Congenital Heart Block
Report:
Respiratory and ventriculophasic sinus arrhythmia
Right atrial abnormality (RAA)
Left atrial abnormality (LAA)
Second degree AV block, unspecified
Junctional rhythm 65/min
AV dissociation with interference
Comment:
Congenital heart blocks are not necessarily complete, although this one, despite obvious sinus captures, was reported as “probably complete heart block”. What the Cardiologist had in mind was “probably congenital heart block”. Clang association.
The last two short cycles have a P wave just before the initial QRS, miming Wenckebach 3:2 conduction. The PR interval is too short for conduction; the QRS terminates just another junctional cycle.
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