{"id":5248,"date":"2010-09-10T12:37:15","date_gmt":"2010-09-10T12:37:15","guid":{"rendered":"http:\/\/cardiophile.org\/?p=5248"},"modified":"2023-10-17T06:11:10","modified_gmt":"2023-10-17T00:41:10","slug":"21-av-block-and-right-ventricular-hypertrophy","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/21-av-block-and-right-ventricular-hypertrophy\/","title":{"rendered":"2:1 AV Block and Right Ventricular Hypertrophy"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/9a7YlZxFeMc?si=6Dzud5gaQIPzyZt8\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">2:1 AV block and right ventricular hypertrophy<\/span><\/h2>\n<figure id=\"attachment_36744\" aria-describedby=\"caption-attachment-36744\" style=\"width: 2477px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-36744\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2010\/09\/2-1-AV-block-and-right-ventricular-hypertrophy.png\" alt=\"2:1 AV block and right ventricular hypertrophy\" width=\"2477\" height=\"675\" \/><figcaption id=\"caption-attachment-36744\" class=\"wp-caption-text\"><span style=\"color: #0000ff;\"><strong>2:1 AV block and right ventricular hypertrophy<\/strong><\/span><\/figcaption><\/figure>\n<p>There are regular P waves at a rate twice that of QRS complexes, indicating 2:1 AV block (or 2:1 AV conduction). P waves are sharp in lead II, suggesting <a href=\"https:\/\/johnsonfrancis.org\/professional\/right-atrial-overload-and-right-ventricular-hypertrophy\/\">right atrial overload<\/a>, which is also manifest as prominent positive deflection of P wave in V1. There is extreme right axis deviation with negative QRS complexes in lead I and aVF as well as positive QRS complexes in aVr. Prominent R waves in V1 and the right axis deviation are due to right ventricular hypertrophy. T wave inversion in V1 to V3 are possibly due to right ventricular strain. Another possibility which has to be considered is postanoxic T wave inversions which can occur after a Stokes &#8211; Adam attack which can occur due to intermittent complete heart block.<\/p>\n<p>A combination of right bundle branch block and right posterior hemiblock can also produce a similar QRS pattern, but the QRS width will be more in that case. Endocardial cushion defects can be considered in the etiology as such a situation can occur if there is AV block and pulmonary hypertension due to a ventricular septal defect. L-transposition may also be thought of as there is a small q wave in V1 while there were none in V6, though not captured in this image. But the q in V1 can very well be explained by right ventricular hypertrophy.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECG demonstrating 2:1 AV block and right ventricular hypertrophy.<\/p>\n","protected":false},"author":1,"featured_media":36744,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[40,2954,3349,3386],"class_list":["post-5248","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library","tag-21-av-block","tag-postanoxic-t-wave-inversions","tag-right-atrial-overload","tag-right-ventricular-hypertrophy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>2:1 AV block and right ventricular hypertrophy<\/title>\n<meta name=\"description\" content=\"ECG demonstrating 2:1 AV block and right ventricular hypertrophy. The atrial rate is double that of ventricular rate. Extreme right axis deviation is seen.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/21-av-block-and-right-ventricular-hypertrophy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"2:1 AV block and right ventricular hypertrophy\" \/>\n<meta property=\"og:description\" content=\"ECG demonstrating 2:1 AV block and right ventricular hypertrophy. The atrial rate is double that of ventricular rate. 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