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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.
Gooden JY, Scantlebury D, Asirvatham S. An Unrecognized, Preventable Cause of Syncope, Malignant Arrhythmia, and Cardiac Death. JAMA Intern Med. 2013;173(20):1915-1917. doi:10.1001/jamainternmed.2013.7425