A Case of Symptomatic Paroxysmal Complete Atrioventricular Block

Figures

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  Figure 1. Initial EKG that showed a sinus rhythm rate of 66, atrial premature complex, PR 142, QRSD 89, and QTc 393 EKG: Electrocardiogram

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  Figure 2. Telemetry strip from a home heart monitor. In rhythm strip A, if you look at the red double-sided arrow you can see the prolonged sinus pauses that were recorded. In rhythm strip B, if you look at the orange single-sided orange arrow, you can appreciate the prolonging P-R interval followed by dropped beats consistent with second-degree AV block Mobitz type 1. In rhythm strip C with the green arrows, you can see consecutive P waves that do not conduct which is suggestive of a high-grade AV block. AV: Atrioventricular

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  Figure 3. Home heart monitor strips. In the bottom strip you can notice initially that the P waves have no associated QRS. P wave with a QRS is shown by a thick black arrow. The next beat was a P wave with a dropped QRS followed by P waves with associated QRS. You can notice that the pink arrow has a P to R interval shorter than the following P-R intervals. The blue arrows have P-R intervals of the same interval that is longer than the preceding pink arrow consistent with a first-degree AV block. AV: Atrioventricular