heart has to work harder to supply all the tissues of the body in full. As the child develops, the heartbeat gradually returns to normal.

Signs of sinus rhythm in babies are similar to adults. The increase in heart rate should fit into the allowable age limit. If a focus of ectopic impulses is detected, then we can talk about a congenital malformation of the heart. It is completely eliminated only by surgery.

Cases of mild sinus arrhythmia are most often associated with the respiratory system. During inhalation, the heart rate quickens and stabilizes on exhalation. Such failures are characteristic of children and pass over time. When conducting an ECG, respiratory arrhythmia must be taken into account, since a cold couch, fear and other factors provoke its aggravation.

The sinus form of arrhythmia can be provoked by more dangerous causes:

Due to the voiced pathological processes, the likelihood of developing complications that can lead to death and disability increases. Among the less severe causes, active growth, rickets and vegetovascular dystonia can be distinguished. In most cases, they go away on their own. It is enough for parents to give the child vitamin complexes and diversify his diet.

Deciphering the electrocardiogram during pregnancy

During the bearing of a child in a woman's body, significant changes occur that affect the results of electrocardiography:

• An increase in the volume of circulating blood contributes to the development of tachycardia and the manifestation of signs of overload of certain parts of the heart muscle.
• The growing uterus provokes a displacement of the internal organs, which is manifested by a change in the location of the electrical axis of the heart.
• Hormonal surges affect all systems in the body, especially the nervous and cardiovascular systems. A woman has attacks of tachycardia after any physical exertion. The heart rate usually rises by no more than 10-20 beats per minute from the norm.

The resulting changes disappear on their own after the birth of a child, but in some cases they develop into a full-fledged pathological process. To prevent it, it is necessary to be observed by a doctor throughout the entire period of pregnancy.

The meaning of letters and numbers on the electrocardiogram

To understand what is at stake in the electrocardiogram, the definitions of the Latin letters that head the teeth will help:

• The PQ interval shows how long it takes for an electrical impulse to travel through the heart muscle (from the atria to the ventricles). In the absence of irritating factors, the length does not exceed 0.2 seconds. Focusing on this indicator, the doctor will assess the general condition of the conduction system. If there is an increase in the distance between the P and Q waves, then the problem may be the development of heart block.
• By the gap between the R-R teeth, the doctor will determine the regularity of contractions and count them.
• The QRS complex helps you see how the signal is being conducted through the ventricles.
• The segment between the S and T waves shows the moment of passage of the excitation wave through the ventricles. Its allowable length is 0.1-0.2 sec. The segment is located on the isoline. If it is slightly displaced, then certain pathological processes can be suspected:
  • higher by 1 mm or more - myocardial infarction;
  • lower by 0.5 or more - ischemic disease;
  • saddle-shaped segment - pericarditis.

It will not be easy for a simple person to decipher an electrocardiogram. To begin with, you will have to familiarize yourself with the definition of the Latin characters that denote the teeth, the features of the intervals between them. Then it is necessary to study the types of heart rhythm and the generally accepted norms of heart rate. Finally, it is desirable to review the options for the conclusions of specialists and the general principles of decoding. Focusing on the studied information, even a person far from medicine will be able to make out a cardiogram.