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EKG Interpretation Continued: Heart Blocks & Paced Rhythms

Heart Blocks: · Most commonly effect the AV junction · The impulse is either slowed at the AV junction or stopped at the AV junction

1st Degree Heart Block

The impulse is delayed at the AV junction Results in a prolonged PR interval > 0.20 QRS conducts in normal fashion

2nd Degree Heart Block Type I

Mobitz Type 1; Wenckebach Characterized by a progressively increasing, abnormally long delay at the AV node. Causes a longer and longer PR interval, until no QRS complex is conducted

1

2nd Degree Type II Heart Block

Mobitz Type II Intermittent block at the AV node that conducts some QRS's normally, but blocks other QRS's completely. This rhythm is considered dangerous enough to indicate a pacemaker.

3rd Degree Heart Block

Complete Heart Block No communication between the atria and the ventricles P waves are generated in a regular rhythm by the atria, QRS complexes are generated in a regular rhythm by the ventricles, BUT there is no orchestration between the P's and QRS's

Bundle Branch Block

Delay in conduction through one or both of the bundle branches Results in a QRS longer than 0.12 seconds Differentiate from ventricular beats because there is a P wave Often no treatment is necessary.

2

Paced Rhythms

Pacemaker spikes appear as a vertical spike before the p or qrs Pacemaker beats are very often wide and distorted

Atrial

Ventricular

Dual

3

Information

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