Möbitz 2 AV Block & Right Bundle Branch Block
Report:
Sinus rhythm 90/min
Second degree AV block, Möbitz 2
Right bundle branch block
Borderline left atrial abnormality (LAA)
Comment:
All the PR intervals, before and after the block, are 0.16â. This is type 2 block, intraventricular: the LBB is blocked too four times during this recording: a BBBB.
The computer reported right axis deviation +117o. The mistake is in including the blocked, late part of the QRS complex. True RAD with RBBB is shown elsewhere.
This trace is another example of how poorly lead 2 performs for ventricular conduction: nobody would guess the existence of RBBB.
The patient may have no other heart disease. Her block remained stable. Below is her ECG from five weeks previously. It is unclear why she was not paced then. She was, eventually. Syncope is a strong indication.
Fig 92a. ECG taken five weeks previously.
Fig 93. Asymptomatic 73 year old lady noted to have bigeminal pulse.
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