What is sinus rhythm heart rate. Features of ECG: sinus rhythm. What is the normal sinus rhythm in adults and children?

The heart is a complex organ that works in a certain rhythm. It is set by sinus node in the right atrium, which is the generator of cardiac impulses, they move from top to bottom

It looks like this: the impulse arrives first at right atrium, and after that he moves to the left. The impulse then follows along the atrioventricular orifice and passes to the cardiac ventricles. Therefore, the organ rhythmically contracts and relaxes, performing the main function of blood transmission.

Without going into medical terminology, the concept of “ sinus rhythm" can be explained this way:

There are cells in the human heart that create an impulse at a certain number of beats per minute.
These cells are located in the sinus node, in the septum between the ventricles, called the atrioventricular node, and in the Purkinje fibers, which are the tissue of the ventricles of the heart.
Sinus rhythm means that the impulse is generated by the sinus node (normally 50 beats per minute).
If it is changed, a different heart node produces a different number of beats per minute.

The main examination in cardiology is electrocardiography. ECG registers electric fields, formed during cardiac activity, giving the specialist the opportunity to assess the condition the most important body human body.
An electrocardiogram is used for various tests:

Determination of contraction frequency, extrasystoles - rapid contractions, arrhythmias - missed contractions.
Myocardial damage – infarction, ischemia.
Electrolyte metabolism disorders: magnesium, calcium, etc.
Cardiac conduction disorders - blockades.
Screening for ischemic heart disease.
Physical condition of the heart muscle.
Data on diseases outside the field of cardiology - thromboembolism pulmonary artery and etc.
The cardiogram of the heart determines sinus rhythm, which is one of the main tasks of electrocardiographic research.

If you feel changes in cardiac activity, you should contact a cardiologist, who will give you a referral for electrocardiography before prescribing treatment.

If on ECG waves P have the same shape, the distance between P-P or R-R is the same, and the frequency of contractions does not exceed 60-80 beats per minute, the interval between beats is in the range from 0.12 to 0.22 seconds - this is the norm.

If the doctor sees that the distance between the P waves and their height are not the same, the sinus rhythm is weak. To determine the cause of weakness, the patient is prescribed a special diagnosis, which helps to identify the causes: either there is a pathology of the node, or there are problems in the autonomic system.

Remember: If the doctor wrote: “Sinus rhythm, vertical position heart", this means that the heart is normal.

In this case, the vertical position is the normal position of the cardiac axis in chest.

Sinus rhythm disorder

If violated, arrhythmias (impaired heart contraction functions) or blockades are possible, which occur when the transmission of cardiac impulses to the muscle is disrupted. If acceleration is detected, this may be a sign of tachycardia; if deceleration is observed, bradycardia is possible.
In cases of irregular rhythm, the body lacks oxygen. The patient feels the symptoms of this pathology: dizziness, fluctuating blood pressure, pain in the chest, difficulty breathing, etc.
When the rhythm exceeds 110 beats/min, tachycardia occurs. If a person is healthy, an acceleration of the heart rate can occur as a result of physical activity, excitement, or stress.

Important: If the rhythm is less than 50, as well as more than 90, the patient needs a cardiac examination.

Factors influencing its change:

Congenital and acquired defects.
Diseases of the myocardium with changes in structure and function - cardiomyopathy.
Infectious lesions of the valves and other parts of the heart - infective endocarditis.
Various overloads: in the emotional and psychological sphere, as well as physical.

Disorders in children

Although this pathology can be observed in childhood, adolescence, and adulthood; in many cases, this does not affect general well-being and is diagnosed during examination for the presence of other diseases.
Except common reasons, disorders in children also have specific, age-related ones:

Congenital defects caused by the course of pregnancy and the birth process of the mother.
Neurological diseases.
Pathologies of the endocrine system.
Intolerance or overdose of certain pharmacological drugs.
Lack of selenium and magnesium in the body.

It is worth noting: arrhythmia is diagnosed in 25% of children, but this does not mean a disease. The incidence of arrhythmia increases in adolescence.

In children and adolescents, respiratory sinus arrhythmia, also called paradoxical pulsus, is often detected. This type arrhythmias are characterized by an increase in heart rate during inhalation and a significant decrease during exhalation.
To normalize the condition, sometimes it is enough to regulate your daily routine and diet. But if the problem cannot be solved in this way, a detailed examination by a doctor who specializes in diagnosis and treatment is necessary. cardiac diseases in children.

Disorders in pregnant women

Pregnancy is a period of restructuring of all systems female body. Special changes also occur in cardiovascular functions.
During pregnancy, sinus rhythm, as a rule, accelerates by 10 beats per minute, and 50% of subjects experience either arrhythmia or tachycardia. Doctors believe that such changes are a relapse of an existing pathology or a manifestation of the female body’s adaptation to the pregnancy process.
Due to the need for additional (increased) nutrition, the frequency of contractions of the heart muscle increases. Also the reason may be physiological changes, occurring during these months. In the vast majority of cases, after childbirth the condition returns to normal.

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

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

This is how the heart contracts: first the atria, and then the ventricles. If, after conducting an ECG, the doctor concluded “sinus, correct rhythm,” then this means that your heart is beating normally, pathological abnormalities there is no conducting system in operation. 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 available method determination of heart rhythm - ECG. This is a method that allows you to determine the frequency and regularity of heart contractions, assess the nature of the rhythm and its source, and diagnose acute or chronic myocardial damage. An ECG is mandatory when preventive examination and medical examination. Any doctor should be able to encrypt a cardiogram and medical worker with secondary medical education.

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

So, ECG signs of sinus rhythm:

Constant shape of the P wave (duration 0.1 s, height 2-2.5 mm),
Same distance between teeth R-R or R-R,
The P wave always precedes the QRS complex,
The distance from the P wave to the subsequent Q wave is the same and equal to 0.12-0.2 s,
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 does a patient need to know before an ECG?

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

3 Heart rate in children

The heartbeat of newborns and toddlers is much faster than that of an adult. If you place your palm on your chest small child, you can hear how often and loudly the tiny heart beats. How younger child, the more often his heart contracts. For example, the norm for a newborn baby is a heart rate of up to 140 beats per minute, and when feeding or crying, it can reach 180 beats per minute.

This is explained by the fact that babies have a more intense metabolism and the fact that the heart is less susceptible to influence vagus nerve, which slows down the heartbeat. By two years of age, the average heart rate is 120-125 per minute, by six - 100-105, and by ten to twelve years the child’s heart rate will correspond to that of 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 three digit number, determining your child’s heart rate. Perhaps a rapid heartbeat is normal for his age. And if the intervals between heart contractions 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 and deceleration, we are talking about an abnormal sinus rhythm or arrhythmia. There are two forms sinus arrhythmia: respiratory (cyclic) and not related to breathing (non-cyclical).

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

ECG signs of respiratory arrhythmia:

Signs of sinus rhythm (P wave normal shape and sizes, always precedes the QRS complex),
Heart rate increases during inhalation and decreases during exhalation,
The duration of R-R is not the same, but the run-up is within 0.15 s.

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

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

ECG signs of non-cyclic arrhythmia:

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

From the above we can conclude: sinus rhythm is the normal rhythm of heart contraction, but sinus rhythm does not exclude possible violations in the work of the heart. It is important that the rhythm is not just sinus, but also correct. Proper sinus rhythm means that your heart beats regularly and rhythmically.

Sinus rhythm of the heart refers to indicators of its work. The correct rhythm is set by the main pacemaker, which is the sinus node. In case of conduction disturbance, a phenomenon occurs with a corresponding change in both the rhythm itself and the quality of the heart, which immediately affects well-being.

The most in a simple way ECG is used to evaluate the correct functioning of the heart. It is this procedure that the therapist refers to if necessary. This is especially true for older patients, with whom it is impossible to begin to understand without printing out the cardiogram.

It is by the printout of the ECG, by the location of the teeth and the distance between them, that a specialist is able to most likely assess the performance of the heart.

Sinus rhythm of the heart is a constant contraction of all walls of the cardiac muscle membrane due to incoming electrical impulses from the main pacemaker - the sinus node. In the absence of any pathologies, the heart rhythm is sinus.

For reference. The sinus node is the largest group of atypical cardiomyocytes - cells responsible for the rhythmic heart pulsation.

This formation is localized in the upper part of the right atrium, at the confluence of the superior and inferior vena cava. The sinus node constantly creates electrical impulses, they go through each layer of the muscle membrane, causing the ventricles of the heart to contract. This process ensures a healthy heartbeat.

Sinus rhythm of the heart is an ECG value indicating the beating of the heart using impulses from the sinus node. When this value is normal, it can be argued that the sinus node is able to overcome electrical impulses created by other clusters of atypical cardiomyocytes.

What is characteristic of a normal heartbeat:

The heart rate is numerically equal from 60 to 90;
Heartbeats are created after an equal amount of time;
The consistency of the beat is unchanged - first the atria contract, then the ventricles. This characteristic can be traced by the characteristic sound of the first and second tones, in addition - with an ECG;
Under normal conditions, the heartbeat may change when different condition person - physical activity, testing pain and others.

For reference. When the doctor concluded, “sinus rhythm frequency<60…90>, you can be calm about the functioning of the heart, since this condition is normal.

What types of sinus rhythm disorders can occur?

The ECG conclusion may have various errors. Even if the electrocardiogram shows features of sinus rhythm, a person may develop pathological processes. It happens that despite the fact that electrical impulses are generated in the sinus node, the rhythmic cardiac pulsation does not satisfy the norm.

What pathologies of sinus rhythm are most common:

An increased number of heartbeats may indicate that the patient has sinus tachycardia;
On the contrary, a reduced number of heart beats may signal the development of sinus bradycardia;
Irregularity of heart contractions, in other words arrhythmia, is characterized by the same frequency of beats that do not occur regularly. The specialist may also suspect that the patient has unexpected impulses occurring in the intervals between normal heart beats. Another pathology that irregular beats may indicate is sick sinus syndrome. This pathology is characterized by a stable, rare heartbeat, moments of “stopping” of cardiac activity, and in addition, the alternate occurrence of an accelerated and slowed down rhythm;
Disturbed regularity of sinus rhythm indicates the absence of response reflexes in the muscular lining of the heart to stimuli from the environment.

Read also on the topic

Dull pain in the heart area

Sinus rhythm with heart rate is normal

In addition to establishing the nature of cardiac pulsation and the leading pacemaker, heart rate is always determined on the ECG. As a rule, the device for taking an electrocardiogram copes with this task independently.

However, his conclusion is not true in all cases. It is much better when the attending doctor calculates the heart rate.

Important. Normal values sinus rhythm will have a number of heart beats in the range from 60 to 90 per minute. However, it must be remembered that not in all cases a shift in value in one direction or another can signal a disease.

For example, the number of heart beats can increase with excitement during the examination, internal experiences, a cigarette smoked before the examination, or physical activity before electrocardiography.

On the other hand, often in people who are actively involved in sports, a decrease in the number of heart beats is found, and the blood flow has normal characteristics. In this case, no deviation from the norm is observed.

Irregular sinus rhythm - what is it?

Sinus rhythm can be regular or irregular. With irregular sinus rhythm, the heart rate may become faster or slower. In this case, the number of heart beats corresponds to the norm, but the intervals between them are not equal. This condition is called arrhythmia. It has a physiological or conditionally pathological nature.

Attention. Physiological arrhythmia is closely related to the act of breathing. When a person inhales, the heart rate increases; when exhaling, it decreases. This condition is typical for children.

Conditionally pathological arrhythmia can be expressed as both tachycardia and bradycardia. The causes of this condition can be heart pathologies, as well as diseases nervous system, infections, following a strict diet, etc.

What does sinus rhythm look like on an ECG, normally and with pathologies?

Conclusion The ECG is called an electrocardiogram. It allows you to record the rhythmic contractions of the heart on paper in the form of a special graph. An ECG records information from a person’s limbs and cardiac zone. The sinus rhythm of the heart is determined using standard leads, which are designated by Roman numerals I, II, III.

Doctors analyze the following components of the electrocardiogram:

P wave;
P-Q distance;
QRS complex;
P-wave spacing;
distance between R teeth;
number of heart beats.

What does a recording of normal sinus heart rhythm look like?

P wave and P-Q interval

The P wave is normally directed upward – positive;
Relative to the R wave, which has the largest size, it is small;
Appears before each QRS complex;
There is normally a small distance between the P wave and the QRS complex ( P-Q interval), while it is equal between these elements throughout the entire graph.

QRS complexes and R-R-R intervals

The largest wave, the R wave, is directed upward in each QRS complex;
The distances between all R waves are normally equal - this is an indicator of the regularity of heart beats.

P-P interval

As in the previous case, the norm is the same distance between the P waves.

What does sinus rhythm pathology look like on an ECG?

Heart rhythm disturbances not only bring to a person discomfort, but can also be a harbinger of serious heart disease.

Sinus tachycardia

If a patient has sinus tachycardia, the following features are identified on the electrocardiogram:

Heart rate exceeds the normal threshold and is more than 90 beats per minute;
The regularity of sinus rhythm is maintained, the P wave always appears before the QRS complex;
Ventricular complex (QRS) without deviations from the norm;
Reducing the gap between P waves;
Increased or decreased T wave height;
The EOS (electrical axis of the heart) can be directed to the left, right, and up.

Irregularities in the functioning of the heart can pose a serious danger to human life. The work of the heart muscle is extremely complex and depends on the coordinated functioning of various anatomical structures responsible for the creation and conduction of electrical impulses. Important role in this belongs to the sinus node. It sets the sinus rhythm, which coordinates the work of various departments

hearts.

Sinus arrhythmia

At rest, the heart rate of most people fluctuates around 60-80 beats/min. In other conditions, for example in a state of emotional overexcitation or during heavy physical exertion, this frequency may change. Arrhythmia will occur if the sinus rhythm is changed. The norm of 0.1 s, according to the ECG, between the R-R intervals will be exceeded. Changes in heart rate during sleep or exercise - normal reaction healthy body. The vast majority of people face this. However, certain diseases can also affect sinus rhythm and cause changes in it.

Sinus tachycardia

This term refers to an increase in heart rate to 90-100 beats/min. A pronounced tendency to this condition may indicate neurocirculatory dystonia. Accelerated sinus rhythm can be caused by some medical supplies or drinking alcohol. Fever, heart failure, myocarditis, thyrotoxicosis, and anemia can also lead to this. In these cases, treatment of tachycardia should be aimed at eliminating the underlying disease.

Sinus bradycardia

In this case, the sinus rhythm does not exceed 55 beats/min. This deviation is often accompanied by respiratory arrhythmia, and in rare cases, extrasystole. Its occurrence can be influenced by various unfavorable processes occurring in the body. For example, ischemic, inflammatory or sclerotic pathologies in the area of the sinus node. They prevent the normal formation of impulses in it or disrupt their transmission to the atrium tissue. Bradycardia can also be caused by viral infections, posterior phrenic myocardial infarction, and certain medications.

Ectopic rhythms

When the sinus node is weak, so-called “ectopic” rhythms may appear. They consist in contractions of the heart under the influence of the automatism of its other parts. As a rule, the frequency of such contractions is less than that supported by sinus rhythm.

Extrasystoles

This term refers to premature heart contractions caused by impulses originating outside the sinus node. Such heart contractions can be caused by any heart disease. However, in many cases, other factors also influence the occurrence of extrasystole. For example, it often manifests itself as a result of psycho-emotional and autonomic disorders. Its appearance can be caused by some medicines, taking stimulants and smoking.

Sinus rhythm of the heart is just one of many indicators that are paid attention to when analyzing a cardiogram. Any deviation from the norm may be evidence developing disease or already running problems. Often, patients with unstable sinus rhythm do not even feel it. In order not to miss a symptom, you should visit the clinic at least once a year. This is especially recommended for people:

in whose family cases of similar diseases have already been recorded;
working in stressful conditions;
leading a sedentary lifestyle.

Ready ECG

Of course, stress and sitting at a computer for a long time does not always mean that the patient will have an irregular sinus rhythm or other disorders, it only places him at risk.

Read more about what heart rhythm is, what its normal rate is, the dangers of its disturbances, and what diseases it can signal later in the article.

What is sinus rhythm on an ECG, and why is it so important?

An ECG can be used to judge the condition of the heart and its problems. As a result of taking a cardiogram, the doctor receives information about the following points:

functioning of the nodes of the conduction system;
heart rate (HR);
the presence of pathological processes;
functional disorders.

A patient who does not have the necessary knowledge is unlikely to be able to give an objective assessment of the cardiac cardiogram. Therefore, you should not worry if the doctor does not give you the cardiogram and is going to take it to a specialist yourself. If a visitor is found to have serious problem, such as acute heart failure or myocardial infarction, then he is immediately taken to a cardiologist.

On an ECG, sinus rhythm indicates that the heart is beating correctly. Any disturbances may indicate that the sinus node is weak and cannot cope with its functions. This is fraught with disturbances in the normal frequency of beats per minute and their regularity.

Example of normal sinus rhythm

Read more about how a heart cardiogram is deciphered, read further in the article.

ECG interpretation: general rules

What a sinus rhythm of one nature or another means, only a doctor can judge. However, he is guided by the norms of indicators - for adults and children they are somewhat different. This article discusses the adult electrocardiogram.

On the latter there are several areas that represent signs of sinus rhythm:

the P wave in the second standard lead is positive and in mandatory comes before the QRS complex;
the duration of the PQ interval is 0.12-0.2 seconds, the same throughout the entire cardiogram;
the shape of the P waves has the same appearance in one lead;
the P-P distance is equal to the R-R distance.

Schematic analysis of ECG readings

This all indicates relatively normal operation hearts. It is necessary to pay attention to the fact that the heart rate is ECG of an adult a person should be within 60-85 beats in 60 seconds. For children under 12 years of age this figure is different. You can see it in the table below.

Heart rate table for children and adults

Note! As you can see, in adults the norm is much stricter. Any deviations may indicate rhythm disturbances.

ECG results can be considered favorable if the rhythm is sinus, the heart rate is normal and the EOS - the electrical axis of the heart is vertical. If the EOS is rejected, this may indicate some problems. A change in position can provoke pressure on some areas, thereby interfering with the normal activity of the heart.

In fact, the deviation of the EOS to the left or right is uncritical. The axis of the heart can be in the position:

vertical;
horizontal;
semi-vertical;
the opposite.

However, a certain reversal of the heart can signal problems. If the axis is deviated to the left, this may indicate left ventricular hypertrophy, arterial hypertension, heart block or conduction disturbances within the ventricles. If the position electrical axis the heart is deviated to the right, left ventricular hypertrophy or blockade may also be observed. An altered position of the electrical axis of the heart is considered normal, but upon first detection it is recommended to undergo a thorough examination.

Some interesting patterns:

the vertical position of the EOS is typical for high and skinny people asthenic type;
the horizontal position of the EOS is typical for short and dense people with a wide chest.

The position of the heart axis must be taken into account when drawing up the conclusion.

What does a disturbance in sinus rhythm on a cardiogram indicate?

First of all, it is worth understanding that the normal rhythm of the heart can easily be ruined by the slightest stress or hassle. Before making a diagnosis, the doctor will have to make sure that ECG abnormalities are not caused by external factors. This is especially true for children who are afraid of sensors - their cardiogram may be incorrect.

Attention: sinus rhythm of the heart is the norm, which indicates proper operation conduction system of this organ.

Example of different ECGs

The following abnormalities in heart contractions are distinguished:

Bradycardia. The heart rate decreases, the patient feels dizzy, tired, apathetic, and prone to fainting. The P-P interval is extended to 0.21 seconds.
Tachycardia. With a normal heart rate of 70 beats, the indicators of such a patient can be above 90 even in a calm state. Such a pulse can cause a level 2 block. An accelerated sinus rhythm is noted.
Arrhythmia. It is characterized by irregularity R-R intervals(more than 0.15 seconds). In this case, the patient may feel discomfort, severe anxiety, and be sensitive to pressure changes. Normal heart rate in patients at rest is 75, 80 or 85 beats per second. Such uneven rhythm is often found in children - this is the norm, and the vast majority outgrow this condition.
Ectopic rhythm. In this case, the rhythm is set not by the sinus node, but by other conducting fibers. Stands out atrial rhythm, rhythm from the AV node, ventricular idioventricular rhythm and rhythm of the coronary sinus or coronary sinus, when the excitation site is very close to the coronary sinus (recorded only by ECG).

It is important to understand that normosystole indicates the health of the heart muscle.

Any changes in normal sinus rhythm are reflected in the ECG, so a professional can easily diagnose the disease.

What affects heart contractions?

When a doctor deciphers data, he takes into account not only what value he sees on paper, but also the patient’s lifestyle. Negatively affects cardiac activity:

stress;
smoking;
alcohol consumption;
taking antiarrhythmic drugs;
physical overload.

Special sports bracelets monitor heart rate during exercise

Often the situation normalizes when a person finds himself in a calm environment. More than half of heart rate problems go away after stress relief. As a percentage, this figure is 62%. It is important to understand that due to busy work, most patients feel discomfort. Regardless of the reasons, if available obvious signs violations, it is recommended to visit a doctor.

The number of beats per minute also depends on age. So, for children the norm may be 160 beats per minute, while for adults (over 12) this figure should be 75 beats per minute.

Sometimes, to clarify the details of the rhythm, doctors prescribe a daily study. In this case, sensors and a memory device are attached to the patient, which he must wear all day. This allows you to track the behavior of the heart muscle throughout the day under different conditions.