Atropine Bradycardia
Report:
Top:
Sinus rhythm 83 - 85/min
Second degree AV block
Escape-capture bigeminy
Ventricular rate 55/min
Bottom:
Sinus tachycardia 100/min
2:1 AV block
Ventricular rate 50/min
Comment:
In the top strip, a basic 2:1 AV block is modified by the junctional escape beats, which prevent conduction of every third P wave and produce the escape-capture bigeminy. The slowing of the ventricular rate attending atropine-induced sinus tachycardia is due to the change in the overall P:QRS ratio from 3:2 to 2:154. This is not, of course, the paradoxical response allegedly associated with small doses of atropine, which consists of slowing of the sinus rate through stimulation of medullary vagal nuclei55.
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