This post is an answer to the ECG Case 308
- Bradycardia – mean ventricular rate 54 bpm
- Marked sinus arrhythmia
- ~2 sec pause between 1st and 2nd complex
- Inferior axis
- 1st Degree AV block – varying magnitude 220-280 ms
Interpretation
- Sinus Node Dysfunction
- Marked sinus bradycardia
- History of collapse / syncope
What happened next ?
The patient remained asymptomatic during episodes of bradycardia. There were no correctable electrolyte abnormalities or culprit medications to account for bradycardia.
A diagnosis of sinus node dysfunction was made and a dual chamber pacemaker was inserted. The patient made an uneventful post-procedural recovery and was discharged home following a brief in-patient stay.
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