Pass ACLS Tip of the Day

Second-Degree AV Blocks and Their Treatment


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To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.

One method of ECG rhythm identification is to ask a series of questions such as:

  • What's the rate (<60, 60-100, 101-149, or >150);
  • Is the rhythm regular or irregular;
  • What's the shape, width, and frequency of P waves and QRS complexes; and
  • What's the P-R interval and is it constant?

ECG characteristics of a second-degree Mobitz type I (Wenckebach).

Identification of unstable bradycardia and its treatment with Atropine.

ECG characteristics of a second-degree Mobitz type II.

Possible effect of using Atropine on patients with a second-degree type II AV block.

Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.

Starting dose and titration of Dopamine and Epinephrine drips.

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Good luck with your ACLS class!

Helpful Listener Links:

Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/

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The Curious Clinicians Podcast: History of Doctor Wenckebach & Mobitz at https://curiousclinicians.com/2022/07/06/episode-52-way-back-wenckebach/

Practice ECGs with rationale at Dialed Medics at https://dialedmedics.com/

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Pass ACLS Tip of the DayBy Paul Taylor

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