A 78-year-old man had an episode of loss of consciousness at home during which he suffered from a subdural hematoma. This ECG is recorded in the Emergency Department:

• Sinus rhythm, 75/min, with Mobitz II second degree AV block
• Ventricular rate 52/min
• Right bundle branch block and left anterior fascicular block (bifascicular block)
• Moderate voltage criteria for left ventricular hypertrophy
• Cannot rule out septal infarction, age undetermined (small Q-waves, V1-V3)
• T wave abnormality, consider inferior and anterolateral ischemia

This ECG is recorded in the ICU, 2 hours after the patient’s admission:

• Sinus rhythm with high grade AV block
• Ventricular escape rhythm (ventricular rate 32/min)
• One AV-conducted beat, one fusion complex