Complete heart block

A 56 years old female came with history of dyspnoea on exertion along with giddiness since last one month. Patient was a known case of diabetes mellitus, and hypertension since last 6 years. Patient pulse during evaluation in the emergency department was 38 beats per minute,  Patient ECG is shown below.

ECG (Click on the image to enlarge it)

ECG is showing bradycardia, there is AV dissociation as you can see P wave (marked by black arrow), are occurring independently of QRS complex, atrial rate was 110 beats per minute, while qrs rate was 38 per minute, there is left axis deviation, qrs complex were of narrow in duration with normal morphology. So the diagnosis of the patient was complete heart block.


Patient was implanted permanent pacemaker and later was discharged in stable condition.

Thank you

Praveen Gupta