Sinus bradycardia. This strip meets the criteria of: regular rhythm, rate less than 60 bpm (40 bpm in this case), regular P waves before every QRS. Sinus bradycardia can have many causes from a completely normal variation to a malfunction of the sinus node. In some cases, enhanced parasympathetic tone causes sinus bradycardia. Well-conditioned athletes typically have sinus bradycardia. Treatment depends upon the cause and the patient's response to the rate. If the rate does not cause hemodynamic impairment, treatment may not be necessary.
This ECG shows a common manifestation with inferior wall M.I., BRADYCARDIA. We see the signs of acute inferior wall M.I.
This strip shows an underlying sinus bradycardia with a rate less than 40/min. There is one "premature" beat, which can be considered to be ectopic, because it interrupts an otherwise regular rhythm. The interesting thing is that the premature beat is not terribly early - it is about 740 ms from the previous beat. If all the beats were spaced like this, the heart rate would be about 84/min. There is probably an element of "escape" here, in that the ectopic beat is able to express itself due to the slow rate.
This is a nice teaching strip of a slowing sinus bradycardia that began around 40 bpm, and is slowing. It is a good example of how the sinus node slows down - there is no abrupt change of rates, rather a change with each R-to-R interval. There is also a first-degree AV block, reflecting slowing of conduction in the AV node. The PR interval is slightly variable at .28 sec. to about .32 sec.
Sticking with the same general theme from my last ECG Challenge for the months of September and October, 2013. This is more of a back-to-basics for some readers but will still challenge others. No information for this patient other than it was an adult. How would you interpret this?
Patient of unknown age and gender with a history of atrial fibrillation. What's your interpretation?
Unfortunately, I have no available clinical data on this patient. Merely looking for an interpretation of the ECG in it's raw form.
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