Coronary sinus rhythm

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Coronary sinus rhythm

Coronary sinus rhythm manifests with inverted P waves in inferior leads. It is also known as low atrial rhythm. PR interval in low atrial rhythm is longer than that in high junctional rhythm, which it mimics on an ECG. It seldom needs any treatment. QRS is narrow and of normal morphology. Very rarely, coronary sinus rhythm may be noted during cardiac rupture.