First-degree heart block (AV block) Second-degree heart block (type 1) First-degree heart block (AV block)įirst-degree heart block involves a fixed prolonged PR interval (>200 ms). Prolonged PR interval (>0.2 seconds)Ī prolonged PR interval suggests the presence of atrioventricular delay (AV block). The PR interval should be between 120-200 ms (3-5 small squares). If P waves are absent and there is an irregular rhythm, it may suggest a diagnosis of atrial fibrillation. If P waves are absent, is there any atrial activity? Do the P waves look normal? – check duration, direction and shapeĤ. If so, is each P wave followed by a QRS complex?ģ. The next step is to look at the P waves and answer the following questions:Ģ.
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