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Heart Blocks

Atrioventricular &
Ventricular Blocks

Abdurahman Wahid, Ns., M.Kep


Dept. Emergency & Critical Care
School of Nursing
Universitas Lambung Mangkurat
ACLS Provider Certified by AHA
ECG Reading Certified by ISEM
Contents
Atrioventricular Blocks
1st degree
2nd degree
Type 1: Mobitz
Type 2: Mobitzh II
3rd degree
Ventricular Blocks
LBBB
RBBB
Bifascicular Block
Trifascicular Block
5 steps for analyze rhythm
Rate
Regularity
P wave
present ?
homogen ?
P:R=1:1?
PR Interval
QRS
Conduction of the Heart
Sinoatrial node

AV node

Bundle of His

Bundle Branches

Purkinje fibers
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Intraventricular Block
Bundle Branch Block
Left Bundle Branch Block
Right Bundle Branch Block
Bifascicular Block
Trifascicular Block
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Bundle Branch Block
Two changes in ECG:
QRS Complex widens
QRS morphology change : Notched Path
Right Bundle Branch Block
Topografi sadapan dan hasil:
Secondary R wave (R') in V1 or V2
Wide Slurred S wave in I, V5, V6
Associated feature: ST segmen Depression and T wave inversion in right
precordial lead
RBBB
LBBB
biasanya disertai LAD
Dx :
Wide QRS duration
Broad monophasic R wave in I, V5 , V6
Absence of Q waves in V5 dan V6
Monophasic R wave
Bifascicular Blocks
Bifascicular Block
RBBB dengan LAD
LBBB dengan RAD
Trifascicular Blocks
Trifascicular Block
Bifascicular Block with First Degree Heart Block
THANK FOR ATTENTION

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