Enk_SUM15_N405b Page 2 of 31
Sinus rhythms and arrhythmias
• Records the impulse originating from the sinus node and follows the path to the atria, AV junction, and through the bundle of His, to the bundle branches and on to
the Purkinje fibers
• Sinus node is the main pacemaker
• Sinus rhythms include
1. Normal sinus rhythm
2. Sinus tachycardia
3. Sinus bradycardia
4. Sinus arrest
I. Normal sinus rhythm
A. Is the standard against which all other rhythms are compared
B. Criteria:
1. Rhythm: regular
2. Heart rate: 60 - 100
3. QRS: less than 0.10
4. P wave: only one precedes each QRS, all have same size, shape and deflection
5. PR interval: 0.12 - 0.20
6. Interpretation: Sinus Rhythm
, lOMoARcPSD|20734855
Enk_SUM15_N405b Page 3 of 31
C. Clinical Presentation – no problems typically associated with rhythm
D. Treatment – no treatment generally associated with this rhythm
II. Sinus Tachycardia
A. Characterized by heart rate greater than 100
B. Causes: fever, any type of hypovolemic such as dehydration or blood loss
C. Criteria:
1. Rhythm: regular
2. Heart rate: 100 - 150
3. QRS: less than 0.10
4. P wave: only one precedes each QRS, all have same size, shape and deflection
5. PR interval: 0.12 - 0.20
6. Interpretation: Sinus Tachycardia
D. Clinical Presentation – dependent on the rate and patient tolerance of the rate
E. Treatment – directed at the underlying cause
IV. Sinus Bradycardia
A. Characterized by heart rate less than 60
B. Criteria:
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