Dawn recently posted an ECG with a 3rd degree AVB and an escape rhythm with narrow QRS complexes (junctional escape rhythm or escape rhythm from the area of the His bundle).
In addition, my ECG today is about a 78-year-old man with DCM who has noticed a significant increase in his existing shortness of breath over the last few days.
The ECG shows 2 different rhythms that are independent of each other (as you would expect from a third-degree AV block). The atrial rate is approx. 70-75 bpm, whereby it is slightly higher when a QRS complex appears between 2 P waves than when this is not the case (ventriculophasic sinus arrhythmia). The ventricular rate is slow, approx. 33 bpm. The QRS complexes are broad and have the shape of an LBBB. The ventricular escape rhythm, that is clearly present here, is interrupted by a ventricular couplet.
If there is no treatable cause, this finding results in a clear indication for a pacemaker (2-chamber pacemaker)