ARRHYTHMIAClinical Case #007

78-Year-Old Male With Fatigue and Very Slow Heart Rate

Patient Presentation

Age: 78

Gender: Male

Onset: Gradual over several days

History: Coronary artery disease, prior inferior MI

Symptoms

Progressive fatigue, lightheadedness, and one episode of near-syncope. No chest pain.

Vitals & Findings

BP 102/64, HR 38 regular. ECG shows complete atrioventricular dissociation (P waves and QRS complexes at independent rates).

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What would you do next?

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