1. Sinus bradycardia usually does not require specific treatment unless the heart rate is below 50 and there is evidence of hypoperfusion.

2. Therapy should begin with atropine as previously described. Most patients will respond to one or two doses.

3. Isoproterenol can be used if atropine is ineffective.

4. External cardiac pacing can be used in the patient refractory to atropine or isoproterenol.

5. Internal pacing is required in the patient with symptomatic recurrent or persistent sinus bradycardia.

SINUS TACHYCARDIA Sinus tachycardia originates from acceleration of the sinus node discharge rate. The ECG characteristics of sinus tachycardia are (1) normal sinus P waves and PR intervals and (2) an atrial rate usually between 100 and 160 ( Fig 24-6).

Clinical Significance Sinus tachycardia represents an acceleration of the sinus node discharge rate, usually in response to three categories of stimuli: (1) physiologic (infants and children, exertion, anxiety, emotions), (2) pharmacologic (atropine, epinephrine and other sympathomimetics, alcohol, nicotine, caffeine), or (3) pathologic (fever, hypoxia, anemia, hypovolemia, pulmonary embolism). In many of these conditions, the increased heart rate is due to an effort to increase cardiac output to match increased circulatory needs.

Anxiety and Panic Attacks

Anxiety and Panic Attacks

Suffering from Anxiety or Panic Attacks? Discover The Secrets to Stop Attacks in Their Tracks! Your heart is racing so fast and you don’t know why, at least not at first. Then your chest tightens and you feel like you are having a heart attack. All of a sudden, you start sweating and getting jittery.

Get My Free Ebook

Post a comment