The patient was a 72-year-old woman who had undergone ablation for atrial fibrillation (AF) and implantation of a mitral bioprosthesis. She was taking diuretics, anticoagulants, and digoxin, and presented to the emergency department because of asthenia. The electrocardiogram (ECG) performed on her arrival is shown in Figure 1. Figure 2 shows the ECG carried out 48hours later.
On the basis of these 2 ECG, what is the suspected diagnosis and expected outcome?
- 1.
The ECG in Figure 1 shows AF with complete atrioventricular block. After discontinuation of digoxin therapy, normal sinus rhythm was recovered, as shown in the ECG in Figure 2.
- 2.
The ECG in Figure 1 shows accelerated atrioventricular junctional rhythm due to digitalis intoxication. After discontinuation of digoxin therapy, the rhythm was normalized, as shown in the ECG in Figure 2.
- 3.
The ECG in Figure 1 shows complete sinoatrial block. Discontinuation of digoxin therapy resulted in sinus rhythm with a second-degree Mobitz sinoatrial block, as shown in the ECG in Figure 2.
- 4.
The ECG in Figure 1 shows AF with complete atrioventricular block in. Discontinuation of digoxin therapy resulted in sinus rhythm with atrial premature complexes, as shown in the ECG in Figure 2.
Suggest a solution to this ECG contest at http://www.revespcardiol.org/es/electroreto/69/08 (only Spanish). The answer will be published in the next issue (September 2016). #RetoECG.