The PR interval progressively lengthens with each beat until the atrial impulse is not conducted and the QRS complex is dropped (Wenckebach phenomenon); AV nodal conduction resumes with the next beat, and the sequence is repeated.

The PR interval progressively lengthens with each beat until the atrial impulse is not conducted and the QRS complex is dropped (Wenckebach phenomenon); AV nodal conduction resumes with the next beat, and the sequence is repeated.

We therefore interpret this tracing as showing “AV dissociation” – since at least some P waves are unrelated to the QRS complexes that follow them. The term AV dissociation should never be used as a “diagnosis” per se.  Instead – it is the result of the underlying rhythm on the tracing.  In this case – the underlying rhythm is sinus bradycardia at a rate of 50/minute (the P-P interval is precisely 6 large boxes in duration for each of the P waves on this tracing). AV dissociation occurs by…

We therefore interpret this tracing as showing “AV dissociation” – since at least some P waves are unrelated to the QRS complexes that follow them. The term AV dissociation should never be used as a “diagnosis” per se. Instead – it is the result of the underlying rhythm on the tracing. In this case – the underlying rhythm is sinus bradycardia at a rate of 50/minute (the P-P interval is precisely 6 large boxes in duration for each of the P waves on this tracing). AV dissociation occurs by…

This rhythm reflects Mobitz Type I AV block or Wenkebach, which is not usually secondary to structural abnormalities when the QRS complex is narrow, but is vagally mediated instead. Increased vagal tone occurs in the young or the athletic with frequencies ranging from 2 to 10%. No treatment is necessary unless the patient is symptomatic.

This rhythm reflects Mobitz Type I AV block or Wenkebach, which is not usually secondary to structural abnormalities when the QRS complex is narrow, but is vagally mediated instead. Increased vagal tone occurs in the young or the athletic with frequencies ranging from 2 to 10%. No treatment is necessary unless the patient is symptomatic.

3rd-degree-AV-block

3rd-degree-AV-block

QRS Complex illustration

QRS Complex illustration

ER RN : Photo

ER RN : Photo

Ventricular fabrilation - no identifiable p waves- QRS complex -or T waves

Ventricular fabrilation - no identifiable p waves- QRS complex -or T waves

Right ventricular hypertrophy occurs mainly in lung disease or in congenital heart disease. The ECG shows a negative QRS complex in I (and thus a right heart axis) and a positive QRS complex in V1.  QRS duration < 120ms Right heart axis (> 110 degrees) Dominant R wave: R/S ratio in V1 or V3R > 1, or R/S ratio in V5 or V6 <= 1 R wave in V1 >= 7 mm R wave in V1 + S wave in V5 or V6 > 10.5 mm rSR= in V1 with R'= > 10 mm qR complex in V1 Secondary ST-T changes in right precordial leads Right…

Right ventricular hypertrophy occurs mainly in lung disease or in congenital heart disease. The ECG shows a negative QRS complex in I (and thus a right heart axis) and a positive QRS complex in V1. QRS duration < 120ms Right heart axis (> 110 degrees) Dominant R wave: R/S ratio in V1 or V3R > 1, or R/S ratio in V5 or V6 <= 1 R wave in V1 >= 7 mm R wave in V1 + S wave in V5 or V6 > 10.5 mm rSR= in V1 with R'= > 10 mm qR complex in V1 Secondary ST-T changes in right precordial leads Right…

Atrial Flutter with a 3 flutter wave to 1 QRS conduction A-flutter is very similar in nature to that of A-fib. Instead of merely quivering, instead the Atria are contracting very rapidly. This can also result in RVR. Additionally A-flutter can be regular or irregular. Before each QRS complex will be at least one flutter wave, sometimes many more. A flutter wave is similar to a P-wave except that often times there will be a varying amount of them.

Atrial Flutter with a 3 flutter wave to 1 QRS conduction A-flutter is very similar in nature to that of A-fib. Instead of merely quivering, instead the Atria are contracting very rapidly. This can also result in RVR. Additionally A-flutter can be regular or irregular. Before each QRS complex will be at least one flutter wave, sometimes many more. A flutter wave is similar to a P-wave except that often times there will be a varying amount of them.

Right Bundle Branch Block | EMS 12-Lead. All of these QRS complexes are different. Most are positively deflected but some are negatively deflected. Most start with an R wave, but a few start with a Q wave. However, they all share one important feature. They all have a terminal R wave! Why? Ask yourself a question. If the right bundle branch is blocked, which ventricle depolarizes first? The left ventricle! So which ventricle depolarizes last? The right ventricle! What is the only precordial…

Right Bundle Branch Block | EMS 12-Lead. All of these QRS complexes are different. Most are positively deflected but some are negatively deflected. Most start with an R wave, but a few start with a Q wave. However, they all share one important feature. They all have a terminal R wave! Why? Ask yourself a question. If the right bundle branch is blocked, which ventricle depolarizes first? The left ventricle! So which ventricle depolarizes last? The right ventricle! What is the only precordial…

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