The phenomenon is explained by variations in heart rate caused by respiration. Sinus arrhythmia (respiratory sinus arrhythmia) fulfills all criteria for sinus rhythm except for the fact that the rhythm is slightly irregular. Treatment of the underlying cause should resolve the sinus tachycardia. Pain, infections, medications, fever, hypovolemia, dehydration, anemia, hyperthyroidism and myocarditis are common etiologies. Sinus tachycardia is always considered pathological and the underlying cause must be investigated. As in sinus rhythm, a P-wave precedes every QRS complex and the P-wave is positive in lead II. Sinus tachycardia can exceed 240 beats/min in children. Sinus tachycardia exists if the heart rate is higher than the upper normal limit. The P-wave is positive in lead II (and also I and aVF).P-wave with constant morphology preceding every QRS complex.Regular rhythm with a ventricular rate within the age-specific normal interval.Sinus rhythm is defined by the following criteria: Sinus rhythm is the normal rhythm in all pediatric patients. Hence, sinus rhythm is the normal rhythm of the heart. The sinoatrial (SA) node is the heart’s pacemaker under normal circumstances and the rhythm is referred to as sinus rhythm. The similarity of the waveforms indicates that the origin of the impulse is the same. Rhythm Normal rhythmĪ rhythm is defined as three consecutive beats with identical waveforms on the ECG. These age variations in heart rate are due to variations in the activity of the autonomic nervous system and changes in the automaticity of the sinoatrial node. After 12 months of age, the heart rate is steadily decreasing, and by age 10 years the rate is the same as in adults. It then gradually decreases to about 120 beats/min at 6 months of age. The heart rate then increases during the first 1 to 2 months to about 150 beats/min. Heart rateĭuring the first week of life, the heart rate is approximately 120 beats/min. Many of the diagnoses mentioned below are discussed in detail in other chapters, to which links are provided throughout the text. Below follows a discussion on each of the nine parameters listed above. It is crucial to be familiar with normal findings, normal variants, and pathology in neonates, infants and during the childhood years. Pediatric and neonatal electrocardiograms differ markedly – in terms of rhythm, morphology, normal findings, normal variants, etc – from adult electrocardiograms. The following parameters must be assessed, in chronological order: The ECG must always be interpreted using a systematic approach in order to minimize the probability of missing significant abnormalities. The neonatal and pediatric electrocardiogram ( ECG) is interpreted using the same principles as in ECG interpretation in adults. Definition of normal and pathological pediatric and neonatal ECG
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