Second degree AV block type 2 |


  1. Phil r moran says

    Hey Jeff ,

    Your video says pace right away for 2nd degree ? TCP should only take place if the patient is symptomatic or showing signs of poor perfusion ? Correct ? Love your program has been a real asset for me ! Thanks so much , Phil

  2. Ina says

    I learned the difference between the two blocks as the second degree block type II the p waves and the qrs waves that are there are married
    In The third degree block the p waves and qrs are divorced (they do not stay together.)

    • Ronnie says

      Light bulb went off with your explanation of second degree type II and third degree blocks
      P(when present) and QRS married in type II and divorced in Third degree. Brilliant

  3. sg says

    I have been symptomatic for 3 years. My kidneys are starting to fail.
    I know this rhythm needs paced.
    I know this leads to 3rd degree block.
    I have an issue with the fact that I have tattoos seems to be more important to the cardio doc than my life.
    Video is great. I’m 2:1 ratio.
    Thank you

  4. Pearly says

    I just love the music. So many different styles of learning on one page!! I also love the comments after. And Jeff from admin always signing of with, KINd regards!!! So pleasant. Great site!!

  5. dianne1984 says

    Great review. I depart a bit from ACLS recs on advanced HB: atropine is likely to increase the atrial rate and, with infrahisian block, can actually decrease the ventricular response. Isoproteronol increases the escape (or ventricular rhythm).
    From an EPdoc

    • Jeff with admin. says

      The main difference is this:
      Mobitz II: There will be a p-wave with every QRS. There may not always be a QRS complex with every p-wave. The rate will usually be regular. Also, the PR interval will be regular.

      3rd Degree Block: There may not be a p-wave with each QRS. And the PR interval will not be the same with each PQRS.
      These videos may help you.
      They are kind of hard to hear but the content is good.
      Kind regards,

      • Dorothy Hondros says

        Thank you Jeff for the most comprehensive ACLS review that I have yet to see! You have made this nervous ICU nurse much more confident!

      • Barbara says

        3rd Degree, the top and the bottom parts of the heart are doing their own thing and “don’t talk to each other” and beat at their own rate, p’s are usually regular and QRS is regular, but usually at a slow ventricular rate.

        2nd Degree, the parties involved talk to each other most of the time, but not always.

    • amyj1979 says

      It was put to me like this: a third degree heart block has no rhyme or reason to the p wave. They just pop up where they want to. No real relation to the QRS. Mobitz, however, the p wave is with a QRS, there just may be some QRS complexes missing. That helped me to understand 🙂

      • ptrimble says

        Excellent explanation — I believe that was what I learned at my first ACLS certification. Thank you!

  6. savvygirl says


    The video says “sometimes has widw QRS”. What else would you see with second degree if the block is occurring in the bundled His? I have seen the portrayed rhythm many times and was not sure what it was. Thank You for the methods you use to teach these concepts. Blocks have always been my problem area.


    • Jeff with admin. says

      For 2nd degree block type II you will see:

      1. nonconducted p-waves (electrical impulse conducts through the AV node but complete conduction through the ventricles is blocked, thus no QRS)
      2. P-waves are not preceded by PR prolongation as with second-degree AV block (Type 1)
      3. fixed PR interval

      Kind regards,

  7. Marmotess says

    I love the content and the music! Even my children are learning over my shoulder. Great site!! Thanks!!

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