![]() ![]() Type II second-degree heart block occurs when there is a blockage in the bundle of His that prevents electrical impulses from being conducted to the ventricles. This type is typically transient and does not require treatment. ![]() This results in progressively longer PR intervals until a QRS complex is not conducted. Type I second-degree heart block is caused by a delay in the conduction of electrical impulses through the AV node. There are two types of second-degree heart block: This is characterized by a pattern of regular P waves followed by irregular QRS complexes. Second-degree heart block occurs when some, but not all, of the electrical impulses are delayed as they travel from the SA node to the AV node. Therefore, medical professionals must be able to identify each type in order to properly diagnose and treat their patients. ![]() The most common types include:Įach type of arrhythmia found on an EKG tracing has its own specific characteristics. However, if the electrical impulses are irregular, this means that an arrhythmia is present. This involves an upright P wave, consistent PR intervals that last from 0.12 to 0.20 seconds, and identical QRS complexes that are no longer than 0.12 seconds.Ī normal sinus rhythm also involves flat ST segments, regular R-R intervals, and a heart rate that is between 60-100 beats per minute. Normal sinus rhythm is the rhythm of the heart when all of the electrical impulses are passing through the heart in a regular pattern. This is often seen in patients with left ventricular hypertrophy. If the mean QRS axis is between +90 and -90 degrees, it is an indication of left-axis deviation. This is often seen in patients with COPD and cor pumonale. If the mean QRS axis is greater than +90 degrees, it is an indication of right-axis deviation. The mean QRS axis is the average of the QRS complex. This can be an indication of a heart block, which is when the electrical impulses are not passing through the heart properly. If the R-R interval exceeds 0.12 seconds, it is known as a prolonged interval. This is measured from the beginning of one R wave to the beginning of the next. The R-R interval is the time it takes for the electrical impulse to travel from the start of one QRS complex to the start of the next. If it is depressed or elevated, it may indicate that the patient has a serious problem with perfusion, which helps with the delivery of oxygen to tissues. The ST segment is the period of time between ventricular depolarization and repolarization. If it is flat or inverted, it’s an indication that the heart is not repolarizing properly, which can occur with ischemia or hyperkalemia. The T wave is the wave of repolarization that passes through the ventricles. However, if it is wider than three boxes, it may indicate that the electrical impulse is not passing through the ventricles properly. It is typically shorter than 0.12 seconds, which is three small boxes on an EKG. The QRS complex is the wave of depolarization that passes through the ventricles. This is measured from the start of the P wave to the start of the QRS complex. The PR interval is the time it takes for the electrical impulse to travel from the SA node to the AV node. The ventricular rate is the number of QRS complexes produced by the ventricles in one minute. The atrial rate is the number of P waves produced by the atria in one minute. ![]() Step 1: Measure the Atrial and Ventricular Rates Measure the Atrial and Ventricular Rates.EKG interpretation is the process of analyzing an EKG reading in order to understand the electrical activity of the heart. ![]()
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