Don't jump to conclusion yet

This patient was admitted due to dizziness.

Image 1

This second degree AV block 2:1 (Image 1) . A 2:1 second degree AV block is a subtype of second degree AV block. It can either be due to a Mobitz I (aka Wenckebach) or Mobitz II. A long strip will resolve the issue. Most authors will say that if the PRI is normal with an a wide QRS then it is most likely type II and it could be type I if the PRI is prolonged and normal QRS.

Image 2

This is from the same patient (Image 2) . There are dropped P waves. There are PRI changes prior to the dropped P. This sinus tachycardia, second degree AV block type II (Mobitz II) with right bundle branch block (RBBB) and left anterior fascicular block (LAFB) pattern. So, the 2:1 was due to a Mobitz II mechanism.

A pacemaker was eventually inserted.

#584