An 70 year old lady who had previously had a few attacks of dizziness, fell and broke her hip. She was found to have slow pulse, ECG was performed. Which is the next best step for management of this patient?: (A) Temporary pacemaker, (B) Permanent pacemaker, (C) I.C.D, (D) Proceed with hip joint Repair surgery
Answer is A. Image shows ventricular rate of 30/min with no relation between P waves and qRS complexes. QRS complexes are broad indicating origin from the ventricle and presence of escape rhythm. All these findings indicate presence of complete hea block. She needs a permanent pacemaker. However in the current circumstances she needs ohopaedic surgery --> to reduce moality -> temporary pacemaker should be the next best step.