From 5K to … the End of the Driveway

ANSWER

The correct interpretation includes sinus tachycardia with complete heart block and an idioventricular rhythm. Careful review of this ECG confirms complete atrioventricular dissociation, which is indicative of complete heart block.

Sinus tachycardia is indicated by a consistent P-P interval at a rate of 110 beats/min, idioventricular rhythm with a regular (but not normal) rate, and prolonged QRS interval of 148 ms. In this patient’s case, the tachycardia was presumed to be due to his upper respiratory infection. He underwent permanent pacemaker placement and resumed his normal activities without restriction.