A 77-year-old patient with cardiovascular risk factors–hypertension and type 2 diabetes mellitus–and a history of untreated paroxysmal atrial fibrillation episodes was admitted due to detection of bradycardia during blood pressure measurement and mild nonspecific dizziness lasting just a few seconds. The patient has never had syncope or other cardiac symptoms but was admitted from the emergency department due to the presence of nonconducted P waves with interference from a ventricular rhythm (wide QRS complex), which was interpreted as atrioventricular block (Figure).
In your opinion, what is the most probable diagnosis of the patient's baseline electrocardiogram?
- 1.
Supraventricular extrasystole with accessory pathway conduction.
- 2.
Isolated ventricular extrasystole and nonconducted atrial extrasystole.
- 3.
Atrial rhythm with Mobitz II atrioventricular block.
- 4.
Atrial rhythm with ventricular extrasystole and concealed ventriculoatrial conduction.
Suggest a diagnosis to this ECG Contest at http://www.revespcardiol.org/es/electroreto/70/10. The answer will be published in the next issue (November 2017). #EKGchallenge.