Identification of Second-Degree AV Blocks and Their Treatment

To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.

One method of ECG rhythm identification is to ask a series of questions such as:

• What's the rate (<60, 60-100, 101-149, or >150);
• Is the rhythm regular or irregular;
• What's the shape and frequency of P waves and QRS complexes; and
• What's the P-R interval and is it constant?

ECG characteristics of a second-degree Mobitz type I (Wenckebach).

Identification of unstable bradycardia and its treatment with Atropine.

ECG characteristics of a second-degree Mobitz type II.

Possible effect of using Atropine on patients with a second-degree type II AV block.

Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.

Starting dose and titration of Dopamine and Epinephrine drips.

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The Curious Clinicians: History of Doctor Wenckebach & Mobitz