Thoughts on this ECG

[celticcare]

2nd degree type 2 AVB with junctional escape beats. Look at the pattern of QRS complexes. Some are closer together, and some farther apart (escape beats). You've got some nonconducted P waves, but the PR interval is regular on the P waves that are conducted.

The QRS itself is not particularly wide as you would see in a LBBB. It's narrow right up until the notched terminal portion of the QRS. This would be typical for early repolarization. With as slow as it is, this may be an early osborn wave of hypothermia. Although, all the osborn waves I've seen were wider than this, so I'm betting on early repol, which was probably preexisting to this presentation.

'zilla

I didn't even think of hypothermia here with the Osborn wave. I picked up on the second degree av block and JER *junctional escape rhythm* but not the osborn wave. Thanks *zilla

[1EMT-P]

I would call this a 2nd Degree Type 2 with Junctional Escape Beats with a borderline Bundle Branch Block.

[crotchitymedic1986]

sorry, its third degree.