The lead II rhythm strip shows four sinus beats with P wave followed by a QRS complex; the fifth P wave is not followed by a QRS complex and represents second degree heart block. There is no change in the PR interval prior to or after the blocked P wave and thus this is Mobitz II second degree heart block. A second episode of second degree heart block can be seen after the seventh QRS complex.
Reproduced with permission by Samuel Levy, MD.
Graphic 51492 Version 2.0
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