EKG/ ECG help

sleepyRN2 · Aug 27, 2009

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

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

SpaceCoastRN · Aug 27, 2009

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).

TiffyRN, BSN, PhD · Aug 27, 2009

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.

ozmalenursie · Aug 27, 2009

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.

cindyford · Aug 27, 2009

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

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dmc_rrt · Aug 27, 2009

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.