What type of rhythm presents a regular rate, PR interval sometimes > 0.20 with dropped QRS complex?

The type of rhythm characterized by a regular rate, a PR interval that can sometimes exceed 0.20 seconds, and dropped QRS complexes is indeed 2nd Degree Type 2 AV Block. In this rhythm, the conduction through the AV node is impaired, leading to the occasional failure of impulse transmission from the atria to the ventricles. This results in a scenario where some of the P waves are not followed by a QRS complex, which reflects the "dropped" QRS phenomenon.

In 2nd Degree Type 2, the PR intervals are typically consistent when a QRS is present, but the dropped beats occur without warning. The fact that the PR interval can occasionally exceed 0.20 seconds indicates a delay in conduction at the AV node, which is a key characteristic of this arrhythmia. It is important to recognize that this type of block is often more serious because the drops are less predictable, leading to a higher risk for progression to complete heart block.

This rhythm differs from 2nd Degree Type 1 AV Block, where the PR interval progressively lengthens until a QRS complex is dropped, and from 3rd Degree AV Block, where there is complete dissociation between atrial and ventricular activity