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EKG Analysis Heart Block Heart Block: Slow Conduction of Depolarization Impulse Usually occurs at the A-V node. May be due to disease, ischemic damage, or drug toxicity. First Degree Heart Block Everything looks sinus EXCEPT the PR interval is greater than .20 seconds First Degree Block First Degree Block Second Degree Block Mobitz I Wenckebach PR interval gets longer on each successive beat until one does not conduct (no QRS) The cycle then repeats R-R irregularity Second Degree Mobitz I (Wenckebach) Second Degree Mobitz I (Wenckebach) Second Degree Mobitz II Not every P wave conducts (no QRS) Usually a fixed ratio of P waves to QRS complexes The P waves that do conduct will have a consistent PR interval R-R irregularity May require a pacemaker if it happens after an M.I. Second Degree Mobitz II Second Degree Mobitz II Third Degree Block (Complete) No P waves are conducted Ventricles depolarize on their own so QRS duration is >.12 No relationship between P waves and QRS complexes R-R will be consistent however No PR interval is present (don’t be fooled!) P waves are going at their own rate while the ventricles go at their own rate Patient will need a pacemaker Third Degree Block (Complete) Laboratory Exercises # 5 Numbers 9-12 Laboratory Exercises #6 Numbers 1-8