Second Degree Heart Block Type II ECG Interpretation


Description

  • The hallmark of this dysrhythmia is a constant P-R interval with missing QRS complexes.
  • This dysrhythmia may present in a couple of different ways.
    • A. QRS complexes occurring in a specific pattern in a ratio with the P waves. This is often referred to as 2:1 or 3:1 block depending upon the ratio of P waves to each QRS complex.
    • B. QRS complexes occur in a more unstable, unpredictable manner.
  • Either presentation requires immediate reporting due to its potential for conversion to Third Degree (Complete) Heart Block.
A.heart block ecg image 106
B.heart block ecg image 107

Practice Strip

heart block ecg image 108

Analyze this tracing using the five steps of rhythm analysis.

Show Answer
  • Rhythm: Atria and Ventricles - Regular
  • Rate: Atria – 125, Ventricles - 41
  • P Wave: Upright
  • PR interval: 0.14 sec
  • QRS: 0.06
  • Interpretation: Second Degree Heart Block Type II, 3:1


Practice Strip #2

heart block ecg image 109

Analyze this tracing using the five steps of rhythm analysis.

Show Answer
  • Rhythm: A – Regular, V - Irregular
  • Rate: Atria – 68, Ventricles - 40
  • P Wave: Upright
  • PR interval: 0.16 sec
  • QRS: 0.08
  • Interpretation: Second Degree Heart Block Type II





Authors and Sources

Authors and Reviewers


Sources

  • Electrocardiography for Healthcare Professionals, 6th Edition Kathryn Booth and Thomas O'Brien
    ISBN10: 1265013470, ISBN13: 9781265013479
    McGraw Hill, 2023
  • Rapid Interpretation of EKG's, Sixth Edition
    Dale Dublin
    Cover Publishing Company
  • EKG Reference Guide
    EKG.Academy
  • 12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
    Aaron Reed
    Create Space Independent Publishing
  • Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
    Elsevier-Health Sciences Division
    Barbara A. Erickson, PhD, RN, CCRN
  • The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
    Publisher: Lippincott Williams & Wilkin)
    ISBN-10: 0781784425; ISBN-13: 978-0781784429
  • Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
  • ECG Reference Guide
    PracticalClinicalSkills.com






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