PMC8225969_01
ECG on presentation showing third degree AVB with ventricular escape rhythm.
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AV block with ventricular escape rhythm (Fig. 1). Asystole was also noted on telemetry leading to a transient loss of consciousness.
ECG post transvenous pacemaker placement.
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Post procedure EKG showed 100 % ventricular capture (Fig. 2).
ECG on Day 3 showing transition to first degree AVB with P-R interval 330 msec.
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An ECG the next day showed transition to a first-degree heart block (P-R interval of 330 ms), heart rate of 78 beats per minute with narrow-complex QRS and diffuse ST-T wave abnormalities, likely due to cardiac memory (Fig. 3).
ECG on Day 4 showing first degree heart block with P-R interval <290 msec.
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On day 4, the P-R interval shortened to 240 ms (Fig. 4); IV ceftriaxone was switched to oral doxycycline, and patient was discharged home to complete the remaining course for a total of 24 days.