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

ECG Weekly Workout with Dr. Amal Mattu


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:

Before watching this week’s video, ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the rhythm?
  3. What is the most likely cause of bradycardia?