Updated on August 15, 2023
When there is a delay of transmission from SA node to ventricles, there will be a prolongation of PR interval on ECG (longer than 200 milli seconds) which is called as first degree heart block.
Most of the times, this is harmless as a heart block.
Mostly due to degeneration of heart’s conducting system. Temporary causes can include imbalance in electrolytes.
The rhythm will look identical to sinus rhythm with the only exception of prolonged PR interval.
On ECG paper, each smallest box is equivalent to 40 milli seconds.
Each big box has 5 small boxes inside, meaning the big box takes 200 milli seconds.
Measure the distance between start of P wave to start of QRS complex to see if PR is prolonged.
Normal PR interval is 120-200milli seconds (that is 3 to 5 small boxes).
If you check the number of small boxes in the following ECG strip, you can see that there are 6 small boxes for the middle beat.
The image also shows a way to calculate heart rate by looking at number of big boxes between R waves. If there is 1 box, rate is 300, if there are 2 boxes between adjacent R waves, the rate is 150 and so on.