Respiratory sinus arrhythmia

Respiratory sinus arrhythmia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Respiratory Sinus Arrhythmia refers to the normal slowing down of heart rate during expiration (breathing out) and speeding up of heart rate during inspiration. Heart rate is normally controlled by centers in the medulla oblongata. One of these centers, the nucleus ambiguus, increases parasympathetic nervous system input to the heart via the vagus nerve. The vagus nerve decreases heart rate by decreasing the rate of SA node firing. Upon expiration the cells in the nucleus ambiguus are activated and heart rate is slowed down. In contrast, inspiration triggers inhibitory signals to the nucleus accumbens and consequently the vagus nerve remains unstimulated.

Example

EKG shown below is courtesy of C. M. Gibson MS MD and copylefted.

• 

  EKG of a patient with acute inferior myocardial infarction shows sinus bradycardia (59 bpm) and respiratory sinus arrhythmia (please note to rhythm line at the bottom). QRS=104 msec, PR=172 msec

References

• Neff RA, Wang J, Baxi S, Evans C, Mendelowitz D (2003). "Respiratory sinus arrhythmia: endogenous activation of nicotinic receptors mediates respiratory modulation of brainstem cardioinhibitory parasympathetic neurons". Circ. Res. 93 (6): 565–72. doi:10.1161/01.RES.0000090361.45027.5B. PMID 12907666.CS1 maint: Multiple names: authors list (link)