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Electrocardiogram Interpretation

Weldon J. Walker, MD
JAMA. 1973;226(11):1361. doi:10.1001/jama.1973.03230110049025.
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To the Editor.—  The interesting article by Lynch et al, "Hereditary Progressive Atrioventricular Conduction Defect: A New Syndrome?" (225: 1465, 1973), was unfortunately marred by poor electrocardiographic interpretation and labeling. The bottom tracing in Fig 1 was stated to show "atrioventricular dissociation due to complete heart block." Actually, the recorded R-R intervals of the standard 12-lead tracing demonstrated atrial and ventricular rates varying from 75 to 48 beats per minute, with identifiable P-R intervals between 0.32 and 0.38 seconds. This tracing showed first-degree atrioventricular block only. Beneath the tracing is an unidentified rhythm strip with apparent complete atrioventricular block, having a ventricular rate of 38 beats per minute and an atrial rate of 75 beats per minute. Certainly the rhythm strip wasn't a part of this particular tracing; if so, it should have been stated to show intermittent complete atrioventricular block.The bottom tracing in Fig 5 was stated to


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