Advanced EKGs - Sinus Node Dysfunction

A summary of sinus node dysfunction, including sinus arrhythmia, SA exit block, sinus pauses, sinus arrest, sinus bradycardia, chronotropic incompetence, sick sinus syndrome, and the tachy-brady syndrome.

[whoKnows-cb]

Was 25 and misdiagnosed for years and finally had a heart implant that showed the long asytole or pause of over two minutes or so on one thank god for medtronics implants and it shows the pauses and sick sinus syndrome

[mythoughts................]

Excellent information. I would highly recommend this video to anybody seeking information about the named issue: Sick Sinus Syndrome

[LeonardoMK]

Great video, Dr Eric.
The EKG videos are the ones I like the most, and they've helped me a lot so far.

Please keep up the excellent work.

[dandonovan]

Very helpful having just suffered 45 and 25 sec pauses, admitted as emergency for pacemaker
I now have a better understanding of this condition after video. Very clear explanation.

[mikelewis]

Strong??? This guy is a beast of a doc. (in a good way. Ive learned so much more). Thank you!!!

[abhijitchatterjee]

Rare teacher who pours his heart while imparting knowledge.

[sunving]

Thank you Doctor Strong, once again I am just a slow learner and quick to forget. A wonderful lecture .

[Owmed]

You are trully one of the best teachers I've had. Keep up the good work!

[sunving]

Thank you Doctor Strong, last time was 10 months ago time fly.

[Alexander-mkkg]

FNP here studying to get ECG-BC with American Board of Cardiovascular Medicine. This def. helped me get through the ABCM's study questions for Advanced ECG interpretation. Thank you!

[azr_]

Semangat Jekaa... Tapi tolong latih terus foot work, wrestling dan jiu jitsu nya supaya lebih pede lagi🎉🎉

[SalmaAhmed-ktnu]

My only problem that I don’t what torques colour is.

[drsal]

Excellent video.. without doubt the best video I have seen.. I have been trying to understand sinus pause, arrest & Exit blocks.


I have noticed that in practice it's quite difficult to distinguish between them.


Could you tell me a how to distinguish between sinus pause or arrest from Second degree Type 2 SA block. Is it just on the basis of PP interval?

[johndoecro]

This was very educational. Please include more ECG examples. 

[alvaronf]

Dr strong, how do you differentiate between sinus pause and sinus arrythmia? How do you know if it is respiratory if a patient brings an ecg to your office?

[zacharytaylor]

The heart block will have EKG changes. 1st degree will have a longer P-R interval, anything longer than .20 is a 1st degree. 2nd degree type 1 will have progressively longer P-R intervals till the dropped beat then resumes this pattern. 2nd degree type 2 will have normal P-R intervals with occasional P wave with no QRS complex. 3rd degree will have no correlation between P waves and QRS complexes and more than likely will have wide complexes due to the ventricle conduction. This is a great video that explains the different issues of the sinus node well, I just thought I would throw my 2 cents in as well.

[sepehralaie]

Sorry to bother you doctor, but I don't get the part about" pp intervals progressively decrease". You said it's analogous to decrease in RR intervals in type 1 of second degree av block, I also don't get this one! can you explain why the RR intervals in type 1 of second degree av block must decrease?It's more logical that RR intervals should increase each time, because SA node sends its impulses regularly but each time it takes more time for the impulse to reach from SA node to the ventricles, so RR intervals must progressively increase prior to the pause! 😢

[judypeng]

SA nodal exit block is AV block? From the 3 degrees of block same like AV

[johnnyflores]

I had a sinus arrhythmia show up on a ekg without significant abnormalities i was having jumped beats that day and thats what showed up on the ekg

[trieudeptrai]

What is the mechanism behide SA nodal exit block, and how we can distinguish between it and AV block, especially in case of type 2 of 2nd degree block because I feel like it look indentical to the type 2 of 2nd AV block? Anyhow, thank you so much for sharing and teaching us.