This ECG was obtained from an 84-year-old woman who was scheduled for surgery. When the anesthesiologist did this ECG, the surgery was cancelled. It is a very good example of fascicular-level blocks.
Second-degree AV block Type II
Just like other subjects we are taught in school, ECG interpretation is usually taught in a very basic, simplistic way. As we add to our knowledge, we are able to determine the mechanisms of more complex rhythms.
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
Unfortunately, I have no available clinical data on this patient. Merely looking for an interpretation of the ECG in it's raw form.
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
APBs = atrial premature beats
RBBB = right bundle-branch block
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