ECG #25

DESCRIPTION:

• Ventricular rate 72 bpm
• Atrioventricular dissociation with complete 3rd degree atrioventricular block
• Accelerated Idioventricular Rhythm (AIVR)
• Right axis deviation (101°)
• Prolonged QRS duration 146 ms
• Right bundle branch block
• ST segment depression in the inferolateral leads (II, III, aVF, V3-6)
• Prolonged QTc 514 ms

INTERPRETATION & CASE PROGRESSION:

Atrioventricular dissociation with complete 3rd degree atrioventricular block resulting in an accelerated atrioventricular rhythm (AIVR). The patient was admitted to the Coronary Care Unit and underwent insertion of a dual-chamber pacemaker. (See Old ECG for comparison)