ECG Quiz 39
|ECG Quiz 39
Though there is superficial resemblance to 2:1 AV block, it is actually complete AV block as illustrated in the lead II rhythm strip at the bottom of the tracing. All the four criteria for complete heart block on ECG are satisfied:
- Regular PP interval
- Regular RR interval
- PP interval shorter than RR interval (atrial rate higher than ventricular rate)
- Totally varying PR interval
Narrow QRS escape rhythm indicates that the level of the block is above the His bundle (supra Hisian block). A good ventricular rate and supra Hisian block in this ECG from a child are features of congenital complete heart block. T wave inversion in anterior leads could be a juvenile pattern. If it is seen in an adult with an Infra Hisian block it would suggest a recent Stokes-Adam attack and consequent hypoxia. In that case one would expect much broader T wave inversions with a prolonged QT interval.