Electrocardiogram of a 73 year-old woman with hypertension, hyperlipidemia, type 2 diabetes and permanent pacemaker.

Rate 67/min
PR 0.19 sec
ORS 0.19 sec
QT 0.46 sec
QTc 0.49 sec
QRS axis -60º

Interpretation: Sinus rhythm sensed by a dual chamber pacemaker with ventricular capture. A-V interval 0.19 sec. Normal pacemaker function (atrial sensing, ventricular pacing).

The patient complained of dizziness and lightheadedness. Her electrocardigram showed second degree A-V block Mobitz type II, left anterior fascicular block and right bundle branch block. Dual chamber pacemaker (DDDR) has been implanted with resolution of symptoms.

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