Elderly Female With Syncope

      A 77-year-old woman with a history of chronic kidney disease presented to the emergency department (ED) by ambulance. The patient was found on the floor of her bedroom, reporting generalized weakness and numerous syncopal episodes. She reported dyspnea but denied chest pain. In the ED, she was alert and oriented. The cardiac monitor demonstrated intermittent bradycardia with frequent ectopy. A 12-lead ECG was obtained (Figure 1).
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