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Vol. 70. Issue 10.
Pages 870 (October 2017)
ECG Contest
DOI: 10.1016/j.rec.2017.04.005
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ECG, October 2017
ECG de octubre de 2017
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Carlos Rubén López Perales
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caruben89@gmail.com

Corresponding author:
, Georgina Fuertes Ferre, Juan Carlos Porres Azpiroz
Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Rev Esp Cardiol. 2017;70:100910.1016/j.rec.2017.03.017
Carlos Rubén López Perales, Georgina Fuertes Ferre, Juan Carlos Porres Azpiroz
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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).

Figure
(0.61MB).

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.

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