ECG of the Week - 2nd May 2016 - Interpretation

This ECG is from a 76 yr old male who presented to his GP with exertional dysponea. Past medical history of hypertension.

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Rate:

• Atrial rate 84 bpm
• Ventricular rate 42 bpm

Rhythm:

• Regular atrial activity
• Regular ventricular activity
• 2:1 Pattern

Axis:

• Normal (-33 deg)

Intervals:

• PR - Normal (~200ms) - when conducted
• QRS - Normal (100ms)
• QT - 450ms

Segments:

• Nil significant changes

Additional:

• Relatively large T waves in leads II, aVF, V3 when compared with QRS voltage

Interpretation:

• 2:1 AV Block

What happened ?

The patient was admitted under the cardiology team, nil reversible causes were identified. During monitoring the patient had runs of Mobitz II 2nd Degree AV block and underwent an uneventful pacemaker insertion.

References / Further Reading

Life in the Fast Lane

• 2nd Degree AV Block - Mobitz II
• 2:1 AV Block

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.