The Visual Nurse

Comparing Second degree type I AV block and complete heart block on ECG:

Whereas we expect a constant PR interval in first degree AV block, as well as second degree type II AV block:

2️⃣nd degree type I (Mobitz I): PR variable
👉🏻Look for a progressive lengthening of the PR interval preceding dropped QRS
👉🏻Expect PR to reset following dropped QRS

3️⃣rd degree: PR variable (not a true PR interval due to loss of A to V communication)
👉🏻Look for a variable and constantly changing PR interval indicating no communication between atria and ventricles
👉🏻Note the QRS may be narrow or wide if the AV junction or ventricles pick up the escape beat, respectively

*From a single lead basic rhythms perspective. Exceptions exist. Bookmark for future reference!


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New nurses: Junctional rhythm recognition on ECG👇🏼

Expect to see a regular narrow complex rhythm at an inherent rate between ~40-60 BPM. The AV junction is capable of producing reliable depolarization (reason for rhythm regularity; compare to A-fib). The narrow complex (