What is the rhythm? Is there AV block?
|See the comments on the annotated ECG below|
There are p-waves and there are QRS complexes and many seem to have no relation to each other. It is easy to believe there is complete AV block.
But there is not AV block. There is accelerated junctional rhythm and a sinus rate that is very near the junctional rate. See the annotated ECG below:
Dr. K. Wang, the rhythm master, had this to say: "The 8th QRS holds the key. It occurs with a shorter R-R interval with a reasonable PR interval, indicating that it is conducted from the P-wave. Thus, there is no complete AV block, just accelerated AV junctional rhythm with interference AV dissociation. Accelerated Junctional Rhythm is a very regular rhythm, and any QRS that occurs with a shorter R-R interval is not from the junction, but is a beat conducted from above."
Thus, there is no AV block and the danger to the patient from the drug overdose is not nearly what it would be had there actually been AV block.
AV Dissociation does not necessarily mean AV block!!