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ECG Findings

  • PR interval greater than 200 ms (normal 120-200 ms) with no significant variation in PR intervals between beats.

  • Each P wave is followed by a QRS complex.

Pearls

  1. This type of heart block usually does not affect heart function and can be considered nonpathologic (especially in athletes or patients with higher vagal tone).

  2. First-degree block may also occur due to heart disease (myocarditis, rheumatic fever), drugs (digoxin, amiodarone, β-blockers, calcium channel blockers), or as a normal part of aging.

FIGURE 23.14A

First-Degree AV Block. (ECG contributor: James V. Ritchie, MD.)

FIGURE 23.14B

The PR interval is fixed (double arrows) and is longer than 0.2 seconds, or five small blocks.

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