Assoc Prof Harry Mond
December 17, 2024
This week we had a Holter monitor recording reported as complete heart block. For obvious reasons this can be a serious diagnosis, but the reporting cardiologist felt it was Wenckebach sequences and requested a review.
Wenckebach sequences almost always have a generous pause at the termination of a sequence.
.png)
In the above example, the blocked P wave extends the R to R interval from about 1000 ms to 1900 ms.
Sometimes this interval is shorter when the preceding PR interval becomes very long and the blocked P wave occurs immediately following the previous T wave.
.png)
Can the pause disappear?
In the following tracing, there is no pause because the blocked P wave is concealed within the QRS of the previous beat. which has a very long PR interval (or is it a junctional escape beat?).
.png)
To receive a free PDF copy of The Fundamentals of Electrocardiograph Interpretation by Harry Mond, subscribe to his email blog by entering your email address below.
Purchase a hard cover or paperback copy of The Fundamentals of Electrocardiograph Interpretation by Harry Mond on Amazon.
May 14, 2025
Fusion is another lesson in timing! Fusion beats are an amalgam of two competing rhythms. Both are responsible for partial depolarization of the respective chambers and depending on the contribution of each, result in progeny with similarities to one or both parents.
May 14, 2025
The ventricular ectopic compensatory pause is a lesson in timing!
