This ECG report documents Mobitz type II heart block with 2:1 block in a patient. Mobitz type II heart block involves sudden conduction block of impulses through the bundle of His, resulting in a constant PR interval prior to blocked P waves. It is usually due to rheumatic heart disease or coronary artery disease and carries a poor prognosis if left untreated. Treatment for symptomatic Mobitz type II heart block involves permanent pacemaker implantation.

1. ECG OF THIS WEEK Dr.A.Meenakshi . PROF.S.TITO’S UNIT. M6

3. Sinus rhythm. Rate 45 per minute. Axis +30 degree. PR interval 180msec. PR interval constant. QRS duration 80 msec. QTc490msec. 2:1 block Constant PP interval. ST-T changes in LeadI,avL,V1,V2. DIAGNOSIS-MOBITZ TYPE II HEART BLOCK with 2:1 BLOCK.

4. Heart block Heart block is a delay or interruption in conduction of atrial impulse through the AV conducting system. FIRST DEGREE AV block; Delay in conduction through the conducting system. Leading to prolonged PR interval >0.20 sec. All P waves are followed by QRS complexes.

5. SECOND DEGREE AV BLOCK; Intermittent failure or interruption of AV conduction. Two types;-Mobitz typeI ,Mobitz typeII. Mobitz typeI or Wenckebach phenomena; Progressive prolongation of PR interval until a beat is dropped.

6. Mobitz type II AV block Sudden block of conduction of an impulse occurs. PR interval of all impulse is constant prior to blocked P wave. Lesion usually occurs in the bundle of HIS. It can be due to Rheumatic carditis,coronary artery disease. Always organic or pathological. Prognosis bad.

7. THIRD DEGREE(COMPLETE AV BLOCK); Complete interruption of AV conduction occurs. P wave has no relationship to QRS complex.

8. Treatment of second degree heart block;- Asymptomatic is treated by vagolytic agent atropine. Indication for permanent pacing;- 1 .Symptomatic second degree AV block 2.AV block in acute anterior MI. 3.Asymptomatic advanced second degree AV block with asystole greater than 3 seconds.

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