Case 144: A 55-Year-Old Woman in the Neurosurgery ICU
History
Diagnosis
History
This 55-year-old woman had surgery two day ago for the removal of a left temporal lobe tumor. Postoperatively, her heart rate was noted to be slow:
Diagnosis
- Marked sinus bradycardia (38/min) with sinus arrhythmia
- Escape junctional bradycardia with isorhythmic AV dissociation
- There is probably one AV capture (second P-QRS)
Marked sinus bradycardia is not uncommon after brain surgery. There is escape of a junctional pacemaker with a slow rate almost identical to that of the sinus node. This is a good example of “isorhythmic dissociation”.
ECG ID: E235