Reappraisal of the Traditional Wenckebach Phenomenon with a Modified Ladder Diagram
Article first published online: 26 JAN 2012
© 2012, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 17, Issue 1, pages 3–7, January 2012
How to Cite
Barold, S. S., Stroobandt, R. X., Sinnaeve, A. F., Andries, E. and Herweg, B. (2012), Reappraisal of the Traditional Wenckebach Phenomenon with a Modified Ladder Diagram. Annals of Noninvasive Electrocardiology, 17: 3–7. doi: 10.1111/j.1542-474X.2011.00474.x
- Issue published online: 26 JAN 2012
- Article first published online: 26 JAN 2012
- second-degree atrioventricular block;
- Wenckebach second-degree atrioventricular block;
- type I second-degree atrioventricular block
Understanding of the traditional Wenckebach phenomenon is enhanced by using a modified ladder diagram where AV conduction in any cycle is represented by a slanted line in the AV bar together with similar AV conduction lines of all the preceding cycles. The diagram facilitates calculation of the duration of RR intervals (equal to the basic PP or sinus interval minus the PR or AV increment applied to this particular cycle) and the duration of the pause (equal to 2 × PP or sinus interval minus the sum of all the increments applied to the AV delay). The modified Wenckebach diagram should help students understand the mysterious clustering of QRS complexes or “paradoxical” increase of the ventricular rate that occurs during a Wenckebach sequence.
Ann Noninvasive Electrocardiol 2012;17(1):3–7