ECG Video Blog #404 (344) — Mobitz I, Mobitz II ... or neither?

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 — CLICK HERE — for a Video presentation of this case! (15 minutes)

• Below are slides used in my video presentation.
• For full discussion of this case — See ECG Blog #344 —

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How would YOU interpret the lead II rhythm strip shown in Figure-1?

• Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? 
• Or — Is it “something else”?

Figure-1: How would YOU interpret this lead II rhythm strip?

Figure: The Ps, Qs, 3R Approach to Rhythm Interpretation.

Figure: It does not matter in what sequence you assess the 5 Parameters (and I often change the sequence, depending on the rhythm ... ).

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Figure: Let's for the moment forget about beats #1 and 2 ...

Figure: 1st-degree AV Block — is simply a sinus rhythm with a long PR interval (ie, more than 1 large box in duration = >0.20 second).

Figure: The 3 types of 2nd-degree AV block.

Figure: 2nd-degree AV block with 2:1 AV conduction.

Figure: 3rd-degree AV block with ventricular escape.

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Additional Material on Today's CASE:

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ECG Media PEARL #4 (4:30 minutes Audio): — takes a brief look at the AV Blocks — and focuses on WHEN to suspect Mobitz I.

• Section 2F (6 pages = the "short" Answer) from my ECG-2014 Pocket Brain book provides quick written review of the AV Blocks (This is a free download).
• Section 20 (54 pages = the "long" Answer) from my ACLS-2013-Arrhythmias Expanded Version provides detailed discussion of WHAT the AV Blocks are — and what they are not! (This is a free download).

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Related ECG Blog Posts to Today’s Case: 

• ECG Blog #185 — Review of the Ps, Qs, 3R Approach for systematic rhythm interpretation.
• ECG Blog #188 — Reviews how to read and draw Laddergrams (with LINKS to more than 50 laddergram cases — many with step-by-step sequential illustration).
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• ECG Blog #164 — Which reviews step-by-step the diagnosis of a Mobitz I 2nd-degree AV block (with sequential laddergram illustration).
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• ECG Blog #168 — A complex dual-level AV Wenckebach (Laddergram).
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• ECG Blog #154 and ECG Blog #55 and ECG Blog #224 and ECG Blog #232 — Acute MI with AV Wenckebach.
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• ECG Blog #63 — Mobitz I with Junctional Escape Beats.