Normal Sinus Rhythm

Normal sinus rhythm is the normal heart rhythm originating from the sinoatrial node with a regular rate and normal conduction.

Also known as: NSR, Regular Sinus Rhythm

ECG Characteristics

Heart Rate60–100 bpm (human), 60–140 bpm (canine)
RhythmRegular
P WaveUpright in leads I, II, aVF; one P wave before each QRS
PR Interval0.12–0.20 seconds
QRS Duration< 0.12 seconds

Mechanism

Impulse originates in the SA node and conducts through the AV node, Bundle of His, and Purkinje fibers in a normal sequence.

Key Features on ECG

  • Regular R-R intervals
  • Upright P waves in lead II
  • Consistent PR interval (0.12–0.20s)
  • Narrow QRS complex (< 0.12s)
  • One P wave preceding each QRS complex

Causes

  • Normal physiological state
  • Adequate autonomic tone
  • Healthy conduction system

Clinical Significance

NSR is the expected baseline rhythm. Its presence indicates normal impulse generation and conduction. Deviations from NSR require investigation.

Frequently Asked Questions

What defines normal sinus rhythm on ECG?

Normal sinus rhythm is defined by a regular rate between 60–100 bpm (in humans), upright P waves in lead II preceding each QRS complex, a consistent PR interval of 0.12–0.20 seconds, and a narrow QRS duration under 0.12 seconds.

What is the normal sinus rhythm rate for dogs?

In dogs, normal sinus rhythm typically ranges from 60–140 bpm, with smaller breeds tending toward the higher end and larger breeds toward the lower end of this range.

How does normal sinus rhythm differ from sinus arrhythmia?

Both originate from the SA node, but sinus arrhythmia has slight R-R interval variation that correlates with the respiratory cycle — the heart rate increases with inspiration and decreases with expiration. This is a normal finding, especially in young individuals and dogs.

See It in Action

Explore this rhythm interactively with our ECG simulator and 3D heart visualization. Adjust parameters in real time and see how changes appear on the ECG.

Opti ECG interactive cardiac axis visualization with 3D heart model

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