3^rd Degree Heart Block

Background

80-year-old male with a history of hypertension

History

• 3 episodes of syncope over 7 months
• 3 hospital / ER visits
• Driving restricted

Initial Workup

• Inconclusive results of CT scan of cerebrum, sonography of carotid arteries, echocardiogram
• ECG showed permanent AV conduction delay of 230 ms with sinus rhythm

Workup

Prior tests (all negative)

• EKG
• EEG
• CT Scan
• Holter
• Reveal implanted

Conclusion

Reveal recorded 3rd degree heart block with ventricular standstill captured.

A dual chamber pacemaker was implanted and antiarrhythmics were adjusted to control SVT and to lower rate.

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