Adams-Stokes / Complete (Third Degree) Atrioventricular Block
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Patient: 75 y/o male. Medical history and anamnesis unknown. Experienced several Adams-Stokes episodes and his wife called EMS. This is a prehospital 12 lead from the LP12.
ECG description:
- No P-QRS relationship. Independent pacemakers.
- Atrial rate is 125 bpm. Ventricular rate is close to zero.
- No escape rhythm present
- P axis is normal at 60 degrees
Discussion:
This is ventricular standstill. The underlying rhythm is sinus tachycardia at 125 bpm, but there is complete failure of the impulses to reach the ventricles. The first QRS complex is of junctional origin, the second is from the ventricles, probably the right ventricle. Unfortunately, this 6 second recording does not tell whether this is an escape rhythm or just single beats.
Leave a Comment October 3, 2009