The 4 Variants of Sinus Arrhythmia

Phasic Sinus Arrhythmia:

 • The rate increases with respiration and decreases with expiration.

 • As the heart rate increases, the P wave amplitude increases (II, Ill and aVF).

 • As the heart decreases, the P wave amplitude decrease.

 • The heart rate change is gradual and rhythmic.

Non-phasic Sinus Arrhythmia:

• The P wave and PR interval are normal

• The PP intervals vary at random and independent of any physiological function.

Ventriculophasic Sinus Arrhythmia:

 • The P to P interval encompassing a QRS complex is shorter than the intervals without an intervening QRS complex.

 • Ventriculophasic sinus arrhythmia is noted in the presence of AV block.

Wandering Atrial Pacemaker:

 • The change in P wave contour is gradual

 • After several cycle the pacemaker shifts back to the sinus node.

 • Variant of sinus arrhythmia



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