EMS 12-Lead: The 12 Rhythms of Christmas – Type II AV-Block

This article is the sixth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas.

Except for first degree,  type II is probably the simplest of the AV-blocks to identify. There’s really only two major criteria:

  1. A P-wave suddenly and unexpectedly fails to conduct to the ventricles.
  2. The PR-intervals of the P-waves that do conduct are fixed and equal.

Let’s examine the ECG below, which exhibits both of those findings. The computer, however, disagrees and suggests and alternate diagnosis. Which is right?

For the rest of this discussion please follow this link or click on the ECG above.

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