FireMedic65 Posted June 4, 2009 Share Posted June 4, 2009 you should clean that stove top Nice strip though, it had me thinking for a moment when I first looked at it myself. Link to comment Share on other sites More sharing options...
ERDoc Posted June 4, 2009 Share Posted June 4, 2009 I agree that the 12 lead shows a 3rd degree block, but the rhythm strip is a 2:1 block. You can't call it a Mobitz 2 because every other beat is dropped so you cannot compare the PR inverals of subsequent beats. Link to comment Share on other sites More sharing options...
mobey Posted June 4, 2009 Author Share Posted June 4, 2009 I agree that the 12 lead shows a 3rd degree block, but the rhythm strip is a 2:1 block. You can't call it a Mobitz 2 because every other beat is dropped so you cannot compare the PR inverals of subsequent beats. Sorry Doc.... I'm confused Isn't every other beat dropped the textbook description of Mobitz II (Classical 2nd degree HB)? Are you thinking of a 2nd degree type 1 (Wenchibach)? Link to comment Share on other sites More sharing options...
ERDoc Posted June 4, 2009 Share Posted June 4, 2009 Nope. With a 2nd degree, type 1 (wenkebach) you have a PR interval that gets longer and longer from beat to beat until you drop a QRS. With a 2nd degree, type 2 you have a constant PR interval with occasional dropped beats. With a 2:1 block you do not have enough sequential beats before the dropped beat to determine if the PR is constant or getting longer. http://library.med.utah.edu/kw/ecg/ecg_out...x.html#AV_block Link to comment Share on other sites More sharing options...
chbare Posted June 4, 2009 Share Posted June 4, 2009 Nope. With a 2nd degree, type 1 (wenkebach) you have a PR interval that gets longer and longer from beat to beat until you drop a QRS. With a 2nd degree, type 2 you have a constant PR interval with occasional dropped beats. With a 2:1 block you do not have enough sequential beats before the dropped beat to determine if the PR is constant or getting longer. http://library.med.utah.edu/kw/ecg/ecg_out...x.html#AV_block You are correct, my ECG FU is weak. Technically, an isolated 2:1 block cannot be reliably associated with a Mobitz I or II pathology because you only have one PRI. Some people may call a 2:1 a high grade 2nd degree block. Take care, chbare. Link to comment Share on other sites More sharing options...
mobey Posted June 5, 2009 Author Share Posted June 5, 2009 Nope. With a 2nd degree, type 1 (wenkebach) you have a PR interval that gets longer and longer from beat to beat until you drop a QRS. With a 2nd degree, type 2 you have a constant PR interval with occasional dropped beats. With a 2:1 block you do not have enough sequential beats before the dropped beat to determine if the PR is constant or getting longer. http://library.med.utah.edu/kw/ecg/ecg_out...x.html#AV_block Ahhhhh....... Thanx Doc, never thought of it that way Link to comment Share on other sites More sharing options...
Mateo_1387 Posted June 5, 2009 Share Posted June 5, 2009 Nope. With a 2nd degree, type 1 (wenkebach) you have a PR interval that gets longer and longer from beat to beat until you drop a QRS. With a 2nd degree, type 2 you have a constant PR interval with occasional dropped beats. With a 2:1 block you do not have enough sequential beats before the dropped beat to determine if the PR is constant or getting longer. http://library.med.utah.edu/kw/ecg/ecg_out...x.html#AV_block Would you be able to tell by the width of the QRS? Type 1 narrow and type 2 wide QRS. Link to comment Share on other sites More sharing options...
chbare Posted June 5, 2009 Share Posted June 5, 2009 Would you be able to tell by the width of the QRS? Type 1 narrow and type 2 wide QRS. Nope. With a Mobitz II and 2:1, you still have some "normally" conducted impulses. Therefore, a type II need not have wide complexes. This is especially true with a junctional pacemaker. Take care, chbare. Link to comment Share on other sites More sharing options...
Job13_5 Posted June 24, 2009 Share Posted June 24, 2009 This is a good strip. If I had only seen the second and third pictures, I would have called it a high grade 2nd degree type II. However, it looks to me, in the first picture, that you have p waves falling on the QRS, which makes me think 3rd degree. However, I figured you wouldn't have a narrow QRS with a 3rd degree....Is that not the case? Link to comment Share on other sites More sharing options...
joesph Posted June 24, 2009 Share Posted June 24, 2009 Could the enalapril have been a player in this guys problem at least in his syptoms or with what his heart is doing. Considering overdose or med screw up. Looked at the drug online and this is what sent me down this trail Link to comment Share on other sites More sharing options...
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