ECG, Block Intraventricular,Preexcitation (Rev)

8/10/2019 ECG, Block Intraventricular,Preexcitation (Rev)

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Teuku Heriansyah


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The Conduction System


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Normal Sinus Rhythm

Rhythm : Regular

Rate : 60100

P wave : Normal in configuration; precede each QRS

PR : Normal ( 0. 120.20 seconds )

QRS : Normal ( less than 0.12 seconds )


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First-degree AV block

Rhythm : Regular

Rate : Usually normal

P wave : Sinus P wave present; one P wave to each QRS

PR : Prolonged ( greater than 0.20 seconds )QRS : Normal


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Second -degree AV block, Mobitz I

Rhythm : Irregular

Rate : Usually slow but can be normal

P wave : Sinus P wave present;

some not followed by QRS complexes

PR : Progressively lengthens

QRS : Normal


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Second-degree AV block, Mobitz II

Rhythm : Regular usually;can be irregular if conduction ratios vary

Rate : Usually slow

P wave : Two, three, or four P waves before each QRS

PR : PR interval of beat with QRS is constant;

PR interval may be normal or prolonged

QRS : Normal if block in His bundle;

wide if block involves bundle branches


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Third-degree AV block (Total AV block)

Rhythm : Regular

Rate : 4060 if block in His bundle;3040 if block involves bundle branches

P wave : Sinus P wave present; bear no relationship to QRS;

can be found hidden in QRS complexes and T waves

PR : Varies greatly

QRS : Normal if block in His bundle;

wide if block involves bundle branches


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Third-degree AV block (Total AV block)


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Second -degree AV block, Mobitz II


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Atrioventricular dissociation secondary to complete heart block


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High-grade atrioventricular block


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QRS Duration > 0.12 secondsR in Leads aVR and V1

S wave in Leads I and V6 >

0.40 seconds

Normal initial QRS

Right Bundle Branch Block


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QRS Duration > 0.12 secondsQ waves absent in Leads I,

V5, V6

Broad notched QRS in Leads

V5, V6 and AVL

Time to R > 0.06 seconds in

wave peak leads V5 and V6

Left Bundle Branch Block


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Left BundleBranch Block


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Small Q wave in Leads I,

aVL, V5 and V6Small R wave in Leads III

and aVF.

Frontal plane axis of -30o

to -90o

QRS duration < 0.12 sec.

Left Anterior Fascicular Block :


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Frontal plane axis of 90o

to 180o

Small R wave in Leads

I and aVL

Tall R wave in Leads II,

III and aVF

Q wave in inferior leads

< 0.04 seconds

Left Posterior Fascicular Block :


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Incomplete right bundle branch block


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Right bundle branch block


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Left bundle branch block


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Wolff-Parkinson-White syndrome


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Wolff-Parkinson-White syndrome


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Thank You

Documents

ECG, Block Intraventricular,Preexcitation (Rev)