EKG 8/12

EKG of the month:

HINT:  This patient is being paced with an AAI pacer…

QUESTION 1:  What is the diagnosis?

QUESTION 2: How would you manage this patient if he became hemodynamically unstable?

Links to EKG sites:

Answer to EKG of the month (July 2012)

ANSWER 1:
Atrial paced rhythm with 100% atrial capture and a second degree AV block with Mobitz I conduction (Wenkebach)

ANSWER 2:
If the patient is hemodynamically stable, there is no need to alter the pacer settings.  If the patient developed hypotension due to the slow heart rate, you could switch to VVI pacing to maintain cardiac output.