Bradyarrhythmias
Bradyarrhythmias
 

Ventricular Escape Rhythm

 
 
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Overview

  • Ventricular escape is an impulse generated by a ventricular focus when the conduction system fails, most commonly due to complete heart block.
    • Look For

    • Bradycardia with ventricular rate <40bpm
    • Wide QRS complexes (120ms)
    • Regular non-conducted P waves (complete heart block) or no P waves (sinus arrest)
  • Ventricular escape beats can also occur after a long pause (sinus arrest) if atrial or junctional escape is not triggered.
    • Ventricular escape in the setting of sinus arrest:
    • Ventricular escape in the setting of sinus arrest
       
    • Ventricular escape in the setting of complete AV block:
    • Ventricular escape in the setting of complete AV block
       
 
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Adan V, Crown LA. Diagnosis and treatment of sick sinus syndrome. American family physician. 2003 Apr;67(8):1725-32.
 Mangrum JM, DiMarco JP. The evaluation and management of bradycardia. New England Journal of Medicine. 2000 Mar 9;342(10):703-9.
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