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A sinus rhythm is any cardiac rhythm in which depolarisation of the cardiac muscle begins at the sinus node. [1] It is necessary, but not sufficient, for normal electrical activity within the heart. [2] On the electrocardiogram (ECG), a sinus rhythm is characterised by the presence of P waves that are normal in morphology. [2]
Schematic representation of a normal sinus rhythm EKG wave. In electrocardiography, the PR interval is the period, measured in milliseconds, that extends from the beginning of the P wave (the onset of atrial depolarization) until the beginning of the QRS complex (the onset of ventricular depolarization); it is normally between 120 and 200 ms in duration.
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [ 5 ] using electrodes placed on the skin.
Cardiac monitoring generally refers to continuous or intermittent monitoring of heart activity to assess a patient's condition relative to their cardiac rhythm.Cardiac monitoring is usually carried out using electrocardiography, which is a noninvasive process that records the heart's electrical activity and displays it in an electrocardiogram. [1]
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
A 12-lead ECG showing atrial fibrillation at approximately 132 beats per minute Diagram of normal sinus rhythm as seen on ECG. In atrial fibrillation the P waves, which represent depolarization of the top of the heart, are absent. Diagnosis of atrial fibrillation is diagnosed on an electrocardiogram (ECG/EKG).
This is known as an escape rhythm. Since this accessory pacemaker also activates independently of the impulse generated at the SA node, two independent rhythms can be noted on the electrocardiogram (ECG). The P waves with a regular P-to-P interval (in other words, a sinus rhythm) represent the first rhythm.
The first finding is that junctional rhythms are regular rhythms. This means that the time interval between beats stays constant. The next normal finding is a normal QRS. Since the impulse still travels down the bundle of His, the QRS will not be wide. Junctional rhythms can present with either bradycardia, a normal heart rate, or tachycardia. [9]