Heart block

  1. Can someome please explain to me a easy way to tell the difference between the different heart blocks thank you.
  2. Visit cns121 profile page

    About cns121

    Joined: Dec '11; Posts: 30; Likes: 6


  3. by   Do-over
    AV blocks? Lets see what I know...

    First degree = PR interval >.20 and consistent

    Mobitz I (wenckebach) = PR interval progressively longer until a QRS complex is dropped, then the cycle starts over (long, longer, longest, dropped - then you've got a wenchebach). P-P and R-R are irregular.

    Mobitz II = intermittent non-conducted P waves... So, I BELIEVE that P-P is regular, while the R-R is irregular. Bad.

    Third degree = P-P regular, R-R regular, but the PR interval changes - no association between the P wave and the QRS complex. Really bad.

    BBB? QRS complex >0.10.

    Thats all I got..
  4. by   Do-over
    Oh, and the rate is generally brady on the types 2 and 3, in my experience...
  5. by   VickyRN
    This is an awesome resource: http://www.icufaqs.org/LastHeartBlock.doc
  6. by   cns121
    Thank you everyone for the information.
  7. by   turnforthenurse
    A first degree block has a PR interval >0.20. Pretty much benign but in rare cases will progress to a higher block.

    Long, longer, drop.....you have a Wenckebach (Mobitz I). The PR interval gets longer and longer and then you have a missed beat.

    If your P's don't always go through, then you have a Mobitz II. Here, the PR interval stays the same, then you will see a P wave without a QRS.

    If your P's and Q's don't agree, you've got yourself a Third Degree. Also known as AV-dissocation. The P waves and QRS complexes are doing their own thing - think of the P's and QRS complexes as "no longer being married to each other."

    Bundle branch blocks have a widened QRS complex, but you really need to do a 12-lead to confirm if it is a left or right BBB.