Conduction Disorders
Sinoatrial, atrioventricular or bundle branch block is the result of delayed conduction through these aspects of the cardiac conduction system.
Overview of sinoatrial exit block
First Degree SA Exit Block
Not detectable on ECG
Second Degree SA Exit Block: Type I
Progressively shortened PP intervals then a missed PQRS
Second Degree SA Exit Block: Type II
Constant PP interval with intermittent missed PQRS
Third Degree SA Exit Block
Complete lack of P waves and QRS complexes ± escape rhythm
Overview of atrioventricular block
First Degree AV Block
PR Interval >200ms
Second Degree AV Block: Type I Mobitz
Progressive PR prolongation then a missed QRS complex
Second Degree AV Block: Type II Mobitz
Constant PR interval with intermittent missed QRS complexes
Advanced Second Degree AV Block
Two or more missed QRS complexes
Complete AV Block
Complete dissociation of P waves and QRS complexes
Left Bundle Branch Block
Wide QRS, broad R / no Q in lateral leads
Left Anterior Fascicular Block
Left axis deviation, QRS 45ms in aVL
Left Posterior Fascicular Block
Right axis deviation, QRS <120ms, rS in I / aVL, qR in III and aVF
Right Bundle Branch Block
Wide QRS, RSR pattern, slurred S wave
Bifascicular Block
RBBB + left or right axis deviation
Trifascicular Block
Incomplete or complete