ECG of the Week - 30th March 2015

This ECG is from an 80 yr old male who presented to the Emergency Department feeling generally unwell for the preceding 10 hours ! He denied chest pain, dysponea or syncope. He had a history of paroxysmal atrial fibrillation and had a single chamber PPM in-situ for bradycardia. Vital signs were within normal limits.

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Sorry about the image quality my scanner is broken so I had to take a picture with my phone !

Things to think about

• What are the key ECG features ?
• What are you going to do about it ?
• How does the pacemaker affect your plan ?