A 68-year-old man is seen in the emergency department after two brief episodes of syncope in the past week. Each episode occurred without warning while he was walking, and he recovered fully within a minute. He has hypertension treated with ramipril and amlodipine, and takes no other medications. He has no chest pain or history of coronary artery disease. On examination, the pulse is regular and slow, and the cardiovascular and neurological examinations are otherwise normal. ECG shows a regular atrial rate with intermittent non-conducted P waves. The PR interval on conducted beats is constant and normal, with no preceding prolongation, and the QRS is wide with a right bundle branch block pattern. Sodium, potassium, calcium, magnesium, creatinine, TSH, and high-sensitivity troponin are normal.
| Heart rate | 44/min |
| Respiratory rate | 16/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 128/76 mm Hg |
Question 1 of 30
Which one of the following is the most appropriate management for this patient?
Select 1. (0 / 1 selected)
Tip: right-click an answer (or press and hold on a phone) to strike it out. Drag over the question text to highlight it.