Bradydysrrhytmias: altered mental status, hypotension, and not able to transcutaneously pace

HPI

A 50-year-old male is brought into the emergency department from prison with bradycardia, hypotension, and altered mental status. Medics started IV fluids and treated with atropine with no response prior to arrival. Transcutaneous pacing was started with electrical but no mechanical capture. The following ECG was obtained in prison:

Presenting ECG — Bradydysrrhytmias: altered mental status, hypotension, and not able to transcutaneously pace

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