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Heart Block

This document summarizes different types of heart block based on ECG findings. It describes first degree AV block where the PR interval is prolonged but every P wave is followed by a QRS complex. It then describes three types of second degree heart block: Mobitz type 1 where the PR interval gradually prolongs before a blocked P wave; Mobitz type 2 where the PR interval remains fixed; and advanced or high grade block where 2 or more P waves are not conducted. Complete heart block is described as a failure of P waves to conduct resulting in dissociation of P waves and QRS complexes.

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239 views17 pages

Heart Block

This document summarizes different types of heart block based on ECG findings. It describes first degree AV block where the PR interval is prolonged but every P wave is followed by a QRS complex. It then describes three types of second degree heart block: Mobitz type 1 where the PR interval gradually prolongs before a blocked P wave; Mobitz type 2 where the PR interval remains fixed; and advanced or high grade block where 2 or more P waves are not conducted. Complete heart block is described as a failure of P waves to conduct resulting in dissociation of P waves and QRS complexes.

Uploaded by

litan das
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

ECG Approach to Heart

Block
Dr. Shirshendu Dhar
M.D Emergency Medicine
Dept of EM
AGMC & GBP Hospital
Atrio-ventricular Conduction System
First Degree AV Block
• The PR interval is prolonged and measures >0.20 seconds

• Every P wave is followed by a QRS complex


1st Degree AV Block
Second Degree AV Block
• Three Types:-

• Mobitz Type 1

• Mobitz Type 2

• Advanced or High Grade AV Block


Type 1 Second Degree AV Block
• Two or more consecutive P waves are conducted
• Only single P waves are blocked
• There is gradual prolongation of the PR interval before a ventricular
complex is dropped
• The PR interval always shortens immediately after the pause
• The QRS complexes are usually narrow
• Group beating is present
• The R-R intervals are variable
Mobitz Type 1
Mobitz Type 1
Type 2 Second Degree AV Block
• Two or more consecutive P aves are conducted

• Only single P waves are blocked

• The PR intervals are fixed and do not vary. The PR interval does not
prolong before or shorten after the pause

• The QRS complexes are wide due to the presence of bundle branch block

• The R-R intervals are fixed.


Mobitz Type 2
Mobitz Type 2
Advanced or High Grade AV Block
• It is a form of 2nd degree Heart block where 2 or more consecutive p
waves are not conducted as in 3:1, 4:1.

• The QRS complex may be narrow or wide.

• The long pause are often terminated by escape beats.


High Grade AV Block
Complete Heart Block
• Complete failure of atrial impulse to capture the ventricles

• Only P waves will be present, unless an escape rhythm comes to


rescue

• The escape rhythm can be narrow or wide

• The P waves and the QRS complexes are completely dissociated


Complete Heart Block
Heart Rate <60/min

A<V
A=V A>V

P Wave Present
PR Interval PR Interval PR Interval PR Interval QRS width
Sinus Node
Normal Prolonged Constant Variable Dysfunction

Narrow Wide
Sinus 1 Degree AV
st
Mobitz Type 2 R-R Interval Idioventricular
Junctional Rhythm
Bradycardia Block Rhythm

• A = P wave
Variable
• V=QRS complex Mobitz Type
Constant
Complete Heart
1 Block
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