ECG Complete heart block

71 years old male with a known case of diabetes mellitus, coronary artery diseases with triple vessel coronary disease with left main stenosis with history of CABG in 2013 comes with chief complaints of giddiness on and off since last 10 days. There was no history of chest pain, syncope, perspiration. During evaluation in the emergency department patient pulse rate was 42 per minute, Blood pressure was 160/80 mmhg, cardiac marker was within normal limit. 

                                                     ECG 1(Click on the image to enlarge it)

 
Description of the ECG-AV dissociation, atrial rate around 100 beats per minute ventricular rate 45 per minute, normal  axis, narrow QRS, ST segment depression with T wave inversion in lead I,aVL, V4-V6


Another ECG of the same patient

Diagnosis of the ECG-Complete heart block. Patient underwent successful Pacemaker implantation.