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Home / Heart Disease / Cardiac Arrhythmias / Sinus Arrhythmia – What Is It?

Sinus Arrhythmia – What Is It?

November 27, 2014 by Dr. Mustafa Ahmed 79 Comments

What is Sinus Arrhythmia?

What is sinus arrhythmia? Heartbeats are like clockwork. In the same way the second hand on a clock ticks regularly each second, the heart has an electrical impulse that is generated and leads to a heartbeat in a regular manner. The timing between each of these generated impulses is known as the P-P interval.

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Most individuals have a minor variation in the P-P interval. Usually however this is small, <0.16 seconds. In individuals with sinus arrhythmia however, the P-P interval may vary by > 0.16 seconds.

Is Sinus Arrhythmia Normal?

There are typically 2 types of sinus arrhythmia. By far the most common is basically benign and known as respiratory sinus arrhythmia. Here the variation in the heart rate is related to the breathing cycle. The rate increases when the person breathes in and decreases when the person breathes out. Its what we call a physiological response and isn’t considered a significant abnormality. Its much more common in children and tends to decrease with age. The cause isn’t exactly known, but is thought related to reflexes related to the pulmonary and the vascular systems. As you can imagine, the sinus arrhythmia may be more pronounced in very heavy breathers, such as people with sleep apnea.

The other form of sinus arrhythmia is less common and known as non-respiratory sinus arrhythmia. It is more common in the elderly where it may occur in association with heart disease. Once again the exact cause is unknown.

Sinus arrhythmia is most commonly seen when the heart rate is slow. And when the heart rate speeds up, during exercise for example, the rhythm tends to become regular. In general, the presence of sinus arrhythmia is not indicative of the need for further testing and people can be reassured as to its generally benign nature.

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Filed Under: Cardiac Arrhythmias Tagged With: Cardiovascular disease, heart disease, Heart failure, heart rhythm

Comments

  1. bernardita canlas says

    August 26, 2016 at 2:37 am

    This was the result of electrocaridographic report of a 12 y/o student of mine. I want to know it her case is serious? I hope for your reply.

    Rate:
    Rhythm: Sinus Autricular: 70-90/min PR Interval: 0.14 sec.
    QRS Axis: Normal Ventricular: 70-90/min QRS Interval: 0.06 sec.
    QT: 0.36 sec
    INTERPRETATION: Sinus Arrhythmia

    Reply
    • Dr. Mustafa Ahmed says

      August 26, 2016 at 4:01 am

      Looks pretty normal to me.

      Reply
      • Jomille says

        August 10, 2017 at 12:45 pm

        I also have sinus arrhythmia. Is it still okay if I play basketball?

        Reply
        • Dr. Mustafa Ahmed says

          August 13, 2017 at 5:24 am

          Sinus arrhythmia, asymptomatic, is not a contraindication in of itself to playing basketball. So likely yes unless you have been told otherwise by a medical professional.

          Reply
      • Andrea Draughn says

        September 29, 2017 at 3:12 pm

        This is my results of a 48hr holter monitor . please help me understand it. Thank you raughn, Andrea was in Sinus with Sinus Arrhythmia.

        The average heart rate, excluding ectopy, was 70 BPM with a minimum of 51 BPM
        at 11:41 D3 and a maximum of 119 BPM at 19:42 D1.
        Heart beats, including ectopy, totaled 202431 beats.

        VENTRICULAR ECTOPICS totaled 4 averaging 0.1 per hour with 4 single, 0
        paired, 0 trigeminy and 0 R on T.

        SUPRAVENTRICULAR ECTOPICS totaled 10 ,with 7 single and 0 paired beats.
        There was 1 SUPRAVENTRICULAR TACHYCARDIA with 3 beats at 12:28 D3 at a rate
        of 102 BPM.

        Draughn, Andrea was in Sinus with Sinus Arrhythmia.
        The average heart rate, excluding ectopy, was 70 BPM with a minimum of 51 BPM
        at 11:41 D3 and a maximum of 119 BPM at 19:42 D1.
        Heart beats, including ectopy, totaled 202431 beats.

        VENTRICULAR ECTOPICS totaled 4 averaging 0.1 per hour with 4 single, 0
        paired, 0 trigeminy and 0 R on T.

        SUPRAVENTRICULAR ECTOPICS totaled 10 ,with 7 single and 0 paired beats.

        Interpretation:
        1. Rhythm is Sinus with Sinus Arrhythmia.
        2. PR and QRS are within normal limits.
        3. (4) Single VE’s.
        4. (7) Single SVE’s, (1) run of 3 beats of run.

        Reply
        • Dr. Mustafa Ahmed says

          October 2, 2017 at 2:53 am

          Looks pretty non eventful and no obvious cause for concern.

          you can follow my twitter at @MustafaAhmedMD

          Reply
          • Ashley R Cobb says

            March 5, 2021 at 1:57 pm

            I’ve had EKG’s in the past and they were all normal just recently at 33 years old they had discovered sinus arrhythmia. Only because I went to the hospital for very swollen legs that comes and goes aka pitting edema… Is it normal to get sinus arrhythmia at 33 when you’ve never had it before ? And could that be the cause of the swollen legs

    • Vincent Van Incan says

      December 9, 2021 at 7:27 pm

      Hi Dr. Mustafa,

      I had this result earlier on my ecg and I would like to seek help on your expertise to interpret the below data.

      Rhythm: Sinus
      Rate: 90
      P.R. 0.16
      Q.R.S 0.08
      Axis Position 45
      Q.T. 0
      Q.T.C 0.44

      Interpretation: (N) Axis, NSSTWR

      Reply
  2. bernardita canlas says

    August 26, 2016 at 2:38 am

    I am looking forward for your respond regarding my question, thanks

    Reply
  3. jennie says

    August 31, 2016 at 5:31 am

    My 4 year old got this diagnosis today. Basically he said it can happen in athletic toddlers. Any thoughts on that?

    Reply
    • jennie says

      August 31, 2016 at 5:32 am

      She is a dancer and just went through dance camp for 3 months and danced 5-6 hrs a day out of a 9 hr day. Then she continues dancing t home.

      Reply
      • Dr. Mustafa Ahmed says

        September 1, 2016 at 3:46 am

        Its essentially a normal variant, and i agree its not likely a cause for concern.

        Reply
  4. Jack says

    September 13, 2016 at 12:48 pm

    So my GP said I have Sinus Arrhythmia and another medical professional said I had an ectopic heartbeat. Doing the inevitable google – they are different things and Sinus Arrhythmia says there are no cardiovascular symptoms yet I get bouts of dizziness and pre-syncope episodes, chest pain and prolonged shortness of breath – to be these are all CV symptoms.

    Any idea?

    Reply
    • Jack says

      September 13, 2016 at 12:49 pm

      p.s. I’m a 29 year old guy who does a lot of sport and exercise both cardio and weights etc.

      Reply
      • Madhavi Ramachandran says

        December 25, 2016 at 1:34 pm

        Hi sir ! This my ECG report . HR 74bpm P: 110ms PR: 149ms QRS : 89ms QT/QTC : 401/446 Ms P/QRS/T : 48/10/36 RV5/SV1 : 0.695:0.576 mV Diagnosis Information. sinus arrhythmia. Poor R wave progression. Flattened T wave (VL,V6). Inverted T wave(V4) pls advise Iam 38yrs old . I have sinusitis @ gastric problem

        Reply
    • Julie says

      February 28, 2017 at 6:22 am

      I am 30, was diagnosed years ago and I have more experiential knowledge about my sinus arrhythmia than my docs can tell me. It’s caused by either stress, spiced foods (actually lots of different types of hard to digest foods can upset it) but by far the thing that upsets it the most is lack of cardio exercise. If I go a week without it, I get palpitations randomly, especially while sitting for too long. As long as I do regular, consistent, non-interval cardio training.. I’m fine!

      Reply
      • TA says

        September 25, 2017 at 2:18 pm

        Hi!

        I too get random palpitations and notice that if i exercise regularly they seem to go away, but yes long periods of sitting and lack of cardio will trigger them for me as well! I was also told i had a sinus arrhythmia. I am 36 and also have low bp.
        Do you know if the palpitations are related to the arrhythmia? I’ve never come across someone with the same symptoms. Thank you for sharing!!

        Reply
        • SF says

          March 10, 2018 at 10:30 am

          Wow I finally sound two people with similar symptoms as myself! I am a 20y/o healthy active female, I have extremely low BP, and some tummy issues too. Whenever I run or work out it tends to sort out the arrhythmia. But days where I don’t work out or or have a lazy day my heart beat gets so slow when I exhale it’ll start to hurt and sometimes palpate. It feels like it has to catch right at the end or something.

          Reply
      • Maria says

        November 25, 2019 at 12:10 am

        I started having multiple heart palpitations per week or sometimes per day about 6 months ago. I am almost 31. I agree, a short, 30 minute, non-interval cardio once a day does help to control it. I do not experience palpitations during or after exercising. However, I do get them if I get up and walk wast or chase the cat, or walk up the stairs or if I worry or stressed out about something. I have not been diagnosed with a specific type of arrhythmia. But I just know I have one and it is related to my bathing. I also seem to have a bradycardia. I am about to schedule an appointment to do some heart testing. When palpitations happen, sometimes very strong ones, they gives me chills and I get very scared. I am not sure what caused them to start happening 6 months ago. I’ve never had them before.

        Reply
        • henry Abad says

          March 17, 2021 at 8:03 pm

          Any updates on this. I just started experiencing same symptoms and was diagnosed with sinus arrhythmia. Still have more tests that need to be done but what have y’all done?
          Thanks in advance

          Reply
        • Henry Abad says

          March 21, 2021 at 6:06 pm

          I have been experiencing the same thing and now seeing a cardiologist but yet to get more results back. Did you happen to have any more information from your side?
          Thanks Adrian

          Reply
  5. Celine Dianne D. Herrera says

    September 14, 2016 at 12:43 pm

    This was the result of my Electrocardiogram. I’m 18 years old.
    RHYTHM: Sinus Arrhythmia
    PR INTERVAL: 0.14
    POSITION: 75
    QRS DURATION: 0.08
    VENTRICULAR RATE: 60-71
    QT: 0.40
    QTC: 0.426

    Reply
  6. Shana says

    October 13, 2016 at 5:37 pm

    I am a 50 year old started having fast heart rate in 90-100 and frequent PVCs been having them constantly for 2 weeks now ….no heart disease otherwise ….. Should I be concerned?

    Reply
    • Dr. Mustafa Ahmed says

      October 14, 2016 at 2:24 am

      You should have an EKG, some blood tests and an echocardiogram to start with.

      Reply
  7. Merwyn D'Sa says

    December 9, 2016 at 7:23 pm

    I’m 76 years of age.
    I take daily 2.5 mg Amlodipine for BP, 20mg Telmisartan, 75 mg Clopivas, 5mg Atorvastatin
    My ECG on 17 July mentioned i have Bradycardia.
    Today’s ECG mentions sinus arrhythmia.
    Should I be concerned about the results of the ECG?
    Should my medication be changed or dosage modified?
    Any further tests to be done?
    Would appreciate your advice by e-mail.
    Thanks

    Reply
    • Dr. Mustafa Ahmed says

      December 11, 2016 at 4:17 am

      Sinus arrhythmia itself is not a cause typically for concern. I cant really comment on the rest without knowing much more about your case. An echocardiogram would be reasonable.

      Reply
  8. noor says

    December 19, 2016 at 8:26 am

    Dear Doc Can i know about my heart condition. i am daignoserd with sinus arrhythmia with unspecified st-t abnormality. i am taking andral 40 day and night and escilotopram. but i feel my cardiologist has not considered or treated me well.As while talking my heart goes down,i feel constant pain in my left shoulder just near armpit.i wonder whats wrong.what should i do now ?

    Reply
  9. Madhavi Ramachandran says

    December 25, 2016 at 1:31 pm

    Hi sir ! This my ECG report . HR 74bpm P: 110ms PR: 149ms QRS : 89ms QT/QTC : 401/446 Ms P/QRS/T : 48/10/36 RV5/SV1 : 0.695:0.576 mV Diagnosis Information. sinus arrhythmia. Poor R wave progression. Flattened T wave (VL,V6). Inverted T wave(V4) pls advise Iam 38yrs old . I have sinusitis @ gastric problem

    Reply
  10. Mary says

    December 29, 2016 at 2:14 am

    My ECG says that I have Sinus arrhythmia. I’m constantly tired and sleepy. With a few bouts if syncope. I’m an active 29 year old. Lady and my doctor says there’s nothing to worry about. But even after resting as long as I do something physical for a few minutes I often feel tired and sleepy. I’ve been taking naps 2-4x a day even with enough sleep. Someone please help me.

    Reply
    • Alex says

      August 22, 2018 at 10:09 am

      My ecg report is sinus arrhythmia with normal sinus rhythm and heart rate is 87 and 82 bpm
      P 96
      Did i need to worry

      Reply
  11. Sherrie says

    January 4, 2017 at 11:29 pm

    Hello I am a healthy 46 year old female. I was experiencing lightheadedness upon position changes. I had an EKG at my routine check up. He results were Sinus rhythm with short PR interval.
    Vent rate 69 BPM
    PR int. 117 ms
    QRS duration 93 ms
    QT/QTc 357/376 ms
    P-R-T 9. 69. 74
    Could you please email your opinion? Thank you very much for your time!

    Reply
    • Dr. Mustafa Ahmed says

      January 6, 2017 at 4:05 am

      Looks like fairly normal values. Would need to see the tracing for further comment.

      Reply
  12. Yusimith Rodriguez says

    March 16, 2017 at 7:21 pm

    hi..

    I am 41 years old, with a lot of medical problems GERD, Helia Hernia, Ulcer, Asthma, etcs

    I just had a sleep studies and they did a EKG no significant myocardial rate or rhythm changes associated with any sleep related physiological events but during sleep I had a relatively fast heart rate with an average of 77, a minimum of 63 and a maximum of 101 Bpm. During all recording both awake and asleep my highest heart rate was 101 bpm, and my lowest rate was 62 bpm but in the meantime my asleep SaO2 87.6% and awake SaO2 95.8% ..

    Please can you tell me if I need to see my Doctor or if I need to be concerned about this .. thank you

    Reply
    • Dr. Mustafa Ahmed says

      March 22, 2017 at 2:01 am

      I would recommend you see a Dr for a follow up if i were you, simply to discuss the results of the sleep study.

      Reply
  13. Samina khatun says

    April 29, 2017 at 8:19 pm

    my brother has his ecg report ‘short sinus otherwise normal’…is it normal Dr. ahmed…?.

    Reply
    • Dr. Mustafa Ahmed says

      May 2, 2017 at 3:48 am

      Sounds normal. Im not familiar with the term short sinus it doesn’t exist.

      Reply
  14. Atik says

    June 9, 2017 at 8:25 am

    Hi Dr. Mustafa Ahmed,

    This is my ECG result. I do not know how to write it but the Dr put it as HR 70, and diagnosed it sinus arrhythmia. Im having constantly pain in my left side chest. Sharp pain.
    I got short breath when happen to sleep. Even during breathing, i can feel the pain happen in center or left side chest. The Dr referring me to specialist next week but i would like to find somethg for myself first. Can you help me for this?

    Reply
    • Dr. Mustafa Ahmed says

      June 12, 2017 at 3:21 am

      The sinus arrhythmia itself is not a cause of chest pain. I suggest further work up is performed and depends on the nature and character of the pain.

      https://myheart.net/articles/angina-or-some-other-chest-pain/

      Reply
  15. Atik says

    June 9, 2017 at 8:35 am

    Hi,

    Im atik
    Additional information
    Dr put statement like this, no acute ischaemic changes

    Reply
    • Dr. Mustafa Ahmed says

      June 12, 2017 at 3:21 am

      That means the EKG itself does not show evidence of heart blockage.

      Reply
  16. Hadijah says

    June 26, 2017 at 6:11 am

    Hello Dr,
    my 9 year old gal was diagonised with sinus arrhythmia, her results are as follows; HB:90bpm
    P :92ms PR:125ms QRS79ms QT/QTc :345/423ms P/QRS/T :44.68/33 deg. RV5/SV1: 1.351/1.614mV. is there cause for worry? what should i do

    Reply
    • Dr. Mustafa Ahmed says

      June 29, 2017 at 5:14 am

      I will ask the pediatric cardiologist to comment. Sinus arrhythmia in isolation is not felt to be dangerous.

      Reply
  17. carlos says

    June 27, 2017 at 11:43 am

    may ecg test have findings that i have a sinus arrythmia is this dangerous? how to cure it or prevent? if thres a medicine to take? thanks….

    Reply
  18. Samantha says

    July 12, 2017 at 7:43 am

    Hi Dr. Mustafa Ahmed,

    Firstly thank you for taking the time, and having the patience, to help everyone :))

    My mom (57, slim and healthy) has just had an ECG done and been told she has Sinus Arrhythmia. Shes the opposite of a hypochondriac and says theres nothing to worry about, but the little bit of googling I’ve done says its normal in youth but probably caused by something else in the elderly…so could you please advise:

    1. Should I be concerned and push to take her to a more thorough heart exam?
    2. Is there ANYTHING she can do to help this condition? Exercise (she does enough, but maybe more cardio I hear?), medication (maybe half an asprin everyday to thin the blood?), diet changes etc?

    My Gran died of high blood pressure related issues in her 50’s so I’m really worried my moms not taking it seriously enough…or maybe thats just making me more paranoid?? Please help!

    Thank you so much for your time and consideration:)) Best wishes xx

    Reply
    • Dr. Mustafa Ahmed says

      July 16, 2017 at 10:44 am

      Why was the EKG done in the first place?

      Sinus arrhythmia isn’t necessarily a disorder, it is in most cases benign. If your mother is only 57 and has no symptoms of cardiac disease and only sinus arrhythmia on an EKG there is likely nothing to worry about and no further testing needed.

      If you are interested in cutting edge information and therapy for heart disease then follow my twitter at @MustafaAhmedMD

      Reply
  19. may diola says

    July 18, 2017 at 10:55 am

    Hi im may diola 25y/o and female. This is the result of my ECG ; rythm- Sinus , qt axis- normal, position – vertical, pr interval- 0.16, qrs-0.04,qt- 0.28

    Interpretation sinus arrythmia

    ..is this okay??

    Reply
    • Dr. Mustafa Ahmed says

      July 19, 2017 at 5:10 am

      The read itself looks fairly normal.

      If you are interested in cutting edge information and therapy for heart disease then follow my twitter at @MustafaAhmedMD

      Reply
  20. sachin says

    July 21, 2017 at 8:10 am

    hello doctor mustafa. can you please help me with this ECG result of my five year old daughter. the following result:
    Vent Rate 88 bpm
    PR Interval 118ms
    QRS Duration 77ms
    QT/QTc 342/413 ms
    PP/RR Interval 682/685 ms
    P/R/T axis 4/81/50

    result
    Sinus Rythem with sinus arrythmia
    T wave changes in anterior leads

    is this a case to worry ?????

    thanks

    Reply
  21. Abby says

    October 17, 2017 at 4:49 am

    Hi Dr.mustafa my name is Abby 23y/o last September. 2017 and this is my ECG result..

    Cardiac rate 70
    P.R interval. 0.16
    Q.R.S. 0.10
    Q.T. 0.38
    AXIS. .+60

    INTERPRETATION: SINUS ARRYTHMIA OTHERWISE NORMAL ECG.

    Is this a case to worry? Bcos until now I have a chest pain and hard breathing?

    Reply
    • Dr. Mustafa Ahmed says

      October 17, 2017 at 5:05 am

      Doesn’t look concerning just based on the report. Make sure you follow up with the person that ordered the test.

      you can follow my twitter at @MustafaAhmedMD

      Reply
  22. Caren Dela Cruz says

    November 3, 2017 at 1:31 am

    Hi Dr.Mustafa this is the result of the ECG of my 13 y/o daughter

    Axis Deviation +60
    Rates Atria: 58 / Vent: 58
    Interval PR: 0.16 / QRS: 0.08 / QT: 0.32
    Implications: SINUS BRADYARRYTHMIA

    May I know your opinion regarding this?
    Thank you

    Reply
    • Dr. Mustafa Ahmed says

      November 5, 2017 at 4:29 am

      Looks relatively normal. Were any concerns raised?

      Reply
  23. Jotennavar says

    January 22, 2018 at 7:19 am

    Hi Dr.Mustafa Ahamad my name is Dicappa 40 y/o last Dec. 2017 and this is my ECG result..

    Dignosis Information
    Sinus Arrhythmia
    Poor R eave Progression(V2)
    Inverted T wave (VS, V6)
    Slight ST Depression (V6)
    Sloght ST Elrvation (V1)

    HR : 92 bpm
    P : 98 ms
    PR : 129 ms
    QRS : 99 ms

    QT / QTc : 341 / 423 ms
    P / QRS / T : 67 / 33 / 222
    RV5 / SV1 : 1.632 / 0.852 mV

    Is it dangerous please suggest doctor

    Reply
    • Dr. Mustafa Ahmed says

      January 26, 2018 at 4:18 am

      You need to have it reviewed by someone that can see the tracing and evaluate your history.

      Reply
  24. Jotennavar says

    January 22, 2018 at 7:28 am

    Hi Dr.Mustafa Ahamad my name is Dicappa 40 y/o last Dec. 2017 and this is my ECG result..

    Dignosis Information
    Sinus Arrhythmia
    Poor R eave Progression(V2)
    Inverted T wave (VS, V6)
    Slight ST Depression (V6)
    Slight ST Elevation (V1)

    HR : 92 bpm
    P : 98 ms
    PR : 129 ms
    QRS : 99 ms

    QT / QTc : 341 / 423 ms
    P / QRS / T : 67 / 33 / 222
    RV5 / SV1 : 1.632 / 0.852 mV

    Is it dangerous please suggest doctor

    Thank you

    Reply
  25. Marie says

    January 27, 2018 at 12:45 am

    Hi I am a 36 year old female who is experiencing palpitations on a regular basis. My heart feels like it is going to pop put of my chest and are very uncomfortable. They are starting to interfere with everyday life. I have been diagnose with irregular sinus. All bloods normal. My ecg results as follow:

    Rate: 88
    PR: 143
    QRSD: 89
    QT: 374
    QTc: 453

    P: 67
    QRS: 66
    T: 37

    Is this dangerous? What do you suggest?

    Thanks

    Reply
  26. Dylan Childs says

    March 5, 2018 at 2:47 am

    How do tachycardia, sinus arrhythmias and AFIB feel different? I will describe my episodes below. Cardio said i don’t have afib although we haven’t caught an episode. Said 24 hr monitor would show some signs. Suggested it’s sinus arrhythmia. Your thoughts?I’ll describe the episodes below:

    + They happen in-frequently–sometimes multiple in a week, sometimes i go a couple weeks without any. I have only had 1 in the last 3 months. I’m sure in the past I have gone even longer
    + They last 5-20 seconds mostly, but sometimes a couple mins..in the past (when drinking coffee or alcohol) have had episodes that lasted 20 to 40 mins.
    + They occur mostly at night in bed, laying down, but also from sudden/awkward change of posture, or drinking coffee/alcohol, from stress/anxiety.
    + They feel like a steady, constant, elevated heart rate(120-150ish). “Pounding” in my chest. There is not fluttering.

    Do you agree with my cardio these aren’t to be worried about? Beta-blockers do great for my blood pressure but would drop my heart rate sometimes into the 40s… So I shouldn’t take them, correct? I didn’t really ever feel faint or anything, though i had ectopic beats sometimes.

    When off the beta-blockers, is it ok that my heart rate is mostly 50s-60s…but sometimes during high stress/anxiety itll get up to 90ish…I take a xanax and it calms down. Cardio said I have sinus rythtm but its very irregular. Do you think i’ll need a pacemaker? Sure hope not .

    Reply
  27. Rose J says

    April 3, 2018 at 2:05 pm

    Hello, I am a 46-year-old woman. In October 2014 I ignored some serious pain after contracting pericarditis from a virus and ended up in the heart hospital, acute pericarditis with myopericarditis(small scar on my heart and pericardium). I had prominent edema and atelectasis with air bronchograms. The cardiologist assigned discharged me, October 31, 2014, with one Colcrys and didn’t see me or follow up with me until January 28, 2015. He used an EKG, SED, and CRP to “clear” me while I was still on Colcrys, which can mask those tests! February 18, 2015 , I ended the Colcrys taper) my MRI indicated “resolving myocarditis”, and my “pericarditis” pain returned fairly similar to the first time February 28th, 2015. I had a follow up with my local cardiologist March 2, 2015, and he diagnosed me “recurrent pericarditis”; however, the pain was the “same” as the myopericardits pain…left arm. He prescribed 2 Colcrys twice a day for 6 months. It returned 6 months after I stopped the Colcrys, March 2016; same type of pain…through my left arm. I took the Colcrys again. I had some small flares, but then a larger flare March 2017 again..through my left arm. April 2017 my ECHO showed “no effusion”. (NewsfIash: Large effusions are not visible on ECHOS unless I had a miraculous recovery October 29th, 2014 when my MRI showed prominent effusion and an ECHO 50-minutes. October 29th, 2014, later showed “no pleural effusion”.) I saw his assistant and followed up with him May 2017 and was put back on Colcrys. It seemed to be resolving, but maybe it was just hiding…again! I think I over-did life in July, doing some home remodeling and gardening and never needed ibuprofen, so I didn’t use it properly when the pain increased. My August 2017 MRI revealed that I still had pericarditis, which I guess I knew never left, and I had trace pleural effusion. This attack was straight to my heart…no left arm…completely horrible! I had an MRI August 2018 because my cardiologist thought I was somatic, which also was partially true…that pain made me feel like I was dying, even though I really did almost die in 2014 I never felt I was dying, zero anxiety) until this year! That MRI suggested no constriction, but I am aware that constriction is not always detectable. Since walking helped the new anxiety I found because this attack hurt way more than all the others, I started walking in August. I had a second flare, which I am assuming was due to influenza exposure. (I am fairly convinced I have Dressler’s syndrome with seasonal flares. I let my cardiologist know that’s what I believe as all other auto-immunes have been excluded, and I know what happened to me now! I made a grave error in 2014 by ignoring pain!) That November 2017 flare lasted until January 2018. My heart monitor in September 2017 was unremarkable.(some PVCs). My cardiologist noted “sinus rhythm and sinus arrhythmia” in January 2018. He said I can ask for another holter monitor if I want, but he felt it was just a phenomenon when I asked him in a mychart message. Usually when I start walking my heart rate goes to 100 HBM fairly quickly. I just have odd jumps to 150-170 occasionally throughout the walks that last 1-5 minutes. I am able to talk in complete sentences and am never breathless..like ever…even though other people who try to keep my pace are! I haven’t tried running because I do know that I “lose” my heart beat when I run. My resting heart rate is 59 HBM. I have changed my whole lifestyle this year and am at a healthy weight with very, very little sodium. I’ve lost 80 pounds since August 2017 and 100 total since January 2017. I walk 8 miles a day and have been since November 2017. I know sinus arrhythmia is usually benign, and I am hopeful that my sinus arrhythmia is just a phenomenon; however, maybe I should be more concerned than I am due to my history. My cardiologist is very good, but I don’t believe he had known I had myopericardits until January 2018. He also didn’t realize I had had trace pleural effusion until January when I had him go into my August MRI. That, the pleural effusion, is what really hurts! I mean the other flare in November “hurt” more at night, but at least during the day I didn’t have to stand all day to avoid the pain..I just had to tap my heart, stop and breathe when the sharp jabs came and at night just suck up the pain and not move at all. Pericarditis is a horribly painful, yet not deadly, disease! I am just wondering if my myocarditis is finally healed and did it cause this arrhythmia or is it just a phenomenon? Is there anything else I can do?

    Reply
  28. alicia says

    April 4, 2018 at 8:41 pm

    i have a sinus rhythm pvc with rbbb rate 58, shoulder blade pain and left breast pain, and shortness of breath

    Reply
  29. Karen says

    April 6, 2018 at 5:14 pm

    I had a holter monitor test done for 24 hrs and it states Rhythm was sinus with episodes of sinus arrhythmia and sinus tachycardia. I do have high bp and am on medication for it. My heart also was beating over 150 times. I am exhausted and feel like my heart is going to jump out of my chest. I just do not feel right. Can you help with what these results mean? Thank you

    Reply
    • Dr. Mustafa Ahmed says

      April 9, 2018 at 2:55 am

      The monitor states that you did not have any out of the ordinary arrhythmia, rather you had some episodes of fast heart rate only that were not due to electrical ‘short circuits’ in your heart conduction pathway. I would recommend you go over the results of the monitor with your physician. Were the episodes of fast heart rates 1) at times of activity? 2) at times of exercise or activity or 3) were they random. This needs to be clarified prior to investigating further.

      you can follow my twitter at @MustafaAhmedMD

      Reply
      • Titilayo says

        April 13, 2018 at 7:25 pm

        Hello,

        Have been complaining about a pain from the left side of my neck to the ankle sometimes it like a stiffness…..it starts from my neck then to my shoulder down to my chest to the back then to my elbow,waist,knee finally my ankle.at times I feel a sharp pain in my chest too…. These my third year still feeling the pain done series of test and x-ray and it all looking fine until recently I did an ECG and it say’s ‘borderline abnormal ECG..sinus arrhythmia’…..would be glad if you can help in any way…..looking forward to your reply.

        Reply
        • Dr. Mustafa Ahmed says

          April 22, 2018 at 5:45 am

          The EKG is most likely normal and the symptoms unrelated.

          Reply
  30. Michelle says

    April 6, 2018 at 11:39 pm

    Hello,

    I had a ECG recently and my Dr called me in for the results.
    Test shows I had Sinus Arrhythmia
    Low QRS volage in extremity leads
    Normal Variant of ECG
    P/PQ; 97 ms/128 ms
    ORS; 84 ms
    QT/QTc/QTd/ 332 ms/ 418 ms/32 ms
    P/ORS/T axis 75 / 57/ 50
    Heartrate 95 bpm

    My Dr has requested that I wear a holter Monitor for 24 hrs to check further.
    I’m somewhat scared….Not sure what this all means.
    My chest hurts, but not like I’m having a heart attack, just achy…pain down my left arm. I’m honestly thought I just pulled a muscle and have brushed it off…Now, I’m concerned.

    Reply
    • Dr. Mustafa Ahmed says

      April 9, 2018 at 2:57 am

      A holter monitor is simply wearing a monitor. https://myheart.net/articles/holter-monitors-explained-by-a-cardiologist/

      you can follow my twitter at @MustafaAhmedMD

      Reply
  31. Daryl Orpilla says

    June 12, 2018 at 9:55 am

    Hi! I’m Daryl, 29 years old… My Ecg result showed my heart rate of 58 bpm…

    P 0.12axis 53 Deg
    Qrs 1.19 axis -14 Deg
    T0.22 axis -2 Deg
    Left type
    Rhythm

    Sinus arrhythmia
    Check AV block of higher degree
    QRS-T interpretation: Pathological left anterior hemi block

    Reply
    • Meghan says

      November 17, 2018 at 12:01 pm

      Hello Doctor,

      I am a 26 year old female who is now on bispoprolol, because I could feel my heart beat and flutter 24/7. I suffered with chest pain daily!

      Can you tell me from the below what condition I have please and will it go away?
      Can I exercise?

      5 VE beats
      570 APB beats

      Highest hear rate 237
      Lowest heart rate 58

      PR Interval 0.122
      QR duration 0.06

      Comments – sinus rhythm and episodes of sinus tachycardia.
      Occasional APBs and one ventricular run.

      They also found on a CT a very tiny amount of calcium… But didn’t really expand on this… Is it something to worry about?

      Thanks in advance.

      Reply
  32. Meghan says

    November 17, 2018 at 3:04 am

    Hi I’m Meghan,

    Messaged you on Twitter 🙂 I’m 26 years old, due to the following I’m on bisoprolol 2.5mg.

    I had a monitor on for 17 hours, looking for some feedback on the sheet I was given.

    I had 5 VE beats and 570 APB beats.
    Max heart rate of 237 and minimum 58.
    PR Interval – 0.122 secs
    QRS duration 0.06

    Comments where: sinus rhythm with episodes of sinus tachycardia.
    Occasional APBs and one ventricular run.

    What condition do i have?
    Will it go away?
    Can I exercise?
    Is pain in chest , dizziness, headaches and ability to feel heart beat 24/7 normal? (Never blacked out)

    They also mentioned I had calcium build-up but nothing to worry about and otherwise a good structure inside.

    Thanks in advance 🙂

    Reply
    • Dr. Mustafa Ahmed says

      January 23, 2019 at 5:52 am

      Hi Meghan,

      You have some extra beats that originate from the top chamber of your heart known as PAC’s. Firstly, don’t worry its not dangerous. It may go away over time it may not. There are sometimes triggers such as alcohol that can trigger these beats, sometimes they just happen. People with PAC’s can exercise just fine. The symptoms you have aren’t normal, and not necessarily anything to worry about, although you should get checked out for sure. The normal heart structure, i assume from an echocardiogram, is reassuring.

      Reply
  33. Meghan says

    November 17, 2018 at 11:58 am

    Hello Doctor,

    I am a 26 year old female who is now on bispoprolol, because I could feel my heart beat and flutter 24/7. I suffered with chest pain daily!

    Can you tell me from the below what condition I have please and will it go away?
    Can I exercise?

    5 VE beats
    570 APB beats

    Highest hear rate 237
    Lowest heart rate 58

    PR Interval 0.122
    QR duration 0.06

    Comments – sinus rhythm and episodes of sinus tachycardia.
    Occasional APBs and one ventricular run.

    They also found on a CT a very tiny amount of calcium… But didn’t really expand on this… Is it something to worry about?

    Thanks in advance.

    Reply
  34. Linda says

    December 19, 2018 at 7:19 pm

    Hi doctor ahmed I recently had an ecg at my doctors surgery, the nurse does the test, think the sounds are relayed onto the hospital, they said it was abnormal and had to wait to see the doctor, I was very nervous, he said what was I worried about that’s it’s ok, I had a minamal inverted T wave, but when I saw my records it also said sinus rhythm. He said come back in couple of weeks more relaxed has I was very anxious during ecg, the Minimal inverted t wave is across v1-V6 I’ve not got chest pain. Can you please tell me if you think I have anything to worry about, having 2nd ecg tomorrow..look forward to your reply .. kind regards Linda .. I feel so anxious right now

    Reply
    • Dr. Mustafa Ahmed says

      December 21, 2018 at 5:55 am

      Non specific T wave changes are not necessarily worrying particularly if the treating dr is reassured.

      you can follow our twitter at @MustafaAhmedMD

      Reply
    • Dr. Mustafa Ahmed says

      January 13, 2019 at 8:44 am

      In general it sounds like its relatively normal. A repeat is a good idea.

      you can follow our twitter at @MustafaAhmedMD

      Reply
  35. Rohini Sharma says

    May 22, 2019 at 7:32 am

    Hello sir
    I am 28 year old female.I suffered with my fast heartbeat daily(my realisation).This is my Ecg report which showed
    HR=73bpm
    P=82
    PR=103
    QRS=78
    QT/QTc=358/396
    IQRS/T=17/26/39
    IVS/SVI-1.400/1.004
    Diagnose Information-Sinus Arrhythmia,Short PR Interval

    Reply
  36. Lindsey says

    May 31, 2019 at 3:43 pm

    Hello,

    Please advise… I am a 26 year old female 5’6 160 pounds, active. I have genetically high cholesterol (225) and just had an EKG done. These are my results:

    Ventricular Rate 59 BPM
    Atrial Rate 59 BPM
    P-R Interval 118 ms
    QRS Duration 84 ms
    Q-T Interval 408 ms
    QTC Calculation(Bazett) 403 ms
    Calculated P Axis 35 degrees
    Calculated R Axis 56 degrees
    Calculated T Axis 36 degrees

    INTERPRETATION:

    Sinus bradycardia with sinus arrhythmia
    Otherwise normal ECG

    Any cause for concern in your opinion?

    Reply
    • Lindsey says

      May 31, 2019 at 3:48 pm

      Sinus bradycardia with sinus arrhythmia
      Otherwise normal ECG

      25mm/s 10mm/mV 150Hz 9.0.3 12SL 241 HD CID: 54

      Vent. rate 59 BPM
      PR interval 118 ms
      QRS duration 84 ms
      QT/QTc 408/403 ms
      P-R-T axes 35 56 36

      Test ind:palpitations

      Reply
    • Dr. Mustafa Ahmed says

      July 5, 2019 at 4:42 am

      The intervals listed look relatively normal,

      Its not really possible to comment on an EKG without seeing it though.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  37. Shane Balicao Castillo says

    August 13, 2021 at 10:51 pm

    Rhythm : Sinus
    Axis : Normal
    Atrial Rate : 63
    Ventricular rate : 63
    PR Interval : 117
    Qrs Duration : 84
    Qtc : 426

    Interpretation : Sinus Rhythm

    Reply
  38. Sandra says

    January 20, 2022 at 10:12 am

    Hi Doctor I have episodes where I feel like my heart isn’t beating right kind of irregular and I feel weak legs and jittery & a bit breathless. During these episodes my ecg and holter show sinus Arrhythmia & sometimes sinus bradycardia. Everything I read seems to suggest that sinus arrhythmia shouldn’t cause symptoms. I get these “episodes” a few times a day and they make me feel unwell.
    I’m 42 and I also have prinzmetal angina.

    Reply

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