Coronary sinus rhythm

Introduction

  • Coronary sinus rhythm arises from the the area of atrioventricular junction near the coronary sinus ostium

  • The impulse activates the atria retrogradely, hence a typical morphology of P waves in limb leads - negative in leads II, III and aVF

ECG characteristics

  • negative P waves in leads II, III and aVF
  • narrow QRS complex
  • normal PR interval
  • slightly slower rate than sinus rhythm

ECG 1 Coronary sinus rhythm with a rate of 48/min, narrow QRS complexes, negative P wave in II, III and a VF - best visible in lead III, 1st degree AV block is present with PR interval of 232ms

References

  1. Čihalík, Čestmír, and Miloš Táborský. 2013. Ekg V Klinické Praxi. Meduca. Olomouc: Solen, Medical education.
  2. https://www.slideshare.net/smcmedicinedept/ecg-coronary-sinus-rhythm?fbclid=IwAR0iBM0_eSrMLMtchMewSO903OhgdFEa9t5pWGKTym1AKct1mioGk0ggVsA
  3. https://cs.wikipedia.org/wiki/Junkčn%C3%AD_rytmus