This rhythm strip was obtained from a man who was suffering an acute inferior wall M.I. There are ST elevation and hyperacute T waves. The rhythm is SINUS ARRHYTHMIA WITH SECOND-DEGREE AV BLOCK, TYPE II. There is also first-degree AV block.
There are more P waves than QRS complexes, with a 3:2 ratio. The atrial rate varies between 55 -68 beats per minute. The sinus rate speeds slightly after the dropped QRS in each group. The ventricular rate is about 40 bpm, with grouped beating. (Regularly irregular.)
The PR intervals are steady at 226 ms (slightly prolonged).
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One Characteristic to Clinch the Diagnosis
With a Mobitz II AV block, the PR interval that immediately precedes the non-conducted P wave and the PR interval that immediately follows it should be equal.
Jerry W. Jones MD FACEP FAAEM
https://www.medicusofhouston.com
Twitter: @jwjmd
Thank you!
Thanks, Dr. Jones.
Dawn Altman, Admin