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Challenges in Clinical Electrocardiography
June 2015

A Patient With a Biventricular Pacemaker Presenting With Chest Pain

Author Affiliations
  • 1Department of Emergency Medicine, Bridgeport Hospital, Bridgeport, Connecticut
  • 2Division of Cardiology (Electrophysiology), Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
  • 3University of Minnesota School of Medicine, Minneapolis
  • 4Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
JAMA Intern Med. 2015;175(6):1053-1055. doi:10.1001/jamainternmed.2015.0515

A man in his 70s with a history of myocardial infarction (MI) and coronary artery bypass surgery, as well as an ejection fraction of 25% and biventricular pacemaker (BVP) placement, was brought to the emergency department for dull chest pain of 2 hours’ duration. An electrocardiogram (ECG) was obtained (Figure 1). Comparison was made with an ECG from 3 years earlier, post-BVP placement (Figure 2).

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