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While the sinoatrial node typically regulates the heartbeat during normal sinus rhythm, PACs occur when another region of the atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat, [1] in contrast to escape beats, in which the normal sinoatrial node fails, leaving a non-nodal pacemaker to initiate a late beat.
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]
The most basic form monitors the heart's native electrical rhythm. When the pacemaker wire or "lead" does not detect heart electrical activity in the chamber – atrium or ventricle – within a normal beat-to-beat time period – most commonly one second – it will stimulate either the atrium or the ventricle with a short low voltage pulse.
Ectopic beat is a disturbance of the cardiac rhythm frequently related to the electrical conduction system of the heart, in which beats arise from fibers or group of fibers outside the region in the heart muscle ordinarily responsible for impulse formation (i.e., the sinoatrial node).
There are 6 different sinus arrhythmia. [1] [2]A normal heart should have a normal sinus rhythm, this rhythm can be identified by a ventricular rate of 60-100 bpm, at a regular rate, with a normal PR interval (0.12 to 0.20 second) and a normal QRS complex (0.12 second and less).
Normal sinus rhythm and ectopic beats - premature ventricular contractions (PVC) and premature atrial contractions (PAC) shown on an EKG. PVCs may be found incidentally on cardiac tests such as a 12-lead electrocardiogram (ECG/EKG) performed for another reason. In those with symptoms suggestive of premature ventricular complexes, the ECG/EKG is ...
Normal sinus rhythm is established by the sinoatrial (SA) node, the heart's pacemaker. The SA node is a specialized grouping of cardiomyocytes in the upper and back walls of the right atrium very close to the opening of the superior vena cava. The SA node has the highest rate of depolarization. [1]
Impulses from the sinus node reach the atrioventricular node which acts as the secondary pacemaker. The cells of the AV node normally discharge at about 40–60 beats per minute, and are called the secondary pacemaker. Further down the electrical conducting system of the heart is the Bundle of His.