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.
This ECG was obtained from an elderly woman who suffered a complete right coronary artery occlusion and inferior wall M.I. In her case, the AV node was also affected, and she developed a third-degree AV block with a junctional escape rhythm. A good ECG for ACLS classes as well as for ECG classes. A lively discussion can be had regarding "types" of complete heart block and the nature of the escape rhythm - when to treat and when to leave the rhythm alone.
This ECG has always caused a lively conversation in ECG classes, both beginner classes and advanced. There is an obvious underlying sinus tachycardia, with clear P waves.
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