ECG of the Week - 21st September 2015

The following ECG is from a 70yr old who presented with lethargy. Past medical history of Aortic Valve Replacement with post operative AF. Vital signs: BP 85/60 RR 18 Sats 94% RA.

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Things to think about

• What are the key ECG features ?
• What are the potential causes ?
• How would you manage this patient ?