The rhythm of the normal pulse is regular apart from sinus arrhythmia that is most often seen in youth. Sinus arrhythmia is the slight speeding up of the pulse on inspiration and the slight slowing of the pulse rate on expiration.
An irregularly irregular pulse occurs in atrial fibrillation. However note that sinus rhythm with multiple extrasystoles may simulate it. Exercise accentuates the irregularity of the pulse seen in atrial fibrillation; extrasystoles disappear during exercise, unless the subject has severe myocardial disease.
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