Assoc Prof Harry Mond
December 2, 2024
I was asked for an opinion on this ECG.
![](https://cdn.prod.website-files.com/675b0fb39c1b52376af55902/675b0fb39c1b52376af55bb1_Is-this-Wenckebach-Image-1-e1583792886354-300x154.jpeg)
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.
![](https://cdn.prod.website-files.com/675b0fb39c1b52376af55902/675b0fb39c1b52376af55bb0_Is-this-Wenckebach-Image-2-e1583792904104-300x150.jpeg)
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