AV dissociation

AV dissociationCreated OnApril 16, 2020Last Updated OnApril 16, 2020byadmin You are here: Main ECG AV dissociation < All Topics Table of Contents ATRIOVENTRICULAR HEART BLOCK OR DISSOCIATION 3-Steps Approach to Diagnosing AV Blocks Find out what the atrium is doing Find out what the ventricle is doing Figure out the relationship between the atrium and ventricle (PR-interval) The answer usually lies in the PR-interval! First degree AV block ECG features: PR interval > 200ms (five small squares) Does not cause haemodynamic disturbance Second degree AV block 2 types: Mobitz type I (Wenckebach) and Mobitz type II Mobitz I (Wenckebach) ECG features: P-waves are regular (P-P interval is constant) Progressive PR-interval lengthening before a non-conducted beat Before diagnosing Mobitz blocks, be certain that the P-P interval is REGULAR, an irregular P-P interval may be simply caused by non-conducted Premature Atrial Complexes Mobitz II ECG features: Arrows in above ECG indicate “dropped” QRS complexes (i.e. Non-conducted P waves) P-waves are regular (P-P interval is constant) Some impulses fail to conduct to the ventricles WITHOUT progressive PR-interval lengthening Before diagnosing Mobitz blocks, be certain that the P-P interval is REGULAR, an irregular P-P interval may be simply caused by non-conducted Premature Atrial Complexes Third degree or complete AV block ECG features: Typically, the patient will have severe bradycardia with independent atrial and ventricular rates, i.e. AV dissociation P-waves are regular (P-P interval is constant) PR-interval is randomly changing Clinical Significance: High risk of sudden cardiac death Requires urgent admission for cardiac monitoring, backup temporary pacing and usually insertion of a permanent pacemaker * We do not own this youtube video, it’s for sharing purpose

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