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Complete AV block

ECG Basics: Third-degree AV Block, Complete Heart Block

Wed, 11/18/2015 - 12:31 -- Dawn

This rhythm strip shows third-degree AV block, also called complete heart block or complete AV block.  The P waves are from the sinus node, and are regular at a rate of about 120/min. (Sinus tachycardia). This is a good strip for showing your students how to "march out" the P waves to find the ones that are hidden behind QRS complexes or T waves. Knowing that the P waves are regular, it is easy to find the hidden ones.

Complete AV Block With Junctional Escape Rhythm

Thu, 09/03/2015 - 23:02 -- Dawn

This ECG was taken from a 90-year-old woman.  We have no other history, unfortunately.  It is a good example of a sinus rhythm with complete AV block, also called third-degree AV block.

The defining characteristics of this rhythm include:   1) an underlying rhythm that is regular and with a physiological rate.  In other words, the P waves are not so fast that they would not be expected to conduct one-to-one.  2)  a second rhythm of regular QRS complexes that is unrelated to the P waves.

Complete AV Block

Tue, 09/16/2014 - 14:26 -- Dawn

This ECG is from an 84-year-old man who experienced dizziness and a fall.  He was not injured in the fall.  In this ECG, we can clearly see regular P waves at about 110 per minute.  We also see wide QRS complexes at about 52 per minute.  There is AV  dissociation - there are no regular PR intervals, or even progressively-prolonging PR intervals.  The atrial and the ventricles are beating to separate rhythms.  What is interesting about this rhythm is the origin of the escape rhythm.

ECG Basics: Pacemaker Failure to Capture

Sun, 04/27/2014 - 17:29 -- Dawn

This ECG is taken from a patient with an implanted pacemaker who was experiencing near-syncope.  She was taken to the hospital by EMS, where the pacemaker was adjusted to obtain ventricular capture.  This ECG did not have a Lead II rhythm strip, so the 12-lead ECG is being presented.  The P waves have been marked with a "P", pacemaker spikes marked with an arrow, and the QRS complexes marked with a "J" because they are junctional.

ECG Basics: Sinus Rhythm With Complete AV Block and Ventricular Escape Rhythm

Sun, 07/28/2013 - 13:36 -- Dawn

This rhythm strip shows a good example of complete (third-degree) AV block with ventricular escape rhythm.  It will be easy for your basic students to "march out" the P waves.  They are regular at a rate of about 88/min., and they are either visible, or are "hiding" in the QRS complex.  The ventricular rhythm is wide and very slow, and completely dissociated from the sinus rhythm.

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