Möbitz I & II Combined: Arrhythmia Simulator
Report:
Sinus rhythm.
Möbitz 1 [Wenckebach] second degree AV block, with 3:2 and 4:3 periods [top strip].
Möbitz 2 second degree AV block, with 3:2 and 4:3 periods.
Complete RBBB coincident with Möbitz II block.
Complete AV block [bottom strip].
Comment:
The strips were produced by an ECG simulator, programmed to show both types of AV block. Marriott, to whom the strips were sent for an opinion, stated that this has not been seen before in the same strip and expressed relief at the subsequent discovery of their true origin.
I came very close to making a fool of myself. The delight of the “discovery” was short-lived. It happened when I returned from a conference and was shown the “really interesting strips” the ICU nurses, knowing my interest in ECGs, saved on a patient with known pseudoxanthoma elasticum. They looked very pleased. There is a lesson in this.
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