n CME : Your SA Journal of CPD - Bradycardia and heart block : ECG education




Symptoms of effort intolerance, dizzy spells and syncope should alert the clinician to the possibility of bradycardia, confirmed by a slow pulse rate. Examination may however be normal. <br>ECG confirmation of the suspected arrhythmia is vital. Normally each p wave is followed by a narrow QRS complex. <br>A conducted wide QRS complex indicates cardiac conduction system disease. <br>AV block is present if a p wave is not followed by a QRS complex. <br>Reversible causes, particularly drugs, need to be excluded. <br>Referral for further evaluation is necessary to decide on the need for permanent cardiac pacing.


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