Heart Blocks & some ICGs

what are the different kinds of heart blocks?

1st degree, 2nd degree type 1 (Mobitz type 1 Wenckebach ), 2nd degree type 2 (Mobitz type 2), 3rd degree

what is 1st degree - ECG morphology, symptoms

PR interval >= 200ms, asymptomatic & normal P wave morphology

what is 2nd degree type 1 - ECG morphology, symptoms, alternate names

PR interval becomes longer until 1 atrial signal doesn’t conduct to ventricle, consequent PR interval is short again, asymptomatic but may be light headed

what is 3rd degree - ECG morphology, symptoms, alternate names

complete heart block aka dissociation or no communication bwt atria and ventricles, severe fatigue, shortness of breath, chest pain, lightheadedness, loss of conciousness

what is 2nd degree type 2 - ECG morphology, symptoms, alternate names

mobitz type 2, wenckebach, consistent PR interval, occasional dropped beats, asympotomatic until more dropped beats then cause palpitations, fatigue, shortness of breath, lightheadedness or chest pain

Premature Atrial Contraction (PAC)

morphology: abnormal P wave, present as missed/skipped beat.

underlying phys: impulse originating in atria outside of sinus

Double potential

morphology: 2 distinct activation signals at atria separated by isoelectric line

phys: line of block or nonconductive tissue, seen at Crista Terminalis

Valvular signal

morphology: smaller atrial electrogram than ventricular

phys: want to tag to ensure they do not attribute to LAT map, mistaken v signal as late A signal (check)

LAA signal

morphology: sharp signals aligned with atrium or as far field signals near LSPV

phys: google ai says trabeculated signal has sharp signals

PV Signal

morphology: similar to LA signals

phys: CS pacing so LA captures and PV shows up later

Mid Diastolic Potential

morphology: occur between 2 tachycardia beats

phys: slow conduction part of VT circuit, tag as site for ablation. confirm how to distinguish from atrial signal/V repolarization

Late potential

morphology: distinct activation from QRS

phys: seen in sinus at areas of scar, tag as area for ablation

fractionated

morphology: jagged ICGs

phys: can be in any chamber, associated with unhealthy tissue