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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 - PowerPoint PPT Presentation
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BlocksDevin Herbert, R3
Aug 23, 2012
AV nodal blocks1st degree: PR >200msec
2nd degree: Type I (Wenckebach) vs. Type II
3rd degree: complete heart block
Bundle Branch BlocksRight BBB: QRS >120msec
RSRI in V1
Slurred S in V6
Left BBB: QRS >120msec
monomorphic S in V1
monomorphic R in V6
HemiblocksLAFB: LAD (-30 to -90o)
R wave in V1
rS in III (usually II and aVF also)
LPFB: RAD (90 to 180o)
Exclusion of RVH
Extreme right Left axis
Right axis Normal
Bifascicular blockRBBB + LAFB or LPFB
Trifascicular block1st degree AV block + bifascicular block
Practice
Sinus bradycardia
1st degree AV block
RBBB
Sinus
2nd degree AV block, 2:1 conduction (likely Type II)
RBBB
Sinus bradycardia
RBBB
LAFB
= Bifascicular block
Sinus
2nd degree AV block, Type II
RBBB
Complete heart block
Ventricular escape
RBBB
LAFB
= Bifascicular block
AV dissociation
LBBB
Sinus bradycardia
2nd degree AV block, 2:1 conduction
A Fib
RBBB
LAFB
= Bifascicular block
Junctional escape
Complete heart block
Sinus
1st degree AV block
RBBB
LAFB
= Trifascicular block
Sinus tachycardia
2nd degree AV block, Type I
The end
Sinus
2nd degree AV block, 2:1 conduction
RBBB