Which ECG feature most accurately identifies Mobitz Type II second-degree AV block?
Sudden dropped QRS complexes without prior PR prolongation
Mobitz Type II second-degree AV block is a disease of the His-Purkinje system in which conduction either succeeds or fails in all-or-none fashion. On the ECG, PR intervals are constant and then a QRS complex is suddenly dropped without any prior PR lengthening.
A shortened PR occurs in pre-excitation, complete AV dissociation defines third-degree block, and progressive PR lengthening before a dropped beat is the signature of Mobitz Type I (Wenckebach) — not Mobitz II.
Hence, Sudden dropped QRS complexes without prior PR prolongation.
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