ECG of the Week - 15th December 2014

This week's ECG is from a 76yr old male who presented to the Emergency Department following an episode of syncope at home. He has a past history of ischaemic cardiac disease, prior CABG and hypertension. He reported no chest pain pre- or post-event, nil recent symptoms and 'was back to normal' when reviewed in the ED. His medications were aspirin, low dose slow release calcium channel blocker and clopidogrel. All vital signs were within normal limits. His ECG is below:

Click to enlarge

Things to consider

• What does his ECG show ?
• How would you manage this patient in your Emergency Department ?
• What would be your disposition for this patient ?
• Can you guess what happened next ?