Ventricular Escape Complex(s) or Rhythm
Let’s talk about ventricular escape complex or rhythm.
Ventricular escape complex is a single wide QRS complex that usually occurs after a pause in which a supraventricular impulse fails to conduct.
Ventricular escape rhythm (also known as idioventricular escape rhythm) is when 3 or more ventricular escape complexes occur in a row at a rate of 30-40 bpm.
Criteria (ventricular escape rhythm)
- Rate: usually 30-40 bpm (sometimes can be 20-50 bpm).
- Wide QRS similar to PVCs, and may have LBBB or RBBB morphology.
- Rhythm is usually regular.
NOTE: Ventricular escape complex/rhythm occurs in response to decreased sinus impulse formation or conduction such as: Sinus arrest, severe sinus bradycardia, third degree AV block, hyperkalaemia, drugs (beta-blocker, calcium-channel blocker or digoxin poisoning), others.
Ventricular escape rhythm in the setting of complete AV block
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