The following ECG is from a 72 year old female who presented to the Emergency Department complaining of dizziness. She has a history of ischaemic cardiac disease, atrial fibrillation and diabetes.
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- Regular ventricular rhythm
- Atrial fibrillation best appreciated in leads V1-2
- Irregular atrial activity
- Absence of P waves
- T wave inversion leads II, III, aVF, V1-4
- ‘Regularised’ Atrial fibrillation
- AF + Complete heart block
- AF – baseline irregularity, no P waves, history of same
- Complete heart block – regular junctional escape rhythm
What happened ?
The patient was not taking digoxin, a common cause of regularised AF, and failed to respond to isoprenaline. She was taken for urgent PPM insertion and following made an uneventful recovery.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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