EKG/ ECG help

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Specializes in med-surg.

Hi I have an EKG i am trying to determine if it is wenckebach or 3rd degree heart block but after hours of searching sites I am still confused, is there some one i can email it two for a little help clarifying this? help!!!!!!!!! please!!!!!

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here's an excellent youtube video which explains how to differentiate av blocks:

http://www.youtube.com/watch?v=vKQlaAlejC4

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Specializes in Emergency Department/Trauma.

Just march out your PR intervals. If they are getting progressively longer until there is a missing QRS, you have a 2nd degree Mobitz 1. If the P waves are disassociated from the QRS (P waves are regular, and QRS complexes are regular but both doing their own thing) you have 3rd degree (complete heart block, AV disassociation or any of the terms you prefer to call it).

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Specializes in Nurse Scientist-Research.

From what I remember, and I guess I could wrong, wenckebach is irregular, and 3rd degree AV block is typically regular. There are many other particulars, but that is the easiest fast way to differentiate the two. This is assuming the patient doesn't have any other additional ectopic beats as well.

For myself, 3rd degree AV block other than being slow; looks "neat and tidy" until you start dissecting the P's and QRS's, then you realize, there is big trouble. Wenkebach looks messy, but ironically enough can be relatively benign to a patient, whereas 3rd degree block is considered a lethal rhythm.

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Specializes in med-surg.

Thanks All,that you tube video nailed it for me, i knew my R-r intervals were constant, pr intervals were variable , but wasn't sure how to define it.

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thank for your forum. this forum is very interesting. i want to make friends with anyone in this forum.:heartbeat

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A third degree heart block is when the P waves are at regular intervals of each other and the QRS are at regular intervals with each other, but the P waves and QRS are not in sync with each other.

Wenchebach is noticable by the PR intervals becoming longer and longer until finally the P wave is dropped, the the PR interval elongation seems to start over again.

Hope this is clear enough for you.

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