I just recently made an ECG to be able to participate in a study and I am curious what "sinus rhythm otherwise normal ECG" means. Is my sinus rhythm out of order? A doctor will be checking my ECG and decide if I am suitable for the study, but it will take a week or more.


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    practicalclinicalskills.com/… Commented Feb 9, 2016 at 18:15
  • I have had a b/ventricular p/m since Oct 2005,it needed replacing in Jan 2015 due to battery nearing going flat,in Melb they put an ordinary p/m in because he was the only one in S/East Aust registered to remove the leads,after 18 months it was not successful,my E/F although was static at 58%,fell to 38% in the 18 months,in Hobart they put a B/V back in and I have been a lot better to the point that today I am back into Sinus Rhythm,for how long I don't know,but have probably been back in S/R for 2/3 months.I don't know what my E/F is today because I haven't had an Echo Cardiagram. Commented Mar 24, 2017 at 10:20

2 Answers 2


Basically you have a normal ECG reading according to the machine.

Sinus rhythm (as explained in the first section of this book chapter) is normal, meaning that the heart is depolarized by a wave starting in the sinus node. That is the first part of the message. It is worth noting, that if your heart rate had been 1 beat per minute less, it would have probably said "sinus bradycardia" as a normal heart rate is considered to be 60-100 beats per minute (BPM). Bradycardia is a heart rate below the 60 bpm threshold (50 bpm in some sources) and tachycardia would be a heart rate above 100 (90 in some sources).

The "otherwise normal" is boilerplate by the machine. As you can see by this feature sheet for the NASAN Simul-G ECG machine, "Otherwise normal ECG" is one of the display options. Speaking as a programmer, it's a little bit of a shortcut, so that if there is a rhythm problem but everything else is good, they can simply put "[rhythm message here] otherwise normal ECG". Better programming would be to omit the "otherwise" when the sinus rhythm is normal.

Now, realize that the machine is simply applying preformatted parameters, and that when it says normal, it just means that your readings fit into what it has defined as normal. It is possible that there is some small thing that doesn't look out of place to the machine but would to a trained cardiologist. I don't say that to alarm you, but just to show you how the machine interprets it.


Basically I agree with JohnP. The "otherwise normal ecg" is an unfortunate phrase.

Sinus rhythm is the normal rhythm of the heart.

So the machine should interpret as: Normal ECG. Rhythm:Sinus Heart Rate : PR interval: etc etc.

By saying otherwise normal ECG, of course creates unnecessary suspicion.Modern machines are improved in doing an automatic diagnosis(better wording too). Nevertheless, I have deactivated the automatic diagnosis in my office, for such events exactly. They can create idiotic worries to the patients and are a cause for wasting our time.

P.S. I am a cardiologist.

That sinus is the normal rhythm of the heart can be verified in millions of authoritative sources. As an example I direct.you to Guyton's.physiology, 11th edition. at the beginning of chapter.10 "rhythmical excitation of.the heart" one can see that the activation of the conduction system of the heart originates in the sinoatrial node. Now, there are some peculiarities in this, but for all intents and purposes and as a general knowledge it's more than enough.

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