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Second-degree AV block Type II

ECG Basics: Second-degree AV Block With Characteristics of Type I and Type II

Thu, 09/01/2016 - 11:51 -- Dawn

This strip shows a second-degree AV block.  During most of the strip, 2:1 conduction is present.  At the beginning, however, two consecutive p waves are conducted, revealing progressive prolongation of the PR interval.  This usually represents a Type I , or nodal, block:  progressive refractoriness of the AV node.   However, the wide QRS ( possibly left bundle branch block), and the fact that the non-conducted p waves are "out in the open" where they should have conducted, points to Type II - an intermi

jer5150's picture

Jason's Blog: ECG Challenge of the Week for Oct. 21-28, 2012

No clinical patient data available for this 12-lead ECG.

What does this tracing show?  Choose the correct answer from the list below.

(1.)  Sinus bradycardia with atrial bigeminy; conducted APBs; prominent U-waves; RBBB
(2.)  Sinus rhythm with 3:2 and 2:1 Type II AV block; RBBB
(3.)  Sinus rhythm with atrial bigeminy; both conducted and nonconducted APBs; RBBB

Acronyms:
APBs = atrial premature beats
RBBB = right bundle-branch block

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