As Figure 1 shows, this patient has long-standing 1° AV block -- dating back to 1949. As shown in the diagram in Figure 2, the impulse from the atrium turns around in the AV junction due to dual AV ...
The diagnosis is normal sinus rhythm, complete heart block with junctional escape rhythm, retrograde P waves, and nonconducted premature atrial complexes. The rhythm is regular at a rate of 48 ...