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Blocks Devin Herbert, R3 Aug 23, 2012

Blocks Devin Herbert, R3 Aug 23, 2012. AV nodal blocks 1 st degree: PR >200msec 2 nd degree: Type I (Wenckebach) vs. Type II 3 rd degree: complete heart block. Bundle Branch Blocks Right BBB : QRS >120msec RSR I in V 1 Slurred S in V 6 Left BBB : QRS >120msec

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Blocks Devin Herbert, R3 Aug 23, 2012

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  1. BlocksDevin Herbert, R3Aug 23, 2012

  2. AV nodal blocks 1st degree: PR >200msec 2nd degree: Type I (Wenckebach) vs. Type II 3rd degree: complete heart block

  3. Bundle Branch Blocks Right BBB: QRS >120msec RSRI in V1 Slurred S in V6 Left BBB: QRS >120msec monomorphic S in V1 monomorphic R in V6

  4. Hemiblocks LAFB: LAD (-30 to -90o) R wave in V1 rS in III (usually II and aVF also) LPFB: RAD (90 to 180o) Exclusion of RVH

  5. Extreme right Left axis Right axis Normal

  6. Bifascicular block RBBB + LAFB or LPFB Trifascicular block 1st degree AV block + bifascicular block

  7. Practice

  8. Sinus bradycardia 1st degree AV block RBBB

  9. Sinus 2nd degree AV block, 2:1 conduction (likely Type II) RBBB

  10. Sinus bradycardia RBBB LAFB = Bifascicular block

  11. Sinus 2nd degree AV block, Type II RBBB

  12. Complete heart block Ventricular escape RBBB LAFB = Bifascicular block

  13. AV dissociation LBBB

  14. Sinus bradycardia 2nd degree AV block, 2:1 conduction

  15. A Fib RBBB LAFB = Bifascicular block

  16. Junctional escape Complete heart block

  17. Sinus 1st degree AV block RBBB LAFB = Trifascicular block

  18. Sinus tachycardia 2nd degree AV block, Type I

  19. The end

  20. Sinus 2nd degree AV block, 2:1 conduction RBBB

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