Coronary sinus heart rate

Heart rate is an important indicator for judging heart health, because heart rate is simply the pattern of heartbeat. Once there is a heart disease problem, it will lead to an imbalance in heart rate, causing people to have various abnormal symptoms in life, and severe cases may even threaten the patient's life. For example, coronary sinus rate is a common heart problem. Let’s take a look at what coronary sinus rate is.

The coronary sinus is the entrance of the coronary vein into the right atrium. If the automaticity of the tissue near the coronary sinus increases and there are more than three consecutive coronary sinus beats, it is called coronary sinus rhythm.

Coronary sinus rhythm is considered to be a special type of escape rhythm originating from the atrioventricular junction of the coronary sinus and the left atrium, respectively. Their common electrocardiographic characteristics are retrograde P wave (Ⅱ, Ⅲ, aVF, inverted P wave), PR interval >0.12s, and heart rate 40-50 beats/min.

Signs:

Coronary sinus rhythm is more common in normal people, presenting as short bursts, and will turn into sinus rhythm when the sinus rate accelerates. The clinical significance is the same as escape rhythm. Some scholars believe that coronary sinus rhythm is more common in patients with venous malformations such as persistent left superior vena cava and absence of inferior vena cava.

ECG features:

The P wave, II, III, and aVF are inverted, the P wave and aVR are upright (occasionally flat or biphasic), the QRS complex duration is normal (such as without intraventricular aberrant conduction or bundle branch block), and the PR interval is >0.12 seconds. This is because the impulses emitted near the coronary sinus must pass through the atrioventricular junction to reach the ventricles, and the distance is longer, so the PR interval is also normal. The impulse sent from the junction reaches the ventricles, which has a shorter distance to travel and takes less time, so the PR interval is less than 0.12 seconds. If the impulse emitted from the junction is accompanied by forward block, the PR interval may also be >0.12 seconds, which makes it difficult to distinguish it from coronary sinus rhythm.

Common causes:

Clinically, coronary sinus rhythm is common in acute rheumatic fever, digitalis poisoning, and acute inferior myocardial infarction.

Disease identification:

Coronary sinus rhythm should also be distinguished from left atrial rhythm. The P wave, I, and V6 of the left atrial rhythm are inverted, while the previous and next P waves, I, and V6 are upright.