ECG Guru - Instructor Resources - ECG Basics https://www.ecgguru.com/ecg/ecg-basics en SINUS ARRHYTHMIA https://www.ecgguru.com/blog/sinus-arrhythmia <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sinus-arrhythmia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Sinusarrhythmia.jpg" width="2900" height="1910" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p><span style="font-size: 10px;">Here we see the EKG of a 15-year-old girl. The rhythm is irregular, with the heart rate fluctuating between approximately 60 and 90 beats per minute. All P waves are identical, and the PR interval is always constant. Therefore, a sinus arrhythmia is present. In this case, it is a respiratory sinus arrhythmia, which is commonly found in younger individuals. The heart rate increases reflexively during inspiration and decreases during exspiration. This physiological sinus arrhythmia is usually no longer present in older individuals.</span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SINUS ARRHYTHMIA 1/5</option><option value="40">Give SINUS ARRHYTHMIA 2/5</option><option value="60">Give SINUS ARRHYTHMIA 3/5</option><option value="80">Give SINUS ARRHYTHMIA 4/5</option><option value="100" selected="selected">Give SINUS ARRHYTHMIA 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-EjY8hI5LB521K8oRkT_cncqur-v77NHg938tNIQY1-w" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsinus-arrhythmia&amp;title=SINUS%20ARRHYTHMIA"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Thu, 10 Aug 2023 07:07:34 +0000 Dr A Röschl 864 at https://www.ecgguru.com https://www.ecgguru.com/blog/sinus-arrhythmia#comments SECOND DEGREE AVB TYPE I (WENCKEBACH) https://www.ecgguru.com/blog/second-degree-avb-type-i-wenckebach <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/second-degree-avb-type-i-wenckebach"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/guru%201.jpg" width="3205" height="2045" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>We see the EKG of an 81-year-old patient with a pacemaker; the PM was briefly deactivated to assess the patient's intrinsic heart rhythm. At the beginning of the EKG, there is already a prolonged AV conduction time, which progressively lengthens from beat to beat. The last conducted P-wave has a PR interval of nearly 800 ms (!). The next P-wave is blocked, but the subsequent displayed P-waves are conducted again, with the PR interval increasing from beat to beat. This indicates a classic second degree AVB Type Mobitz I (Wenckebach). The only unusual aspect is the very long AV conduction time.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20" selected="selected">Give SECOND DEGREE AVB TYPE I (WENCKEBACH) 1/5</option><option value="40">Give SECOND DEGREE AVB TYPE I (WENCKEBACH) 2/5</option><option value="60">Give SECOND DEGREE AVB TYPE I (WENCKEBACH) 3/5</option><option value="80">Give SECOND DEGREE AVB TYPE I (WENCKEBACH) 4/5</option><option value="100">Give SECOND DEGREE AVB TYPE I (WENCKEBACH) 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >1</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-uPhNLT4C1RZDUq4yFICO3x5Zrtl_F7Jbx6O4y0jpDtU" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsecond-degree-avb-type-i-wenckebach&amp;title=SECOND%20DEGREE%20AVB%20TYPE%20I%20%28WENCKEBACH%29"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Sat, 05 Aug 2023 09:27:18 +0000 Dr A Röschl 863 at https://www.ecgguru.com https://www.ecgguru.com/blog/second-degree-avb-type-i-wenckebach#comments SSS (SICK SINUS SYNDROME) https://www.ecgguru.com/blog/sss-sick-sinus-syndrome <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/sss-sick-sinus-syndrome"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/SSS%20ecgguru.jpg" width="2802" height="1784" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>Why does this EKG indicate a sick sinus node? First, we observe a sinus rhythm with a rate just below 60 bpm. Then, there is a pause of approximately 3000 ms, followed not by a sinus beat, but by a junctional escape beat (retrograde/inverted P-wave immediately after the QRS complex). This ECG was recorded at the general practitioner's office, and it can be assumed that no vagal stimulus contributed to the arrhythmia. The same pause recorded in a Holter monitor during the night under the influence of vagal tone, without any other symptoms from the patient, would be evaluated quite differently.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--3" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--6" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give SSS (SICK SINUS SYNDROME) 1/5</option><option value="40">Give SSS (SICK SINUS SYNDROME) 2/5</option><option value="60">Give SSS (SICK SINUS SYNDROME) 3/5</option><option value="80" selected="selected">Give SSS (SICK SINUS SYNDROME) 4/5</option><option value="100">Give SSS (SICK SINUS SYNDROME) 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.7</span></span> <span class="total-votes">(<span >9</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--3" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-xissZKlEZVnuYxr4jXHhh1Wpi6eUqQ5P9dcQ1Ulan0U" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_3"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsss-sick-sinus-syndrome&amp;title=SSS%20%28SICK%20SINUS%20SYNDROME%29"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Thu, 03 Aug 2023 07:37:06 +0000 Dr A Röschl 862 at https://www.ecgguru.com https://www.ecgguru.com/blog/sss-sick-sinus-syndrome#comments Second-degree AV Block, Mobitz Type II https://www.ecgguru.com/blog/second-degree-av-block-mobitz-type-ii <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/second-degree-av-block-mobitz-type-ii"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/1_0.jpg" width="3063" height="1249" alt="" /></a></div><div class="field-item odd"><a href="/blog/second-degree-av-block-mobitz-type-ii"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/2_0.jpg" width="3061" height="1303" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p><span style="font-size: 10px;">We are observing EKG strip 1 in a Holter EKG recording; what can be said about it? There is a sinus rhythm with a normal PQ interval. After 3 sinus beats, a 2:1 AV block develops. When 2:1 AV block occurs, we should not refer to this as Wenckebach (Mobitz I) or Mobitz II, but rather as a high-grade AV block (other forms include: 3:1, 4:1, 5:1, etc.). The 2:1 block can be intranodally localized and behave benignly like a Wenckebach block typically does. However, it could also be infranodally localized with a potentially serious prognosis. Only EKG strip 2 allows us to make a precise diagnosis: here, the criteria for a Mobitz II block are met: sudden and unexpected failure of AV conduction with constant PP intervals (exception: ventriculophasic sinusarhrythmia), and PR intervals. Thus, a pacemaker indication is generally present here, unless there are remediable causes for the AV block. </span></p> <p><span style="font-size: 10px;">In general, it is important to note that the indication for a pacemaker must always be made in the context of all available facts and findings.</span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--4" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--8" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Second-degree AV Block, Mobitz Type II 1/5</option><option value="40">Give Second-degree AV Block, Mobitz Type II 2/5</option><option value="60">Give Second-degree AV Block, Mobitz Type II 3/5</option><option value="80">Give Second-degree AV Block, Mobitz Type II 4/5</option><option value="100">Give Second-degree AV Block, Mobitz Type II 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--4" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-vIDCEiQqbLKFUuXlLc22jAwUO43qSrIHr6i40z-XNb4" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_4"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fsecond-degree-av-block-mobitz-type-ii&amp;title=Second-degree%20AV%20Block%2C%20Mobitz%20Type%20II"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Wed, 02 Aug 2023 08:35:01 +0000 Dr A Röschl 860 at https://www.ecgguru.com https://www.ecgguru.com/blog/second-degree-av-block-mobitz-type-ii#comments ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs https://www.ecgguru.com/ecg/ecg-basics-paroxysmal-supraventricular-tachycardia-converting-sinus-pacs <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-paroxysmal-supraventricular-tachycardia-converting-sinus-pacs"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/169%20SVT%20to%20sinus%20w%20PACs.jpg" width="1800" height="247" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This strip shows a supraventricular tachycardia, rate 196 bpm, after adenosine was administered to the patient.&nbsp; The PSVT breaks, and an irregular rhythm composed of sinus beats and premature atrial contractions ensues.&nbsp; This is common after medical cardioversion. The patient later settled into a normal sinus rhythm.&nbsp; The abrupt change from a fast, regular rhythm to a slower, irregular rhythm is evidence that the tachycardia was due to a reentrant circuit, and not sinus tachycardia.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--5" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--10" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs 1/5</option><option value="40">Give ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs 2/5</option><option value="60">Give ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs 3/5</option><option value="80" selected="selected">Give ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs 4/5</option><option value="100">Give ECG Basics: Paroxysmal Supraventricular Tachycardia Converting to Sinus With PACs 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.3</span></span> <span class="total-votes">(<span >62</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--5" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-eMuMPgwfIYhwsiy51Fjbp8Sx0IJUmPD6-HtnH5jPcg4" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/psvt" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">PSVT</a></div><div class="field-item odd"><a href="/ecg/paroxysmal-supraventricular-tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Paroxysmal supraventricular tachycardia</a></div><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/premature-atrial-contraction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Premature atrial contraction</a></div><div class="field-item even"><a href="/ecg/pac" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">PAC</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_5"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-paroxysmal-supraventricular-tachycardia-converting-sinus-pacs&amp;title=ECG%20Basics%3A%20%20Paroxysmal%20Supraventricular%20Tachycardia%20Converting%20to%20Sinus%20With%20PACs"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Fri, 29 Oct 2021 21:20:52 +0000 Dawn 809 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-paroxysmal-supraventricular-tachycardia-converting-sinus-pacs#comments ECG Basics: Sinus Rhythm With Non-Conducted PACs https://www.ecgguru.com/ecg/ecg-basics-sinus-rhythm-non-conducted-pacs <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-sinus-rhythm-non-conducted-pacs"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Non%20cond%20PACs.jpg" width="2144" height="319" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This is a good strip to demonstrate the change in the appearance of a T wave when a premature P wave occurs on the preceding T wave.&nbsp; The PACs found the atria ready to depolarize and produced a P wave that landed on top of the preceding T wave, making it appear taller than the others.&nbsp; The PACs also reset the sinus node, causing a slight delay before the next sinus discharge.&nbsp; The PACs occurred while the ventricles were still refractory, so no QRS complexes followed.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--6" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--12" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Sinus Rhythm With Non-Conducted PACs 1/5</option><option value="40">Give ECG Basics: Sinus Rhythm With Non-Conducted PACs 2/5</option><option value="60">Give ECG Basics: Sinus Rhythm With Non-Conducted PACs 3/5</option><option value="80" selected="selected">Give ECG Basics: Sinus Rhythm With Non-Conducted PACs 4/5</option><option value="100">Give ECG Basics: Sinus Rhythm With Non-Conducted PACs 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.6</span></span> <span class="total-votes">(<span >27</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--6" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-J2ocJsUOhtv3gWECahVm66w4NDcxOZJDXZZy8gAqywU" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/premature-atrial-contraction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Premature atrial contraction</a></div><div class="field-item even"><a href="/ecg/non-conducted-premature-atrial-contractions" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Non-conducted premature atrial contractions</a></div><div class="field-item odd"><a href="/ecg/non-conducted-pacs" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Non-conducted PACs</a></div><div class="field-item even"><a href="/ecg/pac" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">PAC</a></div><div class="field-item odd"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item even"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_6"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-sinus-rhythm-non-conducted-pacs&amp;title=ECG%20Basics%3A%20Sinus%20Rhythm%20With%20Non-Conducted%20PACs"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Fri, 01 Oct 2021 21:07:39 +0000 Dawn 803 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-sinus-rhythm-non-conducted-pacs#comments ECG Basics: Second-degree AV Block, Type II https://www.ecgguru.com/ecg/ecg-basics-second-degree-av-block-type-ii-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-second-degree-av-block-type-ii-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/167%20AVB%20Type%20II%203%20to%202.jpg" width="1398" height="279" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This rhythm strip was obtained from a man who was suffering an acute inferior wall M.I.&nbsp; There are ST elevation and hyperacute T waves.&nbsp; The rhythm is <strong>SINUS ARRHYTHMIA WITH SECOND-DEGREE AV BLOCK, TYPE II.&nbsp; &nbsp;</strong> There is also first-degree AV block.</p><p>There are more P waves than QRS complexes, with a 3:2 ratio.&nbsp; The atrial rate varies between 55 -68 beats per minute.&nbsp; The sinus rate speeds slightly after the dropped QRS in each group. The ventricular rate is about 40 bpm, with grouped beating. (Regularly irregular.)</p><p>The PR intervals are steady at 226 ms (slightly prolonged).</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--7" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--14" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Second-degree AV Block, Type II 1/5</option><option value="40">Give ECG Basics: Second-degree AV Block, Type II 2/5</option><option value="60">Give ECG Basics: Second-degree AV Block, Type II 3/5</option><option value="80" selected="selected">Give ECG Basics: Second-degree AV Block, Type II 4/5</option><option value="100">Give ECG Basics: Second-degree AV Block, Type II 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--7" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-zGnXsoe8Qc-5-m6dnYtTmSOUG8u7hn-57v2hhOnFr90" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/first-degree-av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">First-degree AV block</a></div><div class="field-item even"><a href="/ecg/sinus-arrhythmia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Sinus arrhythmia</a></div><div class="field-item odd"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/second-degree-av-block-type-ii" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Second-degree AV block Type II</a></div><div class="field-item even"><a href="/ecg/av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">AV Block</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_7"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-second-degree-av-block-type-ii-0&amp;title=ECG%20Basics%3A%20%20Second-degree%20AV%20Block%2C%20Type%20II%20"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Tue, 08 Dec 2020 21:31:26 +0000 Dawn 794 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-second-degree-av-block-type-ii-0#comments ECG Basics: Multifocal Atrial Tachycardia https://www.ecgguru.com/ecg/ecg-basics-multifocal-atrial-tachycardia <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-multifocal-atrial-tachycardia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/MAT%20strip%20edited_0.jpg" width="1800" height="414" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>Multifocal atrial tachycardia is diagosed when an irregular atrial rhythym is over 100 beats per minute.&nbsp; It is caused by multiple competing atrial pacemaker sites.&nbsp; There need to be at least three different P wave morphologies to diagnose MAT.&nbsp; The PR intervals may vary also.&nbsp; &nbsp;It is nearly always seen in very sick patients, often with chronic obstructive pulmonary disease and/or respiratory failure.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--8" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--16" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Multifocal Atrial Tachycardia 1/5</option><option value="40">Give ECG Basics: Multifocal Atrial Tachycardia 2/5</option><option value="60">Give ECG Basics: Multifocal Atrial Tachycardia 3/5</option><option value="80" selected="selected">Give ECG Basics: Multifocal Atrial Tachycardia 4/5</option><option value="100">Give ECG Basics: Multifocal Atrial Tachycardia 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.6</span></span> <span class="total-votes">(<span >9</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--8" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-liyZdvz3D8w_bVLIwteGGywznoTcjygkeaKdzD4_EAs" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/multifocal-atrial-tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Multifocal atrial tachycardia</a></div><div class="field-item odd"><a href="/ecg/mat" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">MAT</a></div><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item even"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_8"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-multifocal-atrial-tachycardia&amp;title=ECG%20Basics%3A%20%20Multifocal%20Atrial%20Tachycardia"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Mon, 04 May 2020 02:22:37 +0000 Dawn 784 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-multifocal-atrial-tachycardia#comments ECG Basics: 2:1 AV Block https://www.ecgguru.com/ecg/ecg-basics-21-av-block <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-21-av-block"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/AVB%202%20to%201%20----0.jpg" width="2066" height="330" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>Second-degree AV block can either be Type I (Wenckebach) or Type II.&nbsp; In either case, some P waves are conducted to the ventricles, and some are not. Type I blocks usually occur in the AV node, and are often benign. Type II blocks are more often "sub-Hisian", or fascicular blocks, and are more likely to progress to higher levels of AV block and bradycardia.&nbsp; When a second-degree AVB is conducted in a 2:1 ratio, it is difficult to differentiate Type I from Type II.&nbsp; Features that favor the diagnosis of Type I are narrow QRS complex and the non-conducted P waves land on the previous T waves - during the refractory period of the ventricles.</p><p>Type II blocks are more likely to have a wide QRS with a bundle branch block morphology.&nbsp; That is because Type II blocks often reflect serious fascicular disease.&nbsp; A typical Type II block is a persistent bifascicular block (ex: RBBB and left anterior hemiblock)) with an <strong>intermittent </strong>block in the third fascicle.&nbsp; Another way to think of it is an intermittent tri-fascicular block. If that one remaining fascicle stops conducting, the patient will be in complete heart block.</p><p>Signs of Type II blocks include the wide QRS and also two or more non-conducted P waves in a row.&nbsp; Also, P waves that are "out in the open", away from the refractory period, but fail to conduct are an ominous sign.</p><p><span style="font-size: 13.008px;">One strategy for reacting to a 2:1 block is to first assess the ventricular rate (54 bpm in this example).&nbsp; Determine if it is adequate for the patient's hemodynamic stability.&nbsp; If not, act to increase the rate.&nbsp; Otherwise, it may be prudent in the stable patient to watch the rhythm strips for a while.&nbsp; Sometimes, two p waves in a row will conduct - unmasking either progressive prolongation of the PR interval (Type I) or stable PR intervals (Type II).&nbsp;</span></p><p><span style="font-size: 13.008px;">The patient in this example was having an inferior wall M.I.&nbsp; The ST elevation will not always show up on a monitor strip, as it does here.&nbsp; A 12-lead ECG is the minimum standard for evaluating for coronary artery disease and acute M.I.&nbsp; It is possible that the 2:1 block will disappear when the atrial rate (about 108 here) is slowed.</span></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--9" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--18" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: 2:1 AV Block 1/5</option><option value="40">Give ECG Basics: 2:1 AV Block 2/5</option><option value="60">Give ECG Basics: 2:1 AV Block 3/5</option><option value="80" selected="selected">Give ECG Basics: 2:1 AV Block 4/5</option><option value="100">Give ECG Basics: 2:1 AV Block 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.5</span></span> <span class="total-votes">(<span >2</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--9" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-kjI2utFEBd56yPqvIK2urBP-ArnHyXFWjp_WrO2dqO0" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/21-av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">2:1 AV block</a></div><div class="field-item odd"><a href="/ecg/av-block-and-st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">AV block and ST elevation</a></div><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/av-block" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">AV Block</a></div><div class="field-item even"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div><div class="field-item odd"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_9"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-21-av-block&amp;title=ECG%20Basics%3A%202%3A1%20AV%20Block"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Fri, 07 Jun 2019 21:48:59 +0000 Dawn 770 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-21-av-block#comments ECG Basics: Ventricular Tachycardia https://www.ecgguru.com/ecg/ecg-basics-ventricular-tachycardia-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-ventricular-tachycardia-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/165%20V%20Tach.jpg" width="1938" height="338" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>V tach is identified by:&nbsp; wide QRS complexes (&gt;.12 seconds), rate faster than 100 bpm.&nbsp; In MONOMORPHIC V tach, all QRS complexes look alike.&nbsp; There are other mechanisms of wide-complex tachycardia, but they can be difficult to differentiate from a single rhythm strip.&nbsp; All WCT should be treated as V tach until proven otherwise.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/383/feed" method="post" id="fivestar-custom-widget--10" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--20" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Ventricular Tachycardia 1/5</option><option value="40">Give ECG Basics: Ventricular Tachycardia 2/5</option><option value="60">Give ECG Basics: Ventricular Tachycardia 3/5</option><option value="80" selected="selected">Give ECG Basics: Ventricular Tachycardia 4/5</option><option value="100">Give ECG Basics: Ventricular Tachycardia 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >4</span></span> <span class="total-votes">(<span >2</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--10" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-sAJx4tFLSXd-NKC329564eMEl9gD3Rpikbf6hYyBIaU" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/wide-complex-tachycardia-0" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Wide-complex tachycardia</a></div><div class="field-item odd"><a href="/ecg/wct" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">WCT</a></div><div class="field-item even"><a href="/ecg/ventricular-tachycardia" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Ventricular tachycardia</a></div><div class="field-item odd"><a href="/ecg/vt" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">VT</a></div><div class="field-item even"><a href="/ecg/rhythm-strip" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Rhythm strip</a></div><div class="field-item odd"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item even"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_10"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-ventricular-tachycardia-0&amp;title=ECG%20Basics%3A%20%20Ventricular%20Tachycardia"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Wed, 20 Dec 2017 21:00:14 +0000 Dawn 749 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-ventricular-tachycardia-0#comments