Both EKGs above are from the same patient, a 70 year old man with many medical comorbidities. He initially presented to the clinic for lightheadedness, presyncope, and palpitations. He switches into and out of the rhythms shown above.Challenge: What is the syndrome described here?
Both EKGs shown under Creative Commons Attribution Share-Alike 3.0 License.
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Polar
This is tachycardia-bradycardia syndrome, related to sick sinus syndrome. Sick sinus syndrome is characterized by chronic inappropriate bradycardia, sinus pauses, and AV conduction disturbances. In tachy-brady syndrome, atrial fibrillation is most commonly seen (but occasionally atrial flutter and PSVT may be seen) alternating with bradycardia.
Sources: UpToDate; Wikipedia.
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