Sinus Arrhythmia: What is it? Symptoms, Causes, Diagnosis, Treatment, Complications and Perspective

A person’s heart should beat at regular intervals, like the second hand on a clock.

An arrhythmia is when there is a problem with the heartbeat or irregular heartbeats. Sinus arrhythmia is a type of arrhythmia. This article analyzes what a sinus arrhythmia is, how it is diagnosed, and whether it is a health problem.

An irregular heartbeat is called an arrhythmia. Sinus arrhythmia is an irregular heart rhythm that is too fast or too slow. One type of sinus arrhythmia, called respiratory sinus arrhythmia, is when the heart rate changes rhythm when you inhale and exhale.

In other words, the beating of your heart changes with your breathing. When you breathe, your heart rate increases. When you exhale, it decreases.

This condition is benign. It is a variation of the heartbeat that occurs naturally and does not mean you have a severe heart condition. This condition is common in adults and young, healthy children.

A respiratory sinus arrhythmia can occur in older people, but in these cases, it is often associated with heart disease or other heart conditions.

Sometimes, sinus arrhythmia occurs with another condition called sinus bradycardia. Bradycardia, or a slow heartbeat, is diagnosed when your heart’s natural rhythm is below 60 beats per minute.


If the low heart rate produces prolonged pauses between beats, you may have sinus bradycardia with sinus arrhythmia. These breaks can be expected while you sleep.

Another type of sinus arrhythmia occurs when the heart beats too fast. This is called sinus tachycardia. It refers to heart rates above 100 beats per minute. Sinus tachycardia usually results from another condition, such as stress, fever, pain, exercise, or medication.

If the heart rate does not resolve quickly, your doctor will treat the underlying problem.

These conditions are not severe or problematic in a young and healthy person. Some people with slow or fast heartbeats may experience lightheadedness or shortness of breath, but others may never experience any symptoms.

Sinus arrhythmia is not related to the sinus cavities in the face but the sinoatrial or sinus node in the heart.

The sinoatrial or sinus node is located in the upper chamber on the right side of the heart, called the right atrium.

The sinus node is the natural ” pacemaker ” of the heart, which means it is responsible for a person’s heart rhythm. Normal sinus rhythm is a regular rhythm found in healthy people.

Sinus arrhythmia means an irregularity in the heart rhythm, which originates in the sinus node. In general, sinus arrhythmias can be:

  • Sinus tachycardia: which is a faster heart rate exceeding 100 beats per minute.
  • Sinus bradycardia is when the heart rate beats slower or less than 60 beats per minute.

Respiratory Sinus Arrhythmia

Respiratory sinus arrhythmia is effectively benign and is not harmful. It happens when a person’s heart rate is related to their breathing cycle. In other words, when the person inhales, their heart rate increases, and when they exhale, the frequency decreases.

Respiratory sinus arrhythmia is more common in children than adults and tends to disappear as they get older.

The time between each beat is known as the PP interval. There is a slight variation of fewer than 0.16 seconds in most people. In cases of respiratory sinus arrhythmia, the PP interval will often be longer than 0.16 seconds when the person exhales.

As the heart accelerates, during exercise, for example, the heart rate tends to become more regular.

What are the symptoms?

People with sinus arrhythmia do not experience any cardiovascular symptoms. You may never experience symptoms of any kind, and the condition may never be diagnosed.

If you know how to detect your pulse, you may feel a slight change in the frequency of your vibration when inhaling and exhaling. However, the differences can be so slight that only one machine can detect the variations.

Talk to your doctor if you experience palpitations or feel that your heart is skipping a beat. Heart palpitations are rarely severe and may occur from time to time. Still, they can be worrisome, and talking to your doctor can help make sure you do not have underlying heart problems.

What causes Sinus Arrhythmia?

It is not clear what causes people to develop a sinus arrhythmia. The researchers suspect that a connection between the heart, the lungs, and the vascular system may play a role.

Sinus arrhythmias are common in children and, sometimes, they are also found in adults. Children who have respiratory sinus arrhythmia will tend to see their symptoms diminish as they age without the need for treatment.

In older people, a sinus arrhythmia can occur due to heart disease or another heart condition. Damage to the sinus node can prevent electrical signals from leaving the nodule and produce constant and regular heartbeats.

In these cases, the sinus arrhythmia results from damage to the heart and is likely to appear after the heart condition develops.

While the exact cause of the respiratory sinus arrhythmia is unknown, researchers believe that it may increase efficiency or allow the heart to work less while maintaining the correct gas levels in the blood.

How is it diagnosed?

Your doctor will perform an electrocardiogram (EKG or ECG) to diagnose a sinus arrhythmia. This test measures the electrical signals of your heart. It can detect all aspects of your heartbeat and help your doctor detect any potential irregularities, such as sinus arrhythmia.

Keep in mind that for most people, sinus arrhythmia is not dangerous or problematic. Even if your doctor suspects you have this irregular heartbeat, you may not order the test to check it. An EKG can be expensive, and a sinus arrhythmia is considered benign.

Your doctor may order an electrocardiogram only if you suspect you have another condition or if you have other symptoms.

Other Irregular Heart Rhythms

A possible cause of arrhythmia is exercising excessively. Many types of arrhythmias originate in other electrical pathways of the heart. The main types include:

  • Atrial fibrillation: the heart beats irregularly due to conduction abnormalities.
  • Supraventricular tachycardia: the heart rate is abnormally fast when at rest.
  • Heart block: when the heart beats more slowly, which can cause a person to collapse.
  • Ventricular fibrillation: the heart has a disorganized rhythm that leads to loss of consciousness and death if left untreated.

Arrhythmias can affect people of any age, although atrial fibrillation is more common in older people. Factors that increase the risk of arrhythmia include:

  • Drink alcohol.
  • The consumption of tobacco.
  • Excessive exercise
  • Consumption of caffeine.
  • Certain medications and recreational drugs.
  • Being overweight.
  • Have a viral illness.
  • Previous heart attack or heart failure.

Sick Sick Syndrome

Sick sinus syndrome (SSS) occurs when the sinus node causes abnormal heart rhythms. This happens when the sinus node heals and is replaced by fibrous tissues over time.

There are several arrhythmias associated with sick sinus syndrome:

  • Atrial fibrillation
  • Severe sinus bradycardia
  • Tachycardic-bradycardic syndrome is also known as techy-Brady syndrome.
  • Block sinus output or sinus pauses.

Sick sinus syndrome most commonly affects older people and both sexes equally. While the sick sinus syndrome may be asymptomatic in some cases, it can also cause a person to experience:

  • Fainting.
  • Heart palpitations.
  • Fatigue.
  • Difficulty breathing.

Treatment often includes the use of a pacemaker. If left untreated, sick sinus syndrome can have severe consequences for a person’s health.

Medications such as digoxin, beta-blockers, and calcium channel blocker can worsen sick sinus syndrome.

How is it treated?

You probably do not need treatment for sinus arrhythmia. Because it is considered a common occurrence and does not lead to any other problem, treatment is not necessary for most people. A sinus arrhythmia can become undetectable as children and young adults grow older.

If you develop a sinus arrhythmia due to another heart condition, such as heart disease, your doctor may treat the original condition. Treating the disorder can help stop the arrhythmia.


Sinus arrhythmias rarely cause complications. The condition is probably not discovered because it rarely causes symptoms or problems.

If the sinus arrhythmia occurs with sinus bradycardia or tachycardia, you may experience some complications with the combination.

You may experience dizziness, difficulty breathing, and fainting for slow heartbeats. Heart palpitations, dizziness, and chest pains can occur with rapid and irregular heartbeats.

Perspective and Forecast

Most people with sinus arrhythmia will live everyday, healthy lives. Some may never know they have this condition. Detection and diagnosis can occur by accident, and treatment is rarely necessary.

For older people with this condition, you must work with your doctor to identify the underlying cause and treatment that may help. The arrhythmia itself is not harmful, but an underlying condition like heart disease can be severe.

Respiratory sinus arrhythmia is not considered a significant health concern. However, other arrhythmias can sometimes indicate heart disease.

An older person with a severe arrhythmia may need a pacemaker. People with sleep apnea are also more likely to experience arrhythmias, including respiratory sinus arrhythmia.

Cases of respiratory sinus arrhythmia in children and young people will often improve without treatment. This is because a child’s heart is still growing and developing, and changes in the heart can lead to arrhythmia of the respiratory sinus.

If a child has a respiratory sinus arrhythmia, a doctor may want to control it but probably will not offer any treatment unless the problem becomes severe, causes symptoms, or continues into adolescence.

However, cases in older people are more unusual and may require further examination. If the respiratory sinus arrhythmia is caused by underlying heart disease, it will be necessary to treat it separately.