A 60 year old female came complaints of giddiness on and off since last one week. Patient was a known case of diabetes mellitus and was on oral hypoglycemic agents. ECG of the patient done in the emergency is shown below.
ECG 1 of the patient
ECG was showing sinus rhythm at rate around 60 beats per minutes, PR interval was 260 msec, atrial rate was 120 beats per minutes, so there were two P wave seen, second P wave appear to merged into T wave, QRS axis was normal, QRS complexes were narrow in duration, there was no other ST-T wave changes seen ,so the diagnosis of patient was 2.1 AV block.
Patient ECG was repeated after one hours. ECG is shown below.
ECG after one hours
ECG is showing atrial rate of 100 beats per minutes, ventricular rate of 41 beats per minute, there was complete AV dissociation as there was no relationship between P wave and qrs complex suggestive of complete heart block.
So the final diagnosis of the patient was 2.1 AV block with intermittent complete heart block. Patient underwent successful VVI pacemaker implantation and later patient was discharged in stable condition.
So the final diagnosis of the patient was 2.1 AV block with intermittent complete heart block. Patient underwent successful VVI pacemaker implantation and later patient was discharged in stable condition.
Thank you,
Praveen Gupta
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