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DV Case 3 Answer: Difference between revisions
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==Answer== | ==Answer== | ||
# In SA block it is more difficult to appreciate the conduction delay as SA conduction is not presented on a surface ECG. | # In [[Sino-atrial_exit_block|SA block]] it is more difficult to appreciate the conduction delay as SA conduction is not presented on a surface ECG. SA block is seen as sudden duplication of the P-P interval, as is the case in 2:1 block, or more difficultly seen as progressive shortening of the P-P interval with a pause thereafter, in case of SA - Wenckebach block. (Definition of a Wenckebach block : decline in progression of the incremental delay). | ||
# Sometimes AV Wenckebach is difficult to see on the ECG as the increment of PR interval can be minimal. The PR interval after a the pause is shorter than in the consecutive beats in the tracing. This could indicate AV Wenckebach. However the conduction in the AV node after a longer pause has recovered more from the preceding depolarization, than during a higher frequency. This makes the short PR interval after a pause is not indicative of AV Wenckebach per se. | # Sometimes AV Wenckebach is difficult to see on the ECG as the increment of PR interval can be minimal. The PR interval after a the pause is shorter than in the consecutive beats in the tracing. This could indicate AV Wenckebach. However the conduction in the AV node after a longer pause has recovered more from the preceding depolarization, than during a higher frequency. This makes the short PR interval after a pause is not indicative of AV Wenckebach per se. | ||
# The cause of the interruption in the rhythm is an [[Atrial_Premature_Complexes|atrial premature beat]] (APB), as seen on the T-wave of the last beat before the pause. This T wave is of a different morphology compared to the preceding T-waves, caused by the APB . The correct diagnosis is: blocked atrial premature beats (APB). | # The cause of the interruption in the rhythm is an [[Atrial_Premature_Complexes|atrial premature beat]] (APB), as seen on the T-wave of the last beat before the pause. This T wave is of a different morphology compared to the preceding T-waves, caused by the APB . The correct diagnosis is: blocked atrial premature beats (APB). | ||