Also known as Mobitz II, Hay

If R-to-R intervals are regular, then blocks can occur as 2:1, 3:1, or 4:1 (P waves to QRS)
If R-to-R intervals are irregular, then block is variable

CAUSES:
- Idiopathic fibrosis and sclerosis of the conduction system (about 50% of patients)
- Ischemic heart disease (40%)
- Drugs (eg, beta-blockers, calcium channel blockers, digoxin, amiodarone)
- Increased vagal tone
- Valvulopathy
- Congenital heart, genetic, or other disorders

INTERVENTIONS: based on AHA 2016 ACLS Guidelines
- Keep airway patent, support breathing
- Start IV/IO, draw/send labs, 12-Lead ECG
- Correct possible causes
- NO Atropine!
- Start Transcutaneous Pacing (TCP).
- May give Dopamine 2-20 mcg/kg per minute and titrate to effect.
- If profound bradycardia after TCP, may give Epinephrine 2-10 mcg/min and titrate to effect.

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