Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Book

Sinus Bradycardia

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
Affiliations
Free Books & Documents
Book

Sinus Bradycardia

Yamama Hafeez et al.
Free Books & Documents

Excerpt

The sinoatrial node (SA) is the default pacemaker and, therefore, a crucial component of the heart's conduction system. It is located subepicardial and is crescent in shape. In an average adult, a sinoatrial node is 13.5 millimeters in length and is innervated by the vagus and sympathetic nerves. The sinoatrial nodal artery supplies blood to the sinoatrial node, it branches off the right coronary artery in 60% of cases, whereas in 40% of cases, it comes off the left circumflex coronary artery. Sinus bradycardia is a cardiac rhythm with appropriate cardiac muscular depolarization initiating from the sinus node generating less than 60 beats per minute (bpm). The diagnosis of sinus bradycardia requires visualization of an electrocardiogram showing a normal sinus rhythm at a rate lower than 60 bpm. Where a normal sinus rhythm has the following criteria:

  1. Regular rhythm, with a P wave before every QRS.

  2. The p wave is upright in leads 1 and 2; the P wave is biphasic in V1.

  3. The maximum height of a P wave is less than or equal to 2.5 mm in leads 2 and 3.

  4. The rate of the rhythm is between 60 bpm and 100 bpm.

PubMed Disclaimer

Conflict of interest statement

Disclosure: Yamama Hafeez declares no relevant financial relationships with ineligible companies.

Disclosure: Shamai Grossman declares no relevant financial relationships with ineligible companies.

References

    1. Thery C, Gosselin B, Lekieffre J, Warembourg H. Pathology of sinoatrial node. Correlations with electrocardiographic findings in 111 patients. Am Heart J. 1977 Jun;93(6):735-40. - PubMed
    1. Truex RC, Smythe MQ, Taylor MJ. Reconstruction of the human sinoatrial node. Anat Rec. 1967 Dec;159(4):371-8. - PubMed
    1. Spodick DH. Normal sinus heart rate: sinus tachycardia and sinus bradycardia redefined. Am Heart J. 1992 Oct;124(4):1119-21. - PubMed
    1. Kadish AH, Buxton AE, Kennedy HL, Knight BP, Mason JW, Schuger CD, Tracy CM, Boone AW, Elnicki M, Hirshfeld JW, Lorell BH, Rodgers GP, Tracy CM, Weitz HH. ACC/AHA clinical competence statement on electrocardiography and ambulatory electrocardiography. A report of the ACC/AHA/ACP-ASIM Task Force on Clinical Competence (ACC/AHA Committee to Develop a Clinical Competence Statement on Electrocardiography and Ambulatory Electrocardiography). J Am Coll Cardiol. 2001 Dec;38(7):2091-100. - PubMed
    1. Silvestri NJ, Ismail H, Zimetbaum P, Raynor EM. Cardiac involvement in the muscular dystrophies. Muscle Nerve. 2018 May;57(5):707-715. - PubMed

Publication types

LinkOut - more resources