PMC5351227_01
(a) 12-lead electrocardiogram showing heart rate of 38 bpm with the absence of P waves suggesting junctional rhythm (b) 12-lead electrocardiogram with heart rate of 74 bpm with irregular RR intervals and fibrillatory P waves suggestive of atrial fibrillation with controlled ventricular rate (c) 12-lead electrocardiogram with heart rate of 44 bpm with atrioventricular dissociation suggestive of complete heart block
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F1
ECG done in the emergency department showed junctional rhythm [Figure 1a]. Echocardiographic evaluation was done in view of sudden hypotension which was normal. ECG revealed atrial fibrillation with controlled ventricular rate which was managed conservatively with rate control drugs [Figure 1b]. On day 4 [Figure 1c], lithium level was 0.9, and she reverted spontaneously to sinus rhythm with bradycardia and finally rate normalized.