Sunday, May 1, 2016

Longer PR after the PVCs is expression of concealed penetration into the AV node.

Interpolated PVCs with "sort of compensatory pause" due to sinus bradycardia and PR quite prolonged at baseline.

Not all PVCs are followed by a pause. If a PVC occurs early enough (especially if the heart rate is slow), it may appear sandwiched in between two normal beats. This is called an interpolatedPVC. 

The sinus impulse following the PVC may be conducted with a longer PR interval because of retrograde concealed conduction by the PVC into the AV junction slowing subsequent conduction of the sinus impulse. 

PVC may retrogradely capture the atrium, reset the sinus node, and be followed by an incomplete pause. Often the retrograde P wave can be seen on the ECG, hiding in the ST-T wave of the PVC


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