342:(AV node), another specialized grouping of cells located in the base of the right atrium, which is the only anatomically normal electrical connection between the atria and ventricles. Impulses coursing through the AV node are slowed before carrying on to the ventricles, allowing for appropriate filling of the ventricles before contraction. The SA and AV nodes are both closely regulated by the autonomic nervous system's fibres, allowing for adjustment of cardiac output by the central nervous system in times of increased metabolic demand.
527:, classically demonstrates grouped patterns of heartbeats on ECG. Throughout the group, the PR interval gradually lengthens until a dropped conduction occurs, resulting in no QRS complex seen on surface ECG following the last P wave. After a delay, the grouping repeats, with the PR interval shortening again to baseline. Type 1 2nd degree AV block due to disease in the AV node (as opposed to in the His-purkinje system) rarely needs intervention with pacemaker implantation.
53:
363:
1054:
473:, and tachycardia-bradycardia syndrome. These conditions can be caused by damage to the native sinus node itself and are frequently accompanied by damaged AV node conduction and reduced backup pacemaker activity. The condition can also be caused by dysfunction of the autonomic nervous system that regulates the node and is commonly exacerbated by medications.
486:
615:, about 61% take place at the bundle branch-Purkinje system, 21% at the AV node, and 15% at the bundle of His. AV block may be ruled out with an ECG indicating "a 1:1 relationship between P waves and QRS complexes." Ventricular bradycardias occurs with sinus bradycardia, sinus arrest, and AV block. Treatment often consists of the administration of
187:. In large population studies of adults without underlying heart disease, resting heart rates of 45-50 BPM appear to be the lower limits of normal, dependent on age and sex. Bradycardia is most likely to be discovered in the elderly, as age and underlying cardiac disease progression contribute to its development.
517:
conduction but are merely delayed. The location of the causal lesion can be anywhere between the AV node and the His-Purkinje system but is most commonly found in the AV node itself. Generally, isolated PR prolongation in 1st degree AV block is not associated with increased mortality or hospitalization.
481:
Bradycardia can also result from the inhibition of the flow of action potentials through the atrioventricular (AV) node. While this can be normal in young patients due to excessive vagus nerve tone, symptomatic bradycardia due to AV node dysfunction in older people is commonly due to structural heart
415:
Sinus arrhythmias are heart rhythm abnormalities characterized by variations in the cardiac cycle length over 120 milliseconds (longest cycle - shortest cycle). These are the most common type of arrhythmia in the general population and usually have no significant consequences. They typically occur in
402:
of less than 50 BPM. Cardiac action potentials are generated from the SA node and propagated through an otherwise normal conduction system, but they occur at a slow rate. It is a common condition found in both healthy individuals and those considered well-conditioned athletes. Studies have found that
516:
in excess of 200 milliseconds. The PR interval represents the length of time between the start of atrial depolarization and the start of ventricular depolarization, representing the flow of electrical impulses between the SA and AV nodes. Despite the term "block," no impulses are fully lost in this
424:
Respiratory sinus arrhythmia refers to the physiologically normal variation in heart rate due to breathing. During inspiration, vagus nerve activity decreases, reducing parasympathetic innervation of the sinoatrial node and causing an increase in heart rate. During expiration, heart rates fall due
631:
For infants, bradycardia is defined as a heart rate less than 100 BPM (normal is around 120â160 BPM). Premature babies are more likely than full-term babies to have apnea and bradycardia spells; their cause is not clearly understood. The spells may be related to centers inside the brain that
586:
may also occur when the electrical impulses from the SA node fail to reach the AV node because of SA or AV block. This is a protective mechanism for the heart to compensate for an SA node that is no longer handling the pacemaking activity and is one of a series of backup sites that can take over
530:
2nd degree, Mobitz type 2 AV block is another phenomenon of intermittently dropped QRS complexes after characteristic groupings of beats seen on surface ECG. The PR and RR intervals are consistent in this condition, followed by a sudden AV block and dropped QRS complex. Because type 2 blocks are
700:
With SA node dysfunction (sometimes called sick sinus syndrome), there may be disordered automaticity or impaired conduction of the impulse from the SA node into the surrounding atrial tissue (an "exit block"). Second-degree sinoatrial blocks can be detected only by use of a 12-lead ECG. It is
452:
Sinoatrial exit block is a similar non-respiratory phenomenon of temporarily lost sinoatrial impulses. However, in contrast to a sinus pause, the action potential is still generated at the SA node but is either unable to leave or delayed from leaving the node, preventing or delaying atrial
811:
A diagnosis of bradycardia in adults is based on a heart rate of less than 60 BPM, although some studies use a heart rate of less than 50 BPM. This is usually determined either by palpation or ECG. If symptoms occur, a determining electrolytes may help determine the underlying cause.
453:
depolarization and subsequent ventricular systole. Therefore, the length of the pause in heartbeats is usually a multiple of the P-P interval, as seen on electrocardiography. Like a sinus pause, a sinoatrial exit block can be symptomatic, especially with prolonged pause length.
1349:"2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society"
253:. In atrioventricular causes of bradycardia, permanent pacemaker implantation is often required when no reversible causes of disease are found. In both SND and atrioventricular blocks, there is little role for medical therapy unless a patient is
2880:
2865:
2850:
353:
that innervate myocardial tissue. The His-Purkinje system conducts action potentials much faster than can be propagated between myocardial cells, allowing the entire ventricular myocardium to contract in less time, improving pump function.
2550:
378:
Most pathological causes of bradycardia result from damage to this normal cardiac conduction system at various levels: the sinoatrial node, the atrioventricular node, or damage to conduction tissue between or after these nodes.
701:
difficult and sometimes impossible to assign a mechanism to any particular bradycardia, but the underlying mechanism is not clinically relevant to treatment, which is the same in both cases of sick sinus syndrome: a permanent
269:
until such time that an appropriate workup can be undertaken and long-term treatment selected. While asymptomatic bradycardias rarely require treatment, consultation with a physician is recommended, especially in the elderly.
1436:
Menozzi C, Brignole M, Alboni P, Boni L, Paparella N, Gaggioli G, et al. (November 1998). "The natural course of untreated sick sinus syndrome and identification of the variables predictive of unfavorable outcome".
610:
in the AV node will produce a wide QRS complex with heart rates between 20 and 40 BPM. Those above the bundle of His, also known as junctional, will typically range between 40 and 60 BPM with a narrow QRS complex. In a
4065:
632:
regulate breathing which may not be fully developed. Touching the baby gently or rocking the incubator slightly will almost always get the baby to start breathing again, which increases the heart rate. The
591:. An AV-junctional escape complex is a normal response that may result from excessive vagal tone on the SA node. Pathological causes include sinus bradycardia, sinus arrest, sinus exit block, or AV block.
222:(SND), atrioventricular block, and other conduction tissue diseases. However, bradycardia can also result without dysfunction of the native conduction system, arising secondary to medications including
523:
is characterized by intermittently lost conduction of impulses between the SA node and the ventricles. 2nd degree block is classified into two types. Mobitz type 1 block, otherwise known by the eponym
2677:"Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"
501:
are divided into three categories, ranked by severity. AV block is diagnosed via surface ECG, which is usually sufficient to locate the causal lesion of the block without the need for an invasive
512:, electrical impulses originating in the SA node (or other ectopic focus above the ventricles) are conducted with significant delay through the AV node. This condition is diagnosed via ECG, with
602:, also known as atrioventricular bradycardia or ventricular escape rhythm, is a heart rate of less than 50 BPM. This is a safety mechanism when a lack of electrical impulse or stimuli from the
962:, can improve symptoms. If discontinuation of these medications is not possible due to clinical need, cardiac pacing can be considered with continuation of the medications. Beta blockers with
245:
The management of bradycardia is generally reserved for patients with symptoms, regardless of minimum heart rate during sleep or the presence of concomitant heart rhythm abnormalities (See:
724:) may result from impaired conduction in the AV node or anywhere below it, such as in the bundle of His. The clinical relevance pertaining to AV blocks is greater than that of SA blocks.
277:(CI) refers to an inadequate rise in heart rate during periods of increased demand, often due to exercise, and is an important sign of SND and an indication for pacemaker implantation.
694:, or degenerative primary electrical disease. Ultimately, the causes act by three mechanisms: depressed automaticity of the heart, conduction block, or escape pacemakers and rhythms.
531:
typically due to lesions below the AV node, the ability for ventricular escape rhythms to maintain cardiac output is compromised. Permanent pacemaker implantation is often required.
4058:
924:
with hydralazine, prazosin, and anticholinergics and myocardial toxicity with sympathomimetics, as well as limited data for this indication, hinder their routine and long-term use.
3639:
249:), which are common with this condition. Untreated SND has been shown to increase the future risk of heart failure and syncope, sometimes warranting definitive treatment with an
416:
the young, athletes or after administration of medications such as morphine. The types of sinus arrhythmia are separated into the respiratory and non-respiratory categories.
349:
originates in the AV node and rapidly splits into a left and right branch, each destined for a different ventricle. Finally, these bundle branches terminate in the small
176:(BPM). While bradycardia can result from various pathologic processes, it is commonly a physiologic response to cardiovascular conditioning or due to asymptomatic type 1
4051:
1754:
Sauer WH, Koplan BA (2022). "The
Bradyarrhythmias: Disorders of the Atrioventricular Node". In Loscalzo J, Fauci AS, Kasper DL, Hauser S, Longo D, Jameson JL (eds.).
815:
Many heathy young adults, and particularly well-trained athletes, have sinus bradycardia that is without symptoms. This can include heart rates of less than 50 or 60
345:
Following slowed conduction through the atrioventricular node, the action potential produced initially at the SA node now flows through the His-Purkinje system. The
2435:"Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"
1565:
Sauer WH, Koplan BA, Zei PC (2022). "Principles of
Clinical Cardiac Electrophysiology". In Loscalzo J, Fauci AS, Kasper DL, Hauser S, Longo D, Jameson JL (eds.).
2628:"Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"
1533:
Loscalzo J, Keaney JF, MacRae CA (2022). "Basic
Biology of the Cardiovascular System". In Loscalzo J, Fauci AS, Kasper DL, Hauser S, Longo D, Jameson JL (eds.).
2806:
403:
50â85% of conditioned athletes have benign sinus bradycardia, as compared to 23% of the general population studied. The heart muscle of athletes has a higher
327:. The SA node contains pacemaker cells that demonstrate "automaticity" and can generate impulses that travel through the heart and create a steady heartbeat.
2753:
242:
are neurological causes of transient symptomatic bradycardia. Hypothyroidism and metabolic derangements are other common extrinsic causes of bradycardia.
3280:
1085:
826:
Temporal correlation of symptoms with bradycardia is necessary for diagnosis of symptomatic bradycardia. This can sometimes be difficult. Challenge with
316:. When these contractions occur in a coordinated fashion, the atria and ventricles of the heart will pump, delivering blood to the rest of the body.
2970:
1244:
Rijnbeek PR, van Herpen G, Bots ML, Man S, Verweij N, Hofman A, et al. (2014). "Normal values of the electrocardiogram for ages 16-90 years".
3697:
864:
Treatment of chronic symptomatic bradycardia first necessitates correlation of symptoms. Once symptoms have been clearly linked to bradycardia,
3014:
1763:
1694:
1574:
1542:
1228:
304:, or heart muscle cells. Like most cells, cardiomyocytes maintain a highly regulated negative voltage at rest and are capable of propagating
4731:
3692:
3501:
3338:
520:
3506:
3496:
3085:
509:
308:, much like neurons. While at rest, the negative cellular voltage of a cardiomyocyte can be raised above a certain threshold (so-called
177:
407:, requiring fewer contractions to circulate the same volume of blood. Asymptomatic sinus bradycardia decreases in prevalence with age.
3803:
3634:
3248:
963:
273:
The term "relative bradycardia" can refer to a heart rate lower than expected in a particular disease state, often a febrile illness.
3674:
1514:
330:
At the beginning of the cardiac cycle, the SA node generates an electrical action potential that spreads across the right and left
3669:
1109:
Martin Brady holds the
Guinness world record for the slowest heart rate, with a certified rate over a minute duration of 27 BPM.
3538:
3319:
1106:
Daniel Green holds the world record for the slowest heartbeat in a healthy human, with a heart rate measured in 2014 of 26 BPM.
779:
3614:
3609:
3533:
680:
203:
3333:
441:. Sinus pause and arrest involve slowing or arresting of automatic impulse generation from the sinus node. This can lead to
2728:
998:. Doses less than 0.5 mg should not be used, which may further decrease the rate. If this is ineffective, intravenous
3960:
3836:
3765:
3597:
1959:
Ye F, Hatahet M, Youniss MA, Toklu HZ, Mazza JJ, Yale S (June 2018). "The
Clinical Significance of Relative Bradycardia".
879:
4488:
3955:
3748:
3731:
3664:
3584:
2963:
865:
771:, among others. Beta blockers may slow the heart rate to a dangerous level if prescribed with calcium channel blockers.
633:
556:
250:
4652:
3798:
4726:
4693:
3243:
210:
due to reduced forward blood flow to the brain, lungs, and skeletal muscle. The types of symptoms often depend on the
2814:
1084:
In clinical practice, elderly people over age 65 and young athletes of both sexes may have sinus bradycardia. The US
323:(SA node). This collection of specialized conduction tissue is located in the right atrium, near the entrance of the
3780:
3268:
3253:
4460:
3555:
1126:
3858:
3523:
3450:
3177:
959:
697:
In general, two types of problems result in bradycardias: disorders of the SA node and disorders of the AV node.
524:
274:
215:
3808:
871:
In people who are unwilling to undergo pacemaker implantation or are not candidates for cardiac pacing, chronic
4216:
3982:
3738:
3528:
3425:
3406:
3236:
3009:
2907:
913:
760:
668:
612:
313:
235:
783:
543:, or atrioventricular nodal bradycardia, is usually caused by the absence of the electrical impulse from the
4316:
4178:
4015:
3989:
3977:
3965:
3950:
3684:
3626:
3430:
3411:
3063:
3003:
2956:
951:
921:
794:
740:
502:
446:
227:
184:
1088:
reported in 2011 that 15.2% of adult males and 6.9% of adult females had clinically defined bradycardia (a
4541:
4379:
4173:
3604:
3570:
3513:
3491:
3313:
3295:
3231:
3098:
3051:
2979:
1031:
955:
891:
838:
717:
713:
691:
687:
599:
498:
462:
219:
1988:"Arrhythmias and conduction defects as presenting symptoms of fatty acid oxidation disorders in children"
4646:
4156:
4043:
3368:
3363:
3258:
3068:
1011:
1003:
909:
721:
709:
664:
652:
465:, covers conditions that include symptomatic sinus bradycardia or persistent chronotropic incompetence,
339:
319:
Normally, the origination of the action potential causing cardiomyocyte contraction originates from the
266:
1347:
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, et al. (August 2019).
2779:
2287:
Franklin SM, Thihalolipavan S, Fontaine JM (May 2017). "Sinus
Bradycardia in Habitual Cocaine Users".
2156:
2030:
183:
Resting heart rates of less than 50 BPM are often normal during sleep in young and healthy adults and
4672:
4579:
4483:
4388:
4201:
4183:
3864:
3392:
3373:
3273:
3184:
3127:
702:
540:
231:
4699:
4528:
4416:
4401:
4340:
4195:
3869:
3726:
3721:
3644:
3548:
3518:
3477:
3103:
3020:
2884:
2718:"Resting Pulse Rate Reference Data for Children, Adolescents, and Adults: United States, 1999â2008"
872:
827:
583:
548:
254:
211:
195:
4411:
4687:
4620:
4598:
4592:
4363:
4207:
4190:
4139:
4078:
4074:
3972:
3770:
3592:
3543:
3168:
3115:
3025:
2591:
Jaillon P (September 1990). "Relevance of intrinsic sympathomimetic activity for beta blockers".
2083:
Ufberg JW, Clark JS (February 2006). "Bradydysrhythmias and atrioventricular conduction blocks".
1829:
Aro AL, Anttonen O, Kerola T, Junttila MJ, Tikkanen JT, Rissanen HA, et al. (January 2014).
1811:
1089:
1038:
1015:
842:
567:
324:
207:
169:
4682:
4406:
2626:
de Caen AR, Berg MD, Chameides L, Gooden CK, Hickey RW, Scott HF, et al. (November 2015).
4479:
4353:
4348:
4271:
4166:
4161:
4134:
4032:
3883:
3841:
3756:
3574:
3472:
3189:
3132:
3030:
2859:
2698:
2657:
2608:
2573:
2531:
2496:
2479:
Ling CA, Crouch MA (1998). "Theophylline for chronic symptomatic bradycardia in the elderly".
2456:
2433:
Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, et al. (November 2010).
2402:
2353:
2304:
2266:
2217:
2135:
2100:
2009:
1968:
1941:
1870:
1852:
1803:
1759:
1733:
1690:
1656:
1621:
1570:
1538:
1510:
1504:
1485:
1454:
1418:
1370:
1271:
1224:
1167:
974:, have less risk of bradycardia and may be useful as replacements of pure beta blockers, like
752:
434:
395:
145:
140:
128:
60:
4584:
4555:
4396:
4311:
4283:
4276:
4261:
4104:
4005:
3897:
3790:
3486:
2688:
2675:
Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL, et al. (November 2015).
2647:
2639:
2600:
2565:
2523:
2514:
Northcote RJ (May 1987). "The clinical significance of intrinsic sympathomimetic activity".
2488:
2446:
2392:
2384:
2343:
2335:
2296:
2256:
2248:
2207:
2199:
2127:
2092:
1999:
1933:
1842:
1795:
1723:
1648:
1611:
1603:
1446:
1408:
1360:
1261:
1253:
834:
466:
438:
305:
173:
76:
2371:
Douedi S, Mararenko A, Alshami A, Al-Azzawi M, Ajam F, Patel S, et al. (August 2021).
2186:
Dominic P, Ahmad J, Awwab H, Bhuiyan MS, Kevil CG, Goeders NE, et al. (January 2022).
4573:
4517:
4510:
4027:
3419:
3400:
3387:
3194:
3073:
1986:
Bonnet D, Martin D, Villain E, Jouvet P, Rabier D, Brivet M, et al. (November 1999).
1786:
Clark BA, Prystowsky EN (December 2021). "Electrocardiography of
Atrioventricular Block".
1113:
967:
936:
932:
905:
898:
861:
Emergency treatment is not needed if the person is asymptomatic or minimally symptomatic.
787:
387:
Bradycardia caused by the alterations of sinus node activity is divided into three types.
362:
350:
320:
4640:
4612:
4493:
4455:
4421:
461:
A syndrome of intrinsic disease of the sinus node, referred to as sick sinus syndrome or
214:
of the slow heart rate, classified by the anatomic location of a dysfunction within the
52:
4451:
4446:
4369:
4321:
4020:
3928:
3826:
3818:
3716:
3226:
3219:
3206:
2901:
2889:
2652:
2627:
2397:
2372:
2348:
2323:
2261:
2236:
2235:
Sharma J, Rathnayaka N, Green C, Moeller FG, Schmitz JM, Shoham D, et al. (2016).
2212:
2187:
1616:
1591:
1257:
1019:
928:
660:
620:
603:
571:
331:
309:
301:
2897:
2893:
2451:
2434:
2131:
2055:
1728:
1711:
1652:
1450:
1053:
4720:
4677:
4633:
4606:
4231:
4144:
4094:
4010:
3921:
3056:
2604:
2527:
1815:
1607:
1027:
607:
587:
pacemaker function when the SA node fails to do so. This would present with a longer
404:
346:
335:
281:
239:
1895:
1290:
4522:
4441:
4299:
4151:
4124:
4116:
3942:
3916:
3760:
3708:
3381:
3357:
3327:
3304:
3173:
3163:
1023:
947:
883:
875:
830:
732:
563:
470:
399:
262:
223:
2300:
853:
The treatment of bradycardia depends on whether the person is stable or unstable.
2948:
2912:
2717:
2693:
2676:
2643:
2252:
1365:
1348:
931:
is present and is the cause of symptomatic bradycardia, symptoms respond well to
4470:
4432:
4358:
4251:
4221:
3877:
3775:
3565:
3482:
3290:
3263:
3214:
3155:
2569:
2237:"Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding"
1159:
1007:
975:
917:
894:
887:
786:
has been suggested as a possible cause of this. In contrast to cocaine however,
736:
588:
552:
513:
246:
2339:
2004:
1987:
1847:
1830:
1799:
17:
4328:
4086:
3905:
3455:
2931:
2874:
2203:
2096:
1937:
1413:
1396:
1219:
983:
943:
728:
676:
656:
645:
544:
133:
845:
and improves subjective symptoms in most people with bradycardia due to SND.
374:): The points on the heart where the ECG signals are measured are also shown.
4304:
1831:"Prognostic significance of prolonged PR interval in the general population"
764:
748:
744:
199:
2702:
2661:
2577:
2460:
2406:
2357:
2308:
2270:
2221:
2104:
2013:
1972:
1945:
1856:
1807:
1737:
1625:
1489:
1473:
1422:
1374:
1275:
1171:
1018:
may be required if the cause of the bradycardia is not rapidly reversible.
2936:
2612:
2535:
2500:
2139:
1660:
1458:
994:
If a person is unstable, the initial recommended treatment is intravenous
4627:
4129:
3831:
2988:
1064: with: discussion regarding the threshold of 60 bpm. You can help by
999:
995:
979:
971:
901:
800:
672:
616:
442:
258:
2373:"COVID-19 induced bradyarrhythmia and relative bradycardia: An overview"
562:
An AV-junctional escape beat is a delayed heartbeat originating from an
485:
2754:"Slowest heart rate: Daniel Green breaks Guinness World Records record"
2388:
1266:
775:
768:
756:
579:
575:
191:
2842:
2492:
2324:"The mammalian diving response: an enigmatic reflex to preserve life?"
4564:
4534:
4099:
3911:
3891:
3046:
2869:
2854:
2282:
2280:
1472:
Ye F, Hatahet M, Youniss MA, Toklu HZ, Mazza JJ, Yale S (June 2018).
1924:
Adams MG, Pelter MM (September 2003). "Ventricular escape rhythms".
882:, can be considered for treatment of symptomatic bradycardia. Other
636:
standard practice is to electronically monitor the heart and lungs.
489:
Characteristic ECGs of atrioventricular blocks, organized by degree.
2118:
Miller MB (May 1998). "Arrhythmias associated with drug toxicity".
1639:
Bryan G, Ward A, Rippe JM (April 1992). "Athletic heart syndrome".
823:
bpm. Such individuals, without symptoms, do not require treatment.
218:. Generally, these classifications involve the broad categories of
4243:
4226:
1590:
Kurian T, Ambrosi C, Hucker W, Fedorov VV, Efimov IR (June 2010).
868:
can be provided to increase heart rate and symptoms will improve.
484:
361:
1223:(12th ed.). Philadelphia, PA: Elsevier. pp. 1312â1320.
4664:
1689:(4th ed.). Lippincott Williams & Wilkins. p. 260.
1342:
1340:
1338:
1336:
1334:
1332:
1330:
1328:
1326:
1324:
1322:
1320:
1221:
Braunwald's Heart
Disease: A Textbook of Cardiovascular Medicine
433:
Non-respiratory causes of sinus arrhythmia include sinus pause,
300:
The heart is a specialized muscle containing repeating units of
4047:
2952:
1318:
1316:
1314:
1312:
1310:
1308:
1306:
1304:
1302:
1300:
1048:
1506:
Design and
Development of Medical Electronic Instrumentation
1037:
In children, giving oxygen, supporting their breathing, and
103:
1030:
are also used in the treatment of acute bradycardia due to
449:
do not create backup sources of cardiac action potentials.
112:
109:
312:) by an incoming action potential, causing the myocyte to
841:(SND) to help correlate symptoms. Theophylline increases
679:. At rest, although tachycardia is more commonly seen in
651:
Non-cardiac causes are usually secondary and can involve
94:
88:
2181:
2179:
2177:
886:
have also been used to treat bradycardia, including the
1871:"AV Junctional Rhythm Disturbances (for Professionals)"
1065:
482:
disease, myocardial ischemia, or age-related fibrosis.
2025:
2023:
1687:
Harwood-Nuss' Clinical Practice of Emergency Medicine
366:
Illustration comparing the ECGs of a healthy person (
100:
79:
2832:
1592:"Anatomy and electrophysiology of the human AV node"
731:
can induce or exacerbate bradycardia. These include
648:
may have many causes, both cardiac and non-cardiac.
106:
91:
85:
82:
4663:
4563:
4554:
4502:
4469:
4430:
4387:
4378:
4339:
4292:
4242:
4115:
4085:
3998:
3941:
3850:
3817:
3789:
3747:
3706:
3683:
3657:
3625:
3583:
3564:
3463:
3449:
3349:
3303:
3289:
3205:
3154:
3147:
3084:
3039:
2996:
2987:
2922:
2836:
1474:"The Clinical Significance of Relative Bradycardia"
257:, which may require the use of medications such as
151:
139:
127:
97:
67:
42:
37:
2807:"Olympic Gold Begins With Good Genes, Experts Say"
2188:"Stimulant Drugs of Abuse and Cardiac Arrhythmias"
2474:
2472:
2470:
1214:
1212:
1210:
1208:
606:occurs. Impulses originating within or below the
559:either before, during, or after the QRS complex.
2716:Yechiam Ostchega, et al. (24 August 2011).
1528:
1526:
1206:
1204:
1202:
1200:
1198:
1196:
1194:
1192:
1190:
1188:
63:seen in lead II with a heart rate of about 50BPM
1166:. Treasure Island (FL): StatPearls Publishing.
946:that induce or exacerbate bradycardia, such as
790:has not been associated with bradyarrhythmias.
190:Bradycardia may be associated with symptoms of
2551:"The evaluation and management of bradycardia"
1749:
1747:
1560:
1558:
1556:
1554:
4059:
2964:
1873:. American Heart Association. 4 December 2008
1781:
1779:
1777:
1775:
8:
2151:
2149:
1390:
1388:
1386:
1384:
659:, metabolic or endocrine issues, especially
338:. This electrical impulse carries on to the
2428:
2426:
2424:
2422:
2420:
2418:
2416:
2085:Emergency Medicine Clinics of North America
1153:
1151:
1149:
1147:
1145:
1143:
683:, acute bradycardia can occur more rarely.
4560:
4384:
4066:
4052:
4044:
3580:
3460:
3300:
3281:Arrhythmogenic right ventricular dysplasia
3151:
2993:
2971:
2957:
2949:
2833:
1902:. Merck Sharp and Dohme Corp. January 2008
1756:Harrison's Principles of Internal Medicine
1567:Harrison's Principles of Internal Medicine
1535:Harrison's Principles of Internal Medicine
1086:Centers for Disease Control and Prevention
803:has been found to be a cause bradycardia.
778:use has been associated with bradycardia.
51:
34:
2692:
2651:
2450:
2396:
2347:
2260:
2211:
2003:
1900:The Merck Manuals: Online Medical Library
1846:
1727:
1615:
1412:
1364:
1265:
671:, situational factors, such as prolonged
1890:
1888:
1116:had a resting heart rate of 28 BPM.
1112:During his career, professional cyclist
686:Cardiac causes include acute or chronic
334:, causing the atrial contraction of the
2078:
2076:
1919:
1917:
1158:Hafeez Y, Grossman SA (9 August 2021).
1139:
3015:Spontaneous coronary artery dissection
1896:"Arrhythmias and Conduction Disorders"
1680:
1678:
1676:
1674:
1672:
1670:
1509:. John Wiley & Sons. p. 371.
1129: â Processes which cause hypopnea
708:AV conduction disturbances (AV block;
238:drugs. Excess vagus nerve activity or
2549:Mangrum JM, DiMarco JP (March 2000).
1596:Pacing and Clinical Electrophysiology
1397:"Evaluating and managing bradycardia"
837:in people with bradycardia caused by
7:
3339:Nonbacterial thrombotic endocarditis
2734:from the original on 10 October 2022
2060:The Lecturio Medical Concept Library
1712:"Sinus Node and Atrial Arrhythmias"
280:The word "bradycardia" is from the
3635:Accelerated idioventricular rhythm
2725:National Health Statistics Reports
1439:The American Journal of Cardiology
1258:10.1016/j.jelectrocard.2014.07.022
964:intrinsic sympathomimetic activity
25:
2452:10.1161/CIRCULATIONAHA.110.970988
1926:American Journal of Critical Care
1788:Cardiac Electrophysiology Clinics
1729:10.1161/CIRCULATIONAHA.116.018011
1401:Trends in Cardiovascular Medicine
370:) and a person with bradycardia (
27:Heart rate below the normal range
1608:10.1111/j.1540-8159.2010.02699.x
1395:Sidhu S, Marine JE (July 2020).
1052:
793:Bradycardia is also part of the
429:Non-respiratory sinus arrhythmia
75:
3320:Subacute bacterial endocarditis
2727:. Centers for Disease Control.
2322:Panneton WM (September 2013).
1758:(21st ed.). McGraw Hill.
1685:Allan B. Wolfson, ed. (2005).
1569:(21st ed.). McGraw Hill.
1537:(21st ed.). McGraw Hill.
681:fatty acid oxidation disorders
240:carotid sinus hypersensitivity
1:
3837:Pulseless electrical activity
3766:Multifocal atrial tachycardia
3640:Catecholaminergic polymorphic
2301:10.1016/j.amjcard.2017.02.018
2132:10.1016/s0733-8627(05)70009-2
1710:John RM, Kumar S (May 2016).
1653:10.1016/S0278-5919(20)30529-9
1451:10.1016/s0002-9149(98)00605-5
1293:. Rotterdam, The Netherlands.
880:adenosine receptor antagonist
570:. It occurs when the rate of
547:. This usually appears on an
46:Bradyarrhythmia, brachycardia
2805:Lovgren S (20 August 2004).
2694:10.1161/cir.0000000000000265
2644:10.1161/cir.0000000000000266
2605:10.1016/0002-9149(90)90758-s
2528:10.1016/0167-5273(87)90309-3
2253:10.1080/08964289.2014.897931
2192:Circ Arrhythm Electrophysiol
1366:10.1161/CIR.0000000000000628
1246:Journal of Electrocardiology
634:neonatal intensive-care unit
578:falls below the rate of the
420:Respiratory sinus arrhythmia
4732:Symptoms and signs: Cardiac
4694:superior vena cava syndrome
2570:10.1056/NEJM200003093421006
555:accompanied by an inverted
425:to the converse occurring.
4748:
3781:Wandering atrial pacemaker
3328:non-infective endocarditis
3269:Endocardial fibroelastosis
2340:10.1152/physiol.00020.2013
2005:10.1161/01.cir.100.22.2248
1800:10.1016/j.ccep.2021.07.001
1641:Clinics in Sports Medicine
960:potassium channel blockers
718:secondary type II AV block
690:, vascular heart disease,
447:ventricular escape rhythms
265:and interventions such as
4607:radial artery sufficiency
3859:hexaxial reference system
3804:Jervell and Lange-Nielsen
3334:LibmanâSacks endocarditis
2687:(18 Suppl 2): S519âS525.
2638:(18 Suppl 2): S526âS542.
2445:(18 Suppl 3): S729âS767.
2204:10.1161/CIRCEP.121.010273
2097:10.1016/j.emc.2005.08.006
1938:10.4037/ajcc2003.12.5.477
1414:10.1016/j.tcm.2019.07.001
714:secondary type I AV block
296:Normal cardiac conduction
275:Chronotropic incompetence
216:cardiac conduction system
155:15% (males), 7% (females)
59:
50:
4217:Pericardial friction rub
3739:Ventricular fibrillation
3010:Coronary artery aneurysm
2811:National Geographic News
1848:10.1093/eurheartj/eht176
1647:(2). Elsevier: 259â272.
952:calcium channel blockers
866:permanent cardiac pacing
819:bpm or even less than 40
741:calcium channel blockers
667:, neurological factors,
613:third-degree heart block
255:hemodynamically unstable
228:calcium channel blockers
4653:NicoladoniâBranham sign
4317:Jugular venous pressure
4179:Pulmonary insufficiency
4016:Diastolic heart failure
3990:Athletic heart syndrome
3951:Ventricular hypertrophy
3685:Pre-excitation syndrome
3539:Left posterior fascicle
3064:Acute coronary syndrome
3004:Coronary artery disease
2120:Emerg Med Clin North Am
1503:Prutchi, David (2005).
956:sodium channel blockers
922:orthostatic hypotension
795:mammalian diving reflex
566:focus somewhere in the
503:electrophysiology study
499:Atrioventricular blocks
4542:Gallavardin phenomenon
4380:Cardiovascular disease
3534:Left anterior fascicle
3314:infective endocarditis
3099:Hibernating myocardium
2980:Cardiovascular disease
2784:Guinness World Records
2157:"What is Bradycardia?"
2031:"What is Bradycardia?"
1835:European Heart Journal
1032:sinus node dysfunction
910:sympathomimetic agents
892:antihypertensive agent
839:sinus node dysfunction
784:β-adrenergic receptors
692:valvular heart disease
688:ischemic heart disease
600:Idioventricular rhythm
494:Atrioventricular block
490:
463:sinus node dysfunction
457:Sinus node dysfunction
375:
220:sinus node dysfunction
178:atrioventricular block
4647:arteriovenous fistula
4461:BrachtâWachter bodies
3698:WolffâParkinsonâWhite
3658:Premature contraction
3556:AdamsâStokes syndrome
3259:Loeffler endocarditis
3069:Myocardial infarction
1127:BezoldâJarisch reflex
1012:transcutaneous pacing
884:positive chronotropes
665:electrolyte imbalance
653:recreational drug use
488:
477:Atrioventricular node
445:or cardiac arrest if
439:sinoatrial exit block
365:
340:atrioventricular node
4484:Pericardial effusion
4389:Aortic insufficiency
4202:Mitral insufficiency
4184:Graham Steell murmur
3865:Right axis deviation
3827:Sudden cardiac death
3185:Pericardial effusion
3128:Ventricular aneurysm
2758:World Record Academy
1289:Rijnbeek PR (2012).
541:AV-junctional rhythm
267:transcutenous pacing
4417:Austin Flint murmur
4196:Carey Coombs murmur
3870:Left axis deviation
3727:Atrial fibrillation
3722:Ventricular flutter
3645:Torsades de pointes
3519:Bundle branch block
3478:Sick sinus syndrome
3264:Cardiac amyloidosis
3249:Tachycardia-induced
3104:Myocardial stunning
3052:Prinzmetal's angina
3021:Coronary thrombosis
2780:"Lowest heart rate"
1291:"Normal ECG values"
1160:"Sinus bradycardia"
1096:Society and culture
942:Discontinuation of
933:replacement therapy
521:2nd degree AV block
510:1st degree AV block
288:"slow", and κιĎδίι
251:implanted pacemaker
4727:Cardiac arrhythmia
4688:Trendelenburg test
4621:pseudohypertension
4599:Right heart strain
4593:pulmonary embolism
4208:Presystolic murmur
4079:circulatory system
4075:Signs and symptoms
3973:Atrial enlargement
3771:Pacemaker syndrome
3693:LownâGanongâLevine
3615:Junctional ectopic
3610:AV nodal reentrant
3116:Myocardial rupture
3026:Coronary vasospasm
2923:External resources
2760:. 29 November 2014
2389:10.1002/joa3.12578
2056:"Bradyarrhythmias"
1090:resting pulse rate
1039:chest compressions
1016:Transvenous pacing
843:resting heart rate
753:cardiac glycosides
669:autonomic reflexes
535:Junctional rhythms
491:
376:
325:superior vena cava
170:resting heart rate
4714:
4713:
4710:
4709:
4673:Friedreich's sign
4580:Cardarelli's sign
4550:
4549:
4480:Cardiac tamponade
4272:Pulsus bisferiens
4162:Functional murmur
4041:
4040:
4033:Obstructive shock
3937:
3936:
3884:Short QT syndrome
3851:Other / ungrouped
3842:Sinoatrial arrest
3757:Ectopic pacemaker
3653:
3652:
3473:Sinus bradycardia
3445:
3444:
3441:
3440:
3190:Cardiac tamponade
3143:
3142:
3133:Dressler syndrome
3031:Myocardial bridge
2946:
2945:
2817:on 20 August 2004
2493:10.1345/aph.17463
2295:(10): 1611â1615.
1998:(22): 2248â2253.
1765:978-1-264-26850-4
1722:(19): 1892â1900.
1696:978-0-7817-5125-4
1576:978-1-264-26850-4
1544:978-1-264-26850-4
1445:(10): 1205â1209.
1230:978-0-323-82467-5
1082:
1081:
1041:are recommended.
990:Acute or unstable
857:Chronic or stable
833:can be used as a
722:tertiary AV block
549:electrocardiogram
396:Sinus bradycardia
391:Sinus bradycardia
306:action potentials
159:
158:
146:electrocardiogram
141:Diagnostic method
61:Sinus bradycardia
32:Medical condition
16:(Redirected from
4739:
4700:Pemberton's sign
4561:
4556:Vascular disease
4402:De Musset's sign
4397:Collapsing pulse
4385:
4284:Pulsus alternans
4277:Pulsus bigeminus
4262:Pulsus paradoxus
4077:relating to the
4068:
4061:
4054:
4045:
4006:Cardiac fibrosis
3898:T wave alternans
3791:Long QT syndrome
3585:Supraventricular
3581:
3514:Intraventricular
3461:
3301:
3152:
2997:Coronary disease
2994:
2973:
2966:
2959:
2950:
2834:
2827:
2826:
2824:
2822:
2813:. Archived from
2802:
2796:
2795:
2793:
2791:
2786:. 11 August 2005
2776:
2770:
2769:
2767:
2765:
2750:
2744:
2743:
2741:
2739:
2733:
2722:
2713:
2707:
2706:
2696:
2672:
2666:
2665:
2655:
2623:
2617:
2616:
2588:
2582:
2581:
2555:
2546:
2540:
2539:
2511:
2505:
2504:
2487:(7â8): 837â839.
2481:Ann Pharmacother
2476:
2465:
2464:
2454:
2430:
2411:
2410:
2400:
2368:
2362:
2361:
2351:
2319:
2313:
2312:
2284:
2275:
2274:
2264:
2232:
2226:
2225:
2215:
2183:
2172:
2171:
2169:
2167:
2153:
2144:
2143:
2115:
2109:
2108:
2080:
2071:
2070:
2068:
2066:
2052:
2046:
2045:
2043:
2041:
2027:
2018:
2017:
2007:
1983:
1977:
1976:
1956:
1950:
1949:
1921:
1912:
1911:
1909:
1907:
1892:
1883:
1882:
1880:
1878:
1867:
1861:
1860:
1850:
1826:
1820:
1819:
1783:
1770:
1769:
1751:
1742:
1741:
1731:
1707:
1701:
1700:
1682:
1665:
1664:
1636:
1630:
1629:
1619:
1587:
1581:
1580:
1562:
1549:
1548:
1530:
1521:
1520:
1500:
1494:
1493:
1469:
1463:
1462:
1433:
1427:
1426:
1416:
1392:
1379:
1378:
1368:
1359:(8): e382âe482.
1344:
1295:
1294:
1286:
1280:
1279:
1269:
1241:
1235:
1234:
1216:
1183:
1182:
1180:
1178:
1155:
1077:
1074:
1056:
1049:
1014:should be used.
970:activity), like
906:anticholinergics
835:diagnostic agent
822:
818:
761:alpha-2 agonists
710:primary AV block
467:sinoatrial block
411:Sinus arrhythmia
174:beats per minute
119:
118:
115:
114:
111:
108:
105:
102:
99:
96:
93:
90:
87:
84:
81:
55:
35:
21:
4747:
4746:
4742:
4741:
4740:
4738:
4737:
4736:
4717:
4716:
4715:
4706:
4683:Kussmaul's sign
4659:
4574:aortic aneurysm
4546:
4518:Anitschkow cell
4511:rheumatic fever
4498:
4465:
4426:
4407:Duroziez's sign
4374:
4335:
4288:
4238:
4111:
4081:
4072:
4042:
4037:
4028:Rheumatic fever
3994:
3933:
3846:
3813:
3785:
3743:
3702:
3679:
3649:
3621:
3568:
3560:
3454:
3437:
3345:
3294:
3285:
3201:
3195:Hemopericardium
3139:
3080:
3074:Unstable angina
3047:Angina pectoris
3040:Active ischemia
3035:
2983:
2977:
2947:
2942:
2941:
2918:
2917:
2845:
2831:
2830:
2820:
2818:
2804:
2803:
2799:
2789:
2787:
2778:
2777:
2773:
2763:
2761:
2752:
2751:
2747:
2737:
2735:
2731:
2720:
2715:
2714:
2710:
2674:
2673:
2669:
2625:
2624:
2620:
2590:
2589:
2585:
2564:(10): 703â709.
2553:
2548:
2547:
2543:
2513:
2512:
2508:
2478:
2477:
2468:
2432:
2431:
2414:
2370:
2369:
2365:
2321:
2320:
2316:
2286:
2285:
2278:
2234:
2233:
2229:
2185:
2184:
2175:
2165:
2163:
2155:
2154:
2147:
2117:
2116:
2112:
2082:
2081:
2074:
2064:
2062:
2054:
2053:
2049:
2039:
2037:
2029:
2028:
2021:
1985:
1984:
1980:
1958:
1957:
1953:
1923:
1922:
1915:
1905:
1903:
1894:
1893:
1886:
1876:
1874:
1869:
1868:
1864:
1828:
1827:
1823:
1785:
1784:
1773:
1766:
1753:
1752:
1745:
1709:
1708:
1704:
1697:
1684:
1683:
1668:
1638:
1637:
1633:
1589:
1588:
1584:
1577:
1564:
1563:
1552:
1545:
1532:
1531:
1524:
1517:
1502:
1501:
1497:
1471:
1470:
1466:
1435:
1434:
1430:
1394:
1393:
1382:
1346:
1345:
1298:
1288:
1287:
1283:
1243:
1242:
1238:
1231:
1218:
1217:
1186:
1176:
1174:
1157:
1156:
1141:
1136:
1123:
1114:Miguel Indurain
1103:
1098:
1092:below 60 BPM).
1078:
1072:
1069:
1062:needs expansion
1047:
1020:Methylxanthines
992:
968:partial agonist
937:thyroid hormone
914:beta-1 agonists
899:alpha-1 blocker
859:
851:
820:
816:
809:
788:methamphetamine
780:Desensitization
642:
629:
597:
537:
496:
479:
459:
431:
422:
413:
393:
385:
360:
351:Purkinje fibers
321:sinoatrial node
298:
166:bradyarrhythmia
123:
78:
74:
33:
28:
23:
22:
18:Slow heart rate
15:
12:
11:
5:
4745:
4743:
4735:
4734:
4729:
4719:
4718:
4712:
4711:
4708:
4707:
4705:
4704:
4703:
4702:
4690:
4685:
4680:
4675:
4669:
4667:
4661:
4660:
4658:
4657:
4656:
4655:
4643:
4638:
4637:
4636:
4624:
4617:
4616:
4615:
4603:
4602:
4601:
4589:
4588:
4587:
4582:
4569:
4567:
4558:
4552:
4551:
4548:
4547:
4545:
4544:
4539:
4538:
4537:
4525:
4520:
4515:
4506:
4504:
4500:
4499:
4497:
4496:
4491:
4475:
4473:
4467:
4466:
4464:
4463:
4458:
4452:Janeway lesion
4449:
4437:
4435:
4428:
4427:
4425:
4424:
4419:
4414:
4409:
4404:
4399:
4393:
4391:
4382:
4376:
4375:
4373:
4372:
4370:Template:Shock
4366:
4361:
4356:
4351:
4345:
4343:
4337:
4336:
4334:
4333:
4331:
4326:
4325:
4324:
4322:Cannon A waves
4314:
4309:
4308:
4307:
4296:
4294:
4290:
4289:
4287:
4286:
4281:
4280:
4279:
4274:
4264:
4259:
4254:
4248:
4246:
4240:
4239:
4237:
4236:
4235:
4234:
4224:
4219:
4214:
4213:
4212:
4211:
4210:
4198:
4193:
4188:
4187:
4186:
4181:
4171:
4170:
4169:
4167:Still's murmur
4164:
4149:
4148:
4147:
4142:
4137:
4132:
4121:
4119:
4113:
4112:
4110:
4109:
4108:
4107:
4097:
4091:
4089:
4083:
4082:
4073:
4071:
4070:
4063:
4056:
4048:
4039:
4038:
4036:
4035:
4030:
4025:
4024:
4023:
4021:Cardiac asthma
4018:
4008:
4002:
4000:
3996:
3995:
3993:
3992:
3987:
3986:
3985:
3980:
3970:
3969:
3968:
3963:
3958:
3947:
3945:
3939:
3938:
3935:
3934:
3932:
3931:
3929:Strain pattern
3926:
3925:
3924:
3919:
3914:
3902:
3901:
3900:
3888:
3887:
3886:
3874:
3873:
3872:
3867:
3854:
3852:
3848:
3847:
3845:
3844:
3839:
3834:
3829:
3823:
3821:
3819:Cardiac arrest
3815:
3814:
3812:
3811:
3806:
3801:
3799:AndersenâTawil
3795:
3793:
3787:
3786:
3784:
3783:
3778:
3773:
3768:
3763:
3753:
3751:
3745:
3744:
3742:
3741:
3736:
3735:
3734:
3724:
3719:
3717:Atrial flutter
3713:
3711:
3704:
3703:
3701:
3700:
3695:
3689:
3687:
3681:
3680:
3678:
3677:
3672:
3667:
3661:
3659:
3655:
3654:
3651:
3650:
3648:
3647:
3642:
3637:
3631:
3629:
3623:
3622:
3620:
3619:
3618:
3617:
3612:
3602:
3601:
3600:
3589:
3587:
3578:
3562:
3561:
3559:
3558:
3553:
3552:
3551:
3546:
3541:
3536:
3531:
3526:
3516:
3511:
3510:
3509:
3504:
3499:
3489:
3480:
3475:
3469:
3467:
3458:
3447:
3446:
3443:
3442:
3439:
3438:
3436:
3435:
3434:
3433:
3428:
3416:
3415:
3414:
3409:
3397:
3396:
3395:
3390:
3378:
3377:
3376:
3371:
3366:
3353:
3351:
3347:
3346:
3344:
3343:
3342:
3341:
3336:
3324:
3323:
3322:
3309:
3307:
3298:
3287:
3286:
3284:
3283:
3278:
3277:
3276:
3271:
3266:
3261:
3256:
3251:
3246:
3241:
3240:
3239:
3227:Cardiomyopathy
3224:
3223:
3222:
3220:Chagas disease
3211:
3209:
3203:
3202:
3200:
3199:
3198:
3197:
3192:
3182:
3181:
3180:
3171:
3160:
3158:
3149:
3145:
3144:
3141:
3140:
3138:
3137:
3136:
3135:
3130:
3120:
3119:
3118:
3108:
3107:
3106:
3101:
3090:
3088:
3082:
3081:
3079:
3078:
3077:
3076:
3071:
3061:
3060:
3059:
3054:
3043:
3041:
3037:
3036:
3034:
3033:
3028:
3023:
3018:
3012:
3007:
3000:
2998:
2991:
2985:
2984:
2978:
2976:
2975:
2968:
2961:
2953:
2944:
2943:
2940:
2939:
2927:
2926:
2924:
2920:
2919:
2916:
2915:
2904:
2877:
2862:
2846:
2841:
2840:
2838:
2837:Classification
2829:
2828:
2797:
2771:
2745:
2708:
2667:
2618:
2599:(9): 21Câ23C.
2583:
2541:
2522:(2): 133â150.
2506:
2466:
2412:
2383:(4): 888â892.
2363:
2334:(5): 284â297.
2314:
2276:
2227:
2198:(1): e010273.
2173:
2145:
2126:(2): 405â417.
2110:
2072:
2047:
2019:
1978:
1951:
1932:(5): 477â478.
1913:
1884:
1862:
1841:(2): 123â129.
1821:
1794:(4): 599â605.
1771:
1764:
1743:
1702:
1695:
1666:
1631:
1602:(6): 754â762.
1582:
1575:
1550:
1543:
1522:
1515:
1495:
1464:
1428:
1407:(5): 265â272.
1380:
1296:
1281:
1252:(6): 914â921.
1236:
1229:
1184:
1138:
1137:
1135:
1132:
1131:
1130:
1122:
1119:
1118:
1117:
1110:
1107:
1102:
1099:
1097:
1094:
1080:
1079:
1059:
1057:
1046:
1043:
991:
988:
929:hypothyroidism
858:
855:
850:
847:
808:
805:
661:hypothyroidism
641:
638:
628:
625:
621:cardiac pacing
596:
593:
572:depolarization
551:with a normal
536:
533:
495:
492:
478:
475:
458:
455:
430:
427:
421:
418:
412:
409:
392:
389:
384:
381:
359:
358:Classification
356:
310:depolarization
302:cardiomyocytes
297:
294:
232:antiarrythmics
164:, also called
157:
156:
153:
149:
148:
143:
137:
136:
131:
125:
124:
122:
121:
71:
69:
65:
64:
57:
56:
48:
47:
44:
40:
39:
31:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
4744:
4733:
4730:
4728:
4725:
4724:
4722:
4701:
4698:
4697:
4696:
4695:
4691:
4689:
4686:
4684:
4681:
4679:
4678:Caput medusae
4676:
4674:
4671:
4670:
4668:
4666:
4662:
4654:
4651:
4650:
4649:
4648:
4644:
4642:
4639:
4635:
4634:Lines of Zahn
4632:
4631:
4630:
4629:
4625:
4623:
4622:
4618:
4614:
4611:
4610:
4609:
4608:
4604:
4600:
4597:
4596:
4595:
4594:
4590:
4586:
4585:Oliver's sign
4583:
4581:
4578:
4577:
4576:
4575:
4571:
4570:
4568:
4566:
4562:
4559:
4557:
4553:
4543:
4540:
4536:
4533:
4532:
4531:
4530:
4526:
4524:
4521:
4519:
4516:
4514:
4512:
4508:
4507:
4505:
4501:
4495:
4492:
4490:
4487:
4485:
4481:
4477:
4476:
4474:
4472:
4468:
4462:
4459:
4457:
4453:
4450:
4448:
4445:
4443:
4439:
4438:
4436:
4434:
4429:
4423:
4420:
4418:
4415:
4413:
4412:MĂźller's sign
4410:
4408:
4405:
4403:
4400:
4398:
4395:
4394:
4392:
4390:
4386:
4383:
4381:
4377:
4371:
4367:
4365:
4362:
4360:
4357:
4355:
4352:
4350:
4347:
4346:
4344:
4342:
4338:
4332:
4330:
4327:
4323:
4320:
4319:
4318:
4315:
4313:
4312:CĹur en sabot
4310:
4306:
4303:
4302:
4301:
4298:
4297:
4295:
4291:
4285:
4282:
4278:
4275:
4273:
4270:
4269:
4268:
4265:
4263:
4260:
4258:
4255:
4253:
4250:
4249:
4247:
4245:
4241:
4233:
4230:
4229:
4228:
4225:
4223:
4220:
4218:
4215:
4209:
4206:
4205:
4204:
4203:
4199:
4197:
4194:
4192:
4189:
4185:
4182:
4180:
4177:
4176:
4175:
4172:
4168:
4165:
4163:
4160:
4159:
4158:
4155:
4154:
4153:
4150:
4146:
4145:Gallop rhythm
4143:
4141:
4138:
4136:
4133:
4131:
4128:
4127:
4126:
4123:
4122:
4120:
4118:
4114:
4106:
4105:Levine's sign
4103:
4102:
4101:
4098:
4096:
4095:Referred pain
4093:
4092:
4090:
4088:
4084:
4080:
4076:
4069:
4064:
4062:
4057:
4055:
4050:
4049:
4046:
4034:
4031:
4029:
4026:
4022:
4019:
4017:
4014:
4013:
4012:
4011:Heart failure
4009:
4007:
4004:
4003:
4001:
3997:
3991:
3988:
3984:
3981:
3979:
3976:
3975:
3974:
3971:
3967:
3964:
3962:
3959:
3957:
3954:
3953:
3952:
3949:
3948:
3946:
3944:
3940:
3930:
3927:
3923:
3922:ST depression
3920:
3918:
3915:
3913:
3910:
3909:
3908:
3907:
3903:
3899:
3896:
3895:
3894:
3893:
3889:
3885:
3882:
3881:
3880:
3879:
3875:
3871:
3868:
3866:
3863:
3862:
3861:
3860:
3856:
3855:
3853:
3849:
3843:
3840:
3838:
3835:
3833:
3830:
3828:
3825:
3824:
3822:
3820:
3816:
3810:
3807:
3805:
3802:
3800:
3797:
3796:
3794:
3792:
3788:
3782:
3779:
3777:
3774:
3772:
3769:
3767:
3764:
3762:
3758:
3755:
3754:
3752:
3750:
3746:
3740:
3737:
3733:
3730:
3729:
3728:
3725:
3723:
3720:
3718:
3715:
3714:
3712:
3710:
3705:
3699:
3696:
3694:
3691:
3690:
3688:
3686:
3682:
3676:
3673:
3671:
3668:
3666:
3663:
3662:
3660:
3656:
3646:
3643:
3641:
3638:
3636:
3633:
3632:
3630:
3628:
3624:
3616:
3613:
3611:
3608:
3607:
3606:
3603:
3599:
3596:
3595:
3594:
3591:
3590:
3588:
3586:
3582:
3579:
3576:
3572:
3567:
3563:
3557:
3554:
3550:
3549:Trifascicular
3547:
3545:
3542:
3540:
3537:
3535:
3532:
3530:
3527:
3525:
3522:
3521:
3520:
3517:
3515:
3512:
3508:
3505:
3503:
3500:
3498:
3495:
3494:
3493:
3490:
3488:
3484:
3481:
3479:
3476:
3474:
3471:
3470:
3468:
3466:
3462:
3459:
3457:
3452:
3448:
3432:
3431:regurgitation
3429:
3427:
3424:
3423:
3422:
3421:
3417:
3413:
3412:regurgitation
3410:
3408:
3405:
3404:
3403:
3402:
3398:
3394:
3393:regurgitation
3391:
3389:
3386:
3385:
3384:
3383:
3379:
3375:
3374:regurgitation
3372:
3370:
3367:
3365:
3362:
3361:
3360:
3359:
3355:
3354:
3352:
3348:
3340:
3337:
3335:
3332:
3331:
3330:
3329:
3325:
3321:
3318:
3317:
3316:
3315:
3311:
3310:
3308:
3306:
3302:
3299:
3297:
3292:
3288:
3282:
3279:
3275:
3272:
3270:
3267:
3265:
3262:
3260:
3257:
3255:
3252:
3250:
3247:
3245:
3242:
3238:
3235:
3234:
3233:
3230:
3229:
3228:
3225:
3221:
3218:
3217:
3216:
3213:
3212:
3210:
3208:
3204:
3196:
3193:
3191:
3188:
3187:
3186:
3183:
3179:
3175:
3172:
3170:
3167:
3166:
3165:
3162:
3161:
3159:
3157:
3153:
3150:
3146:
3134:
3131:
3129:
3126:
3125:
3124:
3121:
3117:
3114:
3113:
3112:
3109:
3105:
3102:
3100:
3097:
3096:
3095:
3092:
3091:
3089:
3087:
3083:
3075:
3072:
3070:
3067:
3066:
3065:
3062:
3058:
3057:Stable angina
3055:
3053:
3050:
3049:
3048:
3045:
3044:
3042:
3038:
3032:
3029:
3027:
3024:
3022:
3019:
3016:
3013:
3011:
3008:
3005:
3002:
3001:
2999:
2995:
2992:
2990:
2986:
2981:
2974:
2969:
2967:
2962:
2960:
2955:
2954:
2951:
2938:
2934:
2933:
2929:
2928:
2925:
2921:
2914:
2910:
2909:
2905:
2903:
2899:
2895:
2891:
2887:
2886:
2882:
2878:
2876:
2872:
2871:
2867:
2863:
2861:
2857:
2856:
2852:
2848:
2847:
2844:
2839:
2835:
2816:
2812:
2808:
2801:
2798:
2785:
2781:
2775:
2772:
2759:
2755:
2749:
2746:
2730:
2726:
2719:
2712:
2709:
2704:
2700:
2695:
2690:
2686:
2682:
2678:
2671:
2668:
2663:
2659:
2654:
2649:
2645:
2641:
2637:
2633:
2629:
2622:
2619:
2614:
2610:
2606:
2602:
2598:
2594:
2587:
2584:
2579:
2575:
2571:
2567:
2563:
2559:
2552:
2545:
2542:
2537:
2533:
2529:
2525:
2521:
2517:
2516:Int J Cardiol
2510:
2507:
2502:
2498:
2494:
2490:
2486:
2482:
2475:
2473:
2471:
2467:
2462:
2458:
2453:
2448:
2444:
2440:
2436:
2429:
2427:
2425:
2423:
2421:
2419:
2417:
2413:
2408:
2404:
2399:
2394:
2390:
2386:
2382:
2378:
2374:
2367:
2364:
2359:
2355:
2350:
2345:
2341:
2337:
2333:
2329:
2325:
2318:
2315:
2310:
2306:
2302:
2298:
2294:
2290:
2283:
2281:
2277:
2272:
2268:
2263:
2258:
2254:
2250:
2246:
2242:
2238:
2231:
2228:
2223:
2219:
2214:
2209:
2205:
2201:
2197:
2193:
2189:
2182:
2180:
2178:
2174:
2162:
2158:
2152:
2150:
2146:
2141:
2137:
2133:
2129:
2125:
2121:
2114:
2111:
2106:
2102:
2098:
2094:
2091:(1): 1â9, v.
2090:
2086:
2079:
2077:
2073:
2061:
2057:
2051:
2048:
2036:
2032:
2026:
2024:
2020:
2015:
2011:
2006:
2001:
1997:
1993:
1989:
1982:
1979:
1974:
1970:
1966:
1962:
1955:
1952:
1947:
1943:
1939:
1935:
1931:
1927:
1920:
1918:
1914:
1901:
1897:
1891:
1889:
1885:
1872:
1866:
1863:
1858:
1854:
1849:
1844:
1840:
1836:
1832:
1825:
1822:
1817:
1813:
1809:
1805:
1801:
1797:
1793:
1789:
1782:
1780:
1778:
1776:
1772:
1767:
1761:
1757:
1750:
1748:
1744:
1739:
1735:
1730:
1725:
1721:
1717:
1713:
1706:
1703:
1698:
1692:
1688:
1681:
1679:
1677:
1675:
1673:
1671:
1667:
1662:
1658:
1654:
1650:
1646:
1642:
1635:
1632:
1627:
1623:
1618:
1613:
1609:
1605:
1601:
1597:
1593:
1586:
1583:
1578:
1572:
1568:
1561:
1559:
1557:
1555:
1551:
1546:
1540:
1536:
1529:
1527:
1523:
1518:
1516:9780471681830
1512:
1508:
1507:
1499:
1496:
1491:
1487:
1483:
1479:
1475:
1468:
1465:
1460:
1456:
1452:
1448:
1444:
1440:
1432:
1429:
1424:
1420:
1415:
1410:
1406:
1402:
1398:
1391:
1389:
1387:
1385:
1381:
1376:
1372:
1367:
1362:
1358:
1354:
1350:
1343:
1341:
1339:
1337:
1335:
1333:
1331:
1329:
1327:
1325:
1323:
1321:
1319:
1317:
1315:
1313:
1311:
1309:
1307:
1305:
1303:
1301:
1297:
1292:
1285:
1282:
1277:
1273:
1268:
1263:
1259:
1255:
1251:
1247:
1240:
1237:
1232:
1226:
1222:
1215:
1213:
1211:
1209:
1207:
1205:
1203:
1201:
1199:
1197:
1195:
1193:
1191:
1189:
1185:
1173:
1169:
1165:
1161:
1154:
1152:
1150:
1148:
1146:
1144:
1140:
1133:
1128:
1125:
1124:
1120:
1115:
1111:
1108:
1105:
1104:
1100:
1095:
1093:
1091:
1087:
1076:
1073:December 2018
1067:
1063:
1060:This section
1058:
1055:
1051:
1050:
1044:
1042:
1040:
1035:
1033:
1029:
1028:aminophylline
1025:
1021:
1017:
1013:
1009:
1005:
1001:
997:
989:
987:
985:
981:
977:
973:
969:
965:
961:
957:
953:
949:
948:beta blockers
945:
940:
938:
934:
930:
925:
923:
919:
915:
911:
907:
903:
900:
896:
893:
889:
885:
881:
877:
874:
869:
867:
862:
856:
854:
848:
846:
844:
840:
836:
832:
829:
824:
813:
806:
804:
802:
798:
796:
791:
789:
785:
781:
777:
772:
770:
766:
762:
758:
754:
750:
746:
742:
738:
734:
733:beta blockers
730:
727:A variety of
725:
723:
719:
715:
711:
706:
704:
698:
695:
693:
689:
684:
682:
678:
674:
670:
666:
662:
658:
654:
649:
647:
639:
637:
635:
626:
624:
622:
618:
614:
609:
608:bundle of His
605:
601:
594:
592:
590:
585:
581:
577:
573:
569:
565:
560:
558:
554:
550:
546:
542:
534:
532:
528:
526:
522:
518:
515:
511:
506:
504:
500:
493:
487:
483:
476:
474:
472:
468:
464:
456:
454:
450:
448:
444:
440:
436:
428:
426:
419:
417:
410:
408:
406:
405:stroke volume
401:
397:
390:
388:
382:
380:
373:
369:
364:
357:
355:
352:
348:
347:bundle of His
343:
341:
337:
336:cardiac cycle
333:
328:
326:
322:
317:
315:
311:
307:
303:
295:
293:
291:
287:
283:
278:
276:
271:
268:
264:
263:isoproterenol
260:
256:
252:
248:
243:
241:
237:
233:
229:
225:
224:beta blockers
221:
217:
213:
209:
205:
201:
197:
193:
188:
186:
181:
179:
175:
171:
167:
163:
154:
150:
147:
144:
142:
138:
135:
132:
130:
126:
117:
73:
72:
70:
68:Pronunciation
66:
62:
58:
54:
49:
45:
41:
36:
30:
19:
4692:
4645:
4641:Adson's sign
4626:
4619:
4613:Allen's test
4605:
4591:
4572:
4527:
4523:Aschoff body
4509:
4494:Ewart's sign
4489:Beck's triad
4478:
4456:Osler's node
4442:endocarditis
4440:
4422:Mayne's sign
4368:See further
4364:Distributive
4300:Palpitations
4266:
4256:
4200:
4152:Heart murmur
4125:Heart sounds
4117:Auscultation
3943:Cardiomegaly
3917:ST elevation
3904:
3890:
3876:
3857:
3761:Ectopic beat
3709:fibrillation
3544:Bifascicular
3464:
3418:
3399:
3380:
3356:
3326:
3312:
3305:Endocarditis
3244:Hypertrophic
3178:Constrictive
3164:Pericarditis
3122:
3110:
3093:
2930:
2906:
2879:
2864:
2849:
2819:. Retrieved
2815:the original
2810:
2800:
2788:. Retrieved
2783:
2774:
2762:. Retrieved
2757:
2748:
2736:. Retrieved
2724:
2711:
2684:
2680:
2670:
2635:
2631:
2621:
2596:
2593:Am J Cardiol
2592:
2586:
2561:
2558:N Engl J Med
2557:
2544:
2519:
2515:
2509:
2484:
2480:
2442:
2438:
2380:
2376:
2366:
2331:
2327:
2317:
2292:
2289:Am J Cardiol
2288:
2244:
2240:
2230:
2195:
2191:
2164:. Retrieved
2160:
2123:
2119:
2113:
2088:
2084:
2063:. Retrieved
2059:
2050:
2038:. Retrieved
2034:
1995:
1991:
1981:
1967:(2): 73â78.
1964:
1960:
1954:
1929:
1925:
1904:. Retrieved
1899:
1875:. Retrieved
1865:
1838:
1834:
1824:
1791:
1787:
1755:
1719:
1715:
1705:
1686:
1644:
1640:
1634:
1599:
1595:
1585:
1566:
1534:
1505:
1498:
1484:(2): 73â78.
1481:
1477:
1467:
1442:
1438:
1431:
1404:
1400:
1356:
1352:
1284:
1249:
1245:
1239:
1220:
1175:. Retrieved
1163:
1083:
1070:
1066:adding to it
1061:
1045:Epidemiology
1036:
1024:theophylline
993:
941:
926:
918:side effects
876:theophylline
870:
863:
860:
852:
831:theophylline
825:
814:
810:
799:
792:
773:
726:
707:
699:
696:
685:
677:autoimmunity
650:
644:Bradycardia
643:
630:
598:
561:
538:
529:
519:
514:PR intervals
507:
497:
480:
471:sinus arrest
460:
451:
435:sinus arrest
432:
423:
414:
400:sinus rhythm
394:
386:
377:
371:
367:
344:
329:
318:
299:
289:
285:
279:
272:
244:
234:, and other
206:, and frank
189:
182:
165:
161:
160:
29:
4471:Pericardium
4447:Roth's spot
4433:endocardium
4359:Hypovolemic
4354:Obstructive
4349:Cardiogenic
4257:Bradycardia
4252:Tachycardia
4222:Heart click
3809:RomanoâWard
3776:Parasystole
3675:Ventricular
3627:Ventricular
3566:Tachycardia
3483:Heart block
3465:Bradycardia
3291:Endocardium
3254:Restrictive
3215:Myocarditis
3156:Pericardium
2937:Bradycardia
2821:8 September
2738:15 December
2681:Circulation
2632:Circulation
2439:Circulation
1992:Circulation
1906:16 December
1877:15 December
1716:Circulation
1353:Circulation
1267:1887/117357
1164:StatPearls
1008:epinephrine
976:propranolol
944:medications
916:. However,
895:hydralazine
888:vasodilator
737:propranolol
729:medications
595:Ventricular
589:PR interval
584:dysrhythmia
568:AV junction
553:QRS complex
247:Sinus pause
236:cholinergic
162:Bradycardia
43:Other names
38:Bradycardia
4721:Categories
4329:Hyperaemia
4191:Continuous
4087:Chest pain
3707:Flutter /
3670:Junctional
3605:Junctional
3598:Multifocal
3571:paroxysmal
3487:Sinoatrial
3456:arrhythmia
3451:Conduction
3207:Myocardium
2932:Patient UK
2377:J Arrhythm
2328:Physiology
2247:(1): 1â8.
1177:16 January
1134:References
1002:infusion (
984:metoprolol
849:Management
646:arrhythmia
545:sinus node
525:Wenckebach
383:Sinus node
134:Cardiology
4305:Apex beat
4174:Diastolic
3966:Pulmonary
3749:Pacemaker
3420:pulmonary
3401:tricuspid
3237:Alcoholic
2241:Behav Med
1816:239091592
807:Diagnosis
765:clonidine
749:diltiazem
745:verapamil
703:pacemaker
627:Infantile
292:"heart".
204:confusion
200:dizziness
172:under 60
152:Frequency
129:Specialty
4628:thrombus
4565:Arterial
4157:Systolic
4130:Split S2
3832:Asystole
3732:Familial
3426:stenosis
3407:stenosis
3388:stenosis
3369:stenosis
3364:prolapse
3086:Sequelae
2989:Ischemia
2790:5 August
2764:5 August
2729:Archived
2703:26472999
2662:26473000
2578:10706901
2461:20956224
2407:34386113
2358:23997188
2309:28341362
2271:24621090
2222:34961335
2105:16308110
2014:10577999
1973:30048576
1946:14503433
1857:23677846
1808:34689889
1738:27166347
1626:20180918
1490:30048576
1423:31311698
1375:30586772
1276:25194872
1172:29630253
1121:See also
1004:dopamine
1000:inotrope
996:atropine
980:atenolol
972:pindolol
902:prazosin
801:COVID-19
774:Chronic
673:bed rest
617:atropine
443:asystole
314:contract
259:atropine
212:etiology
185:athletes
4267:doubled
4232:carotid
3232:Dilated
3174:Chronic
2982:(heart)
2913:D001919
2653:6191296
2613:1977302
2536:2884187
2501:9681101
2398:8339085
2349:3768097
2262:4162850
2213:8766923
2140:9621850
1661:1591784
1617:2889145
1459:9832095
1101:Records
1034:(SND).
966:(i.e.,
920:, like
776:cocaine
769:lithium
757:digoxin
582:. This
580:AV node
576:SA node
574:of the
564:ectopic
284:βĎιδĎĎ
208:syncope
196:dyspnea
192:fatigue
168:, is a
4665:Venous
4535:J wave
4431:Other
4100:Angina
3912:J wave
3665:Atrial
3593:Atrial
3382:aortic
3358:mitral
3350:Valves
3296:valves
3148:Layers
3017:(SCAD)
2902:779.81
2890:427.81
2860:MC81.1
2701:
2660:
2650:
2611:
2576:
2534:
2499:
2459:
2405:
2395:
2356:
2346:
2307:
2269:
2259:
2220:
2210:
2166:5 July
2138:
2103:
2065:5 July
2040:5 July
2012:
1971:
1944:
1855:
1814:
1806:
1762:
1736:
1693:
1659:
1624:
1614:
1573:
1541:
1513:
1488:
1457:
1421:
1373:
1274:
1227:
1170:
982:, and
958:, and
908:, and
897:, the
821:
817:
767:, and
675:, and
640:Causes
604:atrium
557:P wave
437:, and
372:bottom
290:kardia
286:bradys
120:
4503:Other
4341:Shock
4293:Other
4244:Pulse
4227:Bruit
3999:Other
3983:Right
3961:Right
3575:sinus
3524:Right
3274:Viral
3169:Acute
3123:weeks
3094:hours
3006:(CAD)
2898:785.9
2894:659.7
2875:R00.1
2732:(PDF)
2721:(PDF)
2554:(PDF)
2161:WebMD
2035:WebMD
1812:S2CID
1022:like
1010:) or
935:with
912:like
878:, an
763:like
755:like
743:like
735:like
663:, an
657:abuse
398:is a
332:atria
282:Greek
3978:Left
3956:Left
3573:and
3529:Left
3111:days
2908:MeSH
2885:9-CM
2823:2014
2792:2015
2766:2015
2740:2018
2699:PMID
2658:PMID
2609:PMID
2574:PMID
2532:PMID
2497:PMID
2457:PMID
2403:PMID
2354:PMID
2305:PMID
2267:PMID
2218:PMID
2168:2021
2136:PMID
2101:PMID
2067:2021
2042:2021
2010:PMID
1969:PMID
1942:PMID
1908:2009
1879:2009
1853:PMID
1804:PMID
1760:ISBN
1734:PMID
1691:ISBN
1657:PMID
1622:PMID
1571:ISBN
1539:ISBN
1511:ISBN
1486:PMID
1455:PMID
1419:PMID
1371:PMID
1272:PMID
1225:ISBN
1179:2022
1168:PMID
1026:and
890:and
873:oral
828:oral
747:and
619:and
261:and
4529:EKG
2881:ICD
2866:ICD
2851:ICD
2689:doi
2685:132
2648:PMC
2640:doi
2636:132
2601:doi
2566:doi
2562:342
2524:doi
2489:doi
2447:doi
2443:122
2393:PMC
2385:doi
2344:PMC
2336:doi
2297:doi
2293:119
2257:PMC
2249:doi
2208:PMC
2200:doi
2128:doi
2093:doi
2000:doi
1996:100
1965:117
1961:WMJ
1934:doi
1843:doi
1796:doi
1724:doi
1720:133
1649:doi
1612:PMC
1604:doi
1482:117
1478:WMJ
1447:doi
1409:doi
1361:doi
1357:140
1262:hdl
1254:doi
1068:.
927:If
782:of
655:or
539:An
508:In
368:top
104:ÉËr
4723::
4140:S4
4135:S3
3906:ST
3878:QT
3759:/
3507:3°
3502:2°
3497:1°
3492:AV
3485::
3176:/
2935::
2911::
2900:,
2896:,
2892:,
2888::
2873::
2870:10
2858::
2855:11
2809:.
2782:.
2756:.
2723:.
2697:.
2683:.
2679:.
2656:.
2646:.
2634:.
2630:.
2607:.
2597:66
2595:.
2572:.
2560:.
2556:.
2530:.
2520:15
2518:.
2495:.
2485:32
2483:.
2469:^
2455:.
2441:.
2437:.
2415:^
2401:.
2391:.
2381:37
2379:.
2375:.
2352:.
2342:.
2332:28
2330:.
2326:.
2303:.
2291:.
2279:^
2265:.
2255:.
2245:42
2243:.
2239:.
2216:.
2206:.
2196:15
2194:.
2190:.
2176:^
2159:.
2148:^
2134:.
2124:16
2122:.
2099:.
2089:24
2087:.
2075:^
2058:.
2033:.
2022:^
2008:.
1994:.
1990:.
1963:.
1940:.
1930:12
1928:.
1916:^
1898:.
1887:^
1851:.
1839:35
1837:.
1833:.
1810:.
1802:.
1792:13
1790:.
1774:^
1746:^
1732:.
1718:.
1714:.
1669:^
1655:.
1645:11
1643:.
1620:.
1610:.
1600:33
1598:.
1594:.
1553:^
1525:^
1480:.
1476:.
1453:.
1443:82
1441:.
1417:.
1405:30
1403:.
1399:.
1383:^
1369:.
1355:.
1351:.
1299:^
1270:.
1260:.
1250:47
1248:.
1187:^
1162:.
1142:^
1006:,
986:.
978:,
954:,
950:,
939:.
904:,
797:.
759:,
751:,
739:,
720:,
716:,
712:,
705:.
623:.
505:.
469:,
230:,
226:,
202:,
198:,
194:,
180:.
4513::
4486::
4482:/
4454:/
4444::
4067:e
4060:t
4053:v
3892:T
3577:)
3569:(
3453:/
3293:/
2972:e
2965:t
2958:v
2883:-
2868:-
2853:-
2843:D
2825:.
2794:.
2768:.
2742:.
2705:.
2691::
2664:.
2642::
2615:.
2603::
2580:.
2568::
2538:.
2526::
2503:.
2491::
2463:.
2449::
2409:.
2387::
2360:.
2338::
2311:.
2299::
2273:.
2251::
2224:.
2202::
2170:.
2142:.
2130::
2107:.
2095::
2069:.
2044:.
2016:.
2002::
1975:.
1948:.
1936::
1910:.
1881:.
1859:.
1845::
1818:.
1798::
1768:.
1740:.
1726::
1699:.
1663:.
1651::
1628:.
1606::
1579:.
1547:.
1519:.
1492:.
1461:.
1449::
1425:.
1411::
1377:.
1363::
1278:.
1264::
1256::
1233:.
1181:.
1075:)
1071:(
116:/
113:É
110:i
107:d
101:k
98:Ë
95:ÉŞ
92:d
89:ĂŚ
86:r
83:b
80:Ë
77:/
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
