Sinus Pause (sinus arrest)

Prolonged pauses in electrical activity – no P waves or QRS complexes – points to trouble at or near the sinus node.

The return of sinus rhythm occurring off schedule – off the cadence expected from a consistently firing sinus node – suggests that the sinus node ceased impulse formation (sinus arrest or sinus pause).

Several mechanisms can cause the sinus node to falter including ischemia and the untoward effects – toxicity – of nodal medications that slow nodal firing i.e. ABCD – amiodarone, beta blockers, calcium channel blockers, and digitalis. Perhaps the silver lining to this rhythm is that the causes of a sinus arrest could be resolved i.e. alter medication dosing. A permanent implanted cardiac pacemaker may not be required for those who experience pre-syncopal episodes.

sinus bradycardia with a HR of 48, sinus pause, and jec

1. Six Second ECG Guidebook (2012), T Barill, p. 206

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Dynamic ECG rhythm interpretation
Static ECG rhythm interpretation
Clinical Impact Mapping
Acute Coronary Syndromes Overview
Acute Coronary Syndromes In-Depth
ST Segment & T Wave Differential
Identify Bundle Branch Blocks
15 | 18 Lead View Mapping
Electrical Axis
R Wave Progression
Left Bundle Branch Blocks with ACS
Atypical Findings
Acute Non-Ischemic Disease Conditions
Special Cases

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