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Multiple Choice

Which rhythm has a normal heart rate and rhythm with P waves before each QRS?

Normal sinus rhythm occurs when the impulse starts in the SA node and travels through the usual conduction pathways, producing a P wave before every QRS complex with a regular rhythm and a normal rate. Seeing P waves that precede each QRS, along with a normal heart rate and a normal, narrow QRS, indicates the impulse originated in the SA node and conducted normally to the ventricles. This distinguishes it from a junctional rhythm, which often has absent or retrograde P waves and can have a different rate; from a second-degree block type 1, which shows progressively lengthening PR intervals with occasional dropped QRS complexes; and from sinus bradycardia, which has the same P before QRS pattern but a slower rate. Therefore, the rhythm described is normal sinus rhythm.

Normal sinus rhythm occurs when the impulse starts in the SA node and travels through the usual conduction pathways, producing a P wave before every QRS complex with a regular rhythm and a normal rate. Seeing P waves that precede each QRS, along with a normal heart rate and a normal, narrow QRS, indicates the impulse originated in the SA node and conducted normally to the ventricles. This distinguishes it from a junctional rhythm, which often has absent or retrograde P waves and can have a different rate; from a second-degree block type 1, which shows progressively lengthening PR intervals with occasional dropped QRS complexes; and from sinus bradycardia, which has the same P before QRS pattern but a slower rate. Therefore, the rhythm described is normal sinus rhythm.