I was asked for an opinion on this ECG.
There is sequential shortening of the PR interval and no dropped beats.
This is not AV dissociation or isorhythmic AV dissociation as the R to R intervals are different and related to the PR intervals.
This is reversed Wenckebach and below is another example.
Reversed Wenckebach is a rare ECG finding where there is sequential shortening of the PR interval and when it reaches its shortest value, the sequence is repeated often without a dropped beat.
When a dropped beat occurs, there may be syncope and a permanent pacemaker required.
In the good old days this was an arrhythmia associated with digitalis toxicity.
Dr Harry Mond
In 49+ years as a practicing cardiologist, Dr Harry Mond has published 260+ published manuscripts & books. A co-founder of CardioScan, he remains Medical Director and oversees 500K+ heart studies each year.
Download his full profile here.