Publish in this journal
Journal Information
Vol. 73. Issue 9.
Pages 768 (September 2020)
Download PDF
More article options
Vol. 73. Issue 9.
Pages 768 (September 2020)
ECG Contest
DOI: 10.1016/j.rec.2019.12.019
Full text access
Response to ECG, August 2020
Respuesta al ECG de agosto de 2020
Martín Ibarrola
Centro Cardiovascular BV, Buenos Aires, Argentina
Related content
Rev Esp Cardiol. 2020;73:66310.1016/j.rec.2019.12.018
Martín Ibarrola
Article information
Full Text
Download PDF
Figures (1)
Full Text

The PR intervals shorten from beat to beat, until they are superimposed on the QRS complex. Negative T waves are normal until V4 in children and the QTc interval is normal. Another blocked P wave can be seen in the T wave, thus ruling out isorhythmic atrioventricular dissociation (responses 1, 2, and 4 incorrect). An atrial frequency of 100 bpm is observed along with nodal escape rhythm or infra-Hisian rhythm of 48 bpm (response 3, correct). The rhythm strip confirms diagnosis of complete atrioventricular block (figure 1). Cardiac malformation and maternal anti-Ro/SSA and anti-La/SSB antibodies should be ruled out.1 Studies (echocardiography, exercise testing, Holter study) are recommended to stratify the risk of sudden cardiac death and inform the need for permanent pacemaker placement.2

Figure 1
M. Michaelsson, A. Jonzon, T. Riesenfeld.
Isolated congenital complete atrioventricular block in adult life. A prospective study.
Circulation., 92 (1995), pp. 442-449
A.E. Baruteau, R.H. Pass, J.B. Thambo, et al.
Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management.
Eur J Pediatr., 175 (2016), pp. 1235-1248
Copyright © 2019. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?