Scenario: The 2 rhythm strips shown here (approximately 18 minutes apart) are from a 76-year-old woman admitted to the cardiac telemetry unit for exacerbation of heart failure. The patient’s history includes hypertension, type 2 diabetes, diastolic heart failure due to long-standing hypertension, and an atrioventricular (AV) pacemaker. The patient is resting comfortably in bed and is scheduled for discharge in the late afternoon. Given the rhythm strips, is it safe to discharge the patient?

Normal sinus rhythm with possible right atrial enlargement and secondary repolarization changes. There is intermittent AV paced rhythm with appropriate AV sensing and pacing.

A 3-letter code is used to describe the type of pacing used. The first letter denotes the chamber paced: A = atrium, V = ventricle, D = dual (ie, both A and V). The second letter denotes the chamber sensed, using the same nomenclature....

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