Recognition
- • AV dissociation — P and QRS independent
- • Atrial rate > ventricular rate
- • Ventricular escape 20–40 bpm (wide) or 40–60 (narrow)
Key findings
- • Cannon A waves on JVP
Clinical importance
- • Risk of haemodynamic collapse / Stokes-Adams attacks
Management pearls
- • Atropine 500 mcg IV (often ineffective)
- • Isoprenaline / adrenaline infusion
- • Transcutaneous pacing → transvenous → permanent pacemaker
