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Challenges in Clinical Electrocardiography
November 11, 2013

An Unrecognized, Preventable Cause of Syncope, Malignant Arrhythmia, and Cardiac Death

Author Affiliations
  • 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
  • 2Division of Cardiovascular Diseases, Mayo Clinic, Rochester
  • 3Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester
JAMA Intern Med. 2013;173(20):1915-1917. doi:10.1001/jamainternmed.2013.7425

A 68-year-old-man with a history of hypertension, a previous “silent MI (myocardial infarction),” and prior unexplained syncope experienced a witnessed cardiac arrest. Cardiopulmonary resuscitation was promptly begun by his wife. He was subsequently defibrillated and admitted to the coronary care unit on the cooling protocol. During transportation, episodes of atrial fibrillation (AF) were noted. His electrocardiograms (ECGs) at the time of evaluation of his syncope 10 years before and on admission to hospital are shown in Figure 1.

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