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ARRHYTHMIAS CAUSED BY DISTURBANCE OF FUNCTION OF SINUS NODE AUTOMATISM

— Sinus tachycardia (Fig. 31 a) is characterized by the heart rate of 100-140 per minute with a regular rhythm at rest.

An acceleration of regular sinus rhythm is noted on the ECG, PQ may be diminished.

Causes:

— noncardiac — emotional agitations, fever, bleeding, intoxication, adrenalin release in pheochromocytoma;

— cardiac — endo-, peri- and myocardites, myocardial infarction.
Treatment: elimination of causes; medicamentous therapy — /3-adreno-

blockers anaprilinum (propranolol) 0.03-0.1 mg/kg, esmolol 0.5 mg/kg, trasicor, obsidan, inderal 0.08-0.15 mg/kg at the rate of 1 mg/min.; calcium antagonists — verapimil (isoptin) 0.075-0.15 mg/kg.

— Sinus bradycardia (Fig. 31 b) is characterized by slowing down of
heart rate less than 60 per min., with regular rhythm.

On ECG there is normal and stable sequence of R-R interval with infrequent rhythm.

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