HPI:  An 80-year-old male with a history of HTN, atrial fibrillation and an unknown “kidney problem” presents to the ED after being found unresponsive at home by his son. He was noted to have progressive lower extremity weakness over the past week. The patient was unresponsive when EMS arrived with hypotension and marked bradycardia. The following ECG is obtained:

Case ECG

 

 

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