Sinus Rhythm with Mobitz Type I AV Block (Wenkebach.) Did you know that Dr. Wenkebach discovered this arrhythmia with a stethoscope? (He also had some help from Dr. Einthoven's Galvinometer.)
This diagnosis was made by the ER Physician. I received an email from a Paramedic student who suggested that it may indeed be a Mobitz II type AV Block. On further examination of the tracing, I have to agree with Peter Bonadonna EMT-P (Director of Paramedic Education; Monroe Community College, Rochester, New York) This is not an AV Block at all, but is in fact a sinus rhythm with PACs. Note the PACs, beats 2 and 5, and the non-conducted P-wave hidden in the T-wave after beat #5. As Peter points out, the PR Intervals in PACs can be longer than the native Sinus beats. What do you think? Please send an email with your opinion to Doc.
