Sinus tachycardia- rate is 100–150 beats per minute

example : exercise or anxiety, pain, left ventricular failure, asthma,

thyrotoxicosis or iatrogenic causes (e.g. β-agonists).

sinus bradycardia - rate is less than 60 beats per minute

common in athletes, in young healthy individuals - physically fit, and
patients taking beta-blockers. raised intracranial pressure or sinoatrial (SA) node disease
(‘sick-sinus syndrome’), and is common during myocardial
infarction.

atrial rate in atrial fibrillation is around 350 beats per

minute, Ventricular filling is consequently inadequate and cardiac output falls.

Atrial flutter has a rate of 250–350 per minute.

Atrioventricular block
• First degree: prolongation of the PR interval.
• Second degree: two types, namely Mobitz I - PR interval lengthens progressively until a Pwave fails to be conducted to the
ventricles (Wenckebach phenomenon), and Mobitz II, in which there is a constant PR interval with variable failure to conduct to
the ventricles.
The importance of first- and second-degree block is that
either may presage complete (third-degree) heart block.
This is especially so in the case of Mobitz II block.
• Third degree: There is complete AV dissociation with
emergence of an idioventricular rhythm (usually around
50 per minute, although the rhythm may be slower, e.g.
30–40 per minute). Severe cerebral underperfusion with
syncope sometimes followed by convulsions
(Stokes–Adams attacks) often results.

- Bradydysrhythmia, consider pacing.

- Tachydysrhythmia consider direct current (DC) cardioversion.
- Consider the possibility of hyperkalaemia or other electrolyte disorder, especially in renal disease, as
a precipitating cause and treat accordingly.
- several anti-dysrhythmic drugs can themselves cause dysrhythmias and shorten life