Scenario: This ECG (lead V1) was obtained from an 81-year-old man in the critical care unit after an acute myocardial infarction with left ventricular dysfunction. Specifically, his ejection fraction was 14% and the scar volume of the left ventricle on the positron emission tomography, or PET, scan was 25%. His condition was pharmacologically managed with digoxin, beta blockers, and angiotension-converting enzyme inhibitors. Notably, he denied feeling any dizziness, vertigo, or syncope during the recording.

Third degree atrioventricular (AV) block with slow junctional escape rhythm, followed by ventricular standstill

This ECG shows a third degree AV block, also known as a complete heart block. The condition also can be called a complete AV dissociation because there is no association between the P waves and QRS complexes. The underlying escape rhythm is a slow junctional rhythm (narrow QRS complexes) at a rate of 30/min. This rhythm quickly fails because none...

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