STAT ECG Diagnoses: chronic atrial fibrillation with bradycardia and hypotension

ECG Weekly Workout with Dr. Amal Mattu


A 87-year-old man with history of HTN, CKD, CHF (EF 45%), and chronic atrial fibrillation presents with 1-week history of generalized weakness, loss of appetite and intermittent dizziness. He denies chest pain, shortness of breath, or vomiting. On exam, he is found to be hypertensive, bradycardic, and in mild congestive heart failure. The following ECG is obtained and compared to his baseline ECG:

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

  1. What ECG abnormalities do you notice?
  2. What are your top differentials?
  3. What is the most likely diagnosis?