Compact Clinical Guide to Arrhythmia and 12-Lead EKG Interpretation by Goldsworthy Sandra RN MSc PhD(c) CNCC(C) CMSN(C); Graham Leslie RN MN CNCC(C) CHSE;

Author:Goldsworthy, Sandra, RN, MSc, PhD(c), CNCC(C), CMSN(C); Graham, Leslie, RN, MN, CNCC(C), CHSE;
Language: eng
Format: epub
Publisher: Springer Publishing Company
Published: 2016-06-03T09:30:00+00:00

First-Degree AV Block

Figure 4.1 Two examples of first-degree heart block.

Unique Characteristics

Rhythm

Regular

Rate

60–100 beats/minute

P waves

Upright, symmetrical, one for every QRS

PRi

Prolonged > 0.20 seconds

QRS

0.06–0.10 seconds

Causes

First-degree heart block can be a normal finding in some people but other causes include ischemia to the AV node area, rheumatic heart disease, myocardial infarction (MI), increased vagal tone, or increased potassium.

Treatment

Treatment is not required for first-degree heart block as it is typically asymptomatic. It is important, however, to continue to monitor for an increasing block, which can occur with prolonged ischemia at the AV node/junctional tissue area.

Tips for Interpretation

First-degree heart block looks identical to normal sinus rhythm with one key difference; the PRi is prolonged (> 0.20 seconds) and constant.

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