ECG Blog #104 (My ECG Guru Comments-2) - AV Blocks/AV Dissociation

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As a source of tracings for practice and/or teaching — I have decided to LINK many of the ECGs I have commented on as Contributing Expert for ECG Guru (www.ecgguru.com). 

• NOTE: The ECG Guru is dedicated to providing free resources for ECG Teachers and their Students. Search the ECG Guru site if you ever are in need of cases on a particular subject.

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Regarding My Comments on the ECG Guru:

• ECG Blog #103 — Acute MI ECGs (Comments #848; 838; 823; 819; 801 ).
• ECG Blog # 104 (Comments #828; 836) — AV Blocks/AV Dissociation.
•    ECG Blog #105 — AV Block Basics Video (www.avblockecg.com).
• ECG Blog #123 — LINKS to My ECG Guru Posts (Volume-1).
• ECG Blog #124 — Using a Normal ECG for Teaching (ECG Guru).

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ECG for Comment #828 — on the ECG Guru (Instructor Collection — posted 9/16/2014):

This ECG was obtained from an 84-year old man who became dizzy and fell. He was not injured in the fall. Subsequent ECGs showed progressive slowing that clearly required insertion of a pacemaker.

• How would you interpret this 12-lead ECG — given that this 84-year old man presented with syncope?
• Is there complete AV Block?
• Is there complete AV Dissociation? Are you certain?
• What happens at the end of this 12-lead ECG?

Figure-1: ECG obtained from an 84-year old man admitted for syncope. (Our gratitude to Sebastian Garay for use of this case and all tracings.).

• For My Interpretation — See ECG Guru Comment-828.

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ECG for Comment #836 — on the ECG Guru (Instructor Collection — posted 11/4/2014):

This ECG was obtained from an 62-year old man. Unfortunately, there is no clinical information available.

• How would you interpret this 12-lead ECG and long lead II rhythm strip? 
• Can you explain why the rhythm is irregular? (HINT — Why did I place this tracing with my ECG Guru Comments about AV block?)
• Can you explain the change in QRS morphology?

Figure-1: ECG obtained from an 62-year old man.  No history available ...

• For My Interpretation — See ECG Guru Comment-836.

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