Case 1: An 83 Year-Old Man with Chest Pain and Syncope
History
Diagnosis
ECG 2
ECG 2 Diagnosis
History
An 83 year-old man with ischemic cardiomyopathy, previous bypass surgery, persistent atrial fibrillation presents to the emergency room with an episode of syncope after exertional chest pain. The EP team was asked to see him to interrogate his implantable defibrillator (ICD) which was implanted 3 months previously for primary prevention reasons. The interrogation is shown below.
Diagnosis
- Initially irregular rhythm, likely atrial fibrillation with single PVC
- Second row shows onset of ventricular fibrillation after short-coupled PVC
ECG 2
Interrogation strip continued from previous slide…
ECG 2 Diagnosis
- Ventricular fibrillation with 36J shock resulting in termination of AF
- Possible termination of AF with resultant sinus rhythm given regular QRS rhythm at end of tracing – would need to confirm with ECG
ECG ID: E820