tag:blogger.com,1999:blog-3364570834099131201.post3164673217363912811..comments2024-03-23T08:57:50.965-04:00Comments on ECG Interpretation: ECG Interpretation Review #55 (Mobitz I - Mobitz II - AV Block - Acute MI - STEMI - Chest Pain - Group)ECG Interpretationhttp://www.blogger.com/profile/02309020028961384995noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-3364570834099131201.post-21392066238734394342015-08-14T16:44:38.202-04:002015-08-14T16:44:38.202-04:00@ Mostafa — 2nd-Degree AV Block, Mobitz Type I ( =...@ Mostafa — 2nd-Degree AV Block, Mobitz Type I ( = AV Wenckebach) typically manifests the "Footprints of Wenckebach". Among these are group beating; regular atrial rate; progressively decreasing R-R interval until the beat is dropped; PR/RP reciprocity — and the pause containing the dropped beat being less than twice the shortest R-R interval. Note all cases manifest each of the "footprints" — but being aware of them helps facilitate identification of AV Wenckebach. Typically — the greatest increment (difference) in PR interval is between the 1st and 2nd beat in a sequence. The fact that the greatest increment tends to occur between the 1st and 2nd beats in any sequence tends to make this first R-R interval longer than other R-R intervals. You are correct that there is irregularity with Wenckebach (as long as it is not strict 2:1) — but rather than the "irregular irregularity" that is seen with AFib — with Wenckebach there are GROUPS of beats with a REGULAR irregularity ( = patterned beating) — and this feature IS well seen in the above case.<br /><br />Please note that some of the above "footprints" are subtle and advanced concepts. But GROUP beating is important and easy to recognize — and you should be able to easily see it in this case if you step back a little bit from the tracing.<br /><br />I have developed an hour-long ECG Video on the Basics of AV Blocks (www.avblockecg.com). The link below takes you to 30:09 in this video, which is where I begin to discuss the 2nd-Degree forms of AV Block. Very soon thereafter I get into how to recognize the above "Footprints" of Wenckebach. Please try to watch this video! THANKS of your interest!<br /><br />— https://youtu.be/Ih5a1ER2umI?t=30m9s —ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-29437244865854784412015-08-14T07:21:43.405-04:002015-08-14T07:21:43.405-04:00I don't understand this point (Progressive dec...I don't understand this point (Progressive decrease in the R-R interval within groups (because the greatest increment in PR interval is usually between the first and second beats in any one group) <br />The rhythm will be irregular irregular according to this point ?<br />How the greatest increment in PR intevral between 1st and 2nd beat Anonymoushttps://www.blogger.com/profile/06475696764299734880noreply@blogger.com