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E.C.G.

Course – VII
AV blocks
Dr. Michael Kassirer

”Dept. Internal Medicine ”D


Tel-Aviv Medical center
:Objectives
By the end of lesson 7 the student will:
 Know how to diagnose 1, 2nd degree (type I
and II), and 3rd degree AV blocks
 Understand the difference between high
and low AV blocks and their clinical
implication.
 Understand the difference between wide
and narrow QRS complex, regarding AV
blocks.
1° Av Block
2° Av Block (Mobitz I) =
Wenckebach
2° ( Av Block (Mobitz II
Second degree AV block – Mobitz type 2

Normal
N/A P>R
P>R

 No of Ps > No of QRS
 PR interval does not prolongs from beat
to beat
3° AV Block (Complete
(AVB

 AV dissociation
 QRS narrow or wide (=
slower HR)
High vs. Low degree AVB

1° AVB 2° AVB Mobitz I


2° AVB Mobitz I 3° AVB

Bradycardia unlikely Bradycardia possible

(Pacemaker (STBY / permanent


Bi-Fascicular block
Tri-Fascicular block

1º AV block
RBBB
Left anterior hemiblock

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