Clinical case 1

A 78-year-old male is brought in by ambulance after a brief syncopal episode. He states that while walking briskly in the park he started to feel short of breath and experienced palpitations. He felt lightheaded and was sweating profusely before he collapsed. He recovered immediately. There was no evidence of seizure activity.

On arrival at the Emergency Department, he was asymptomatic. His examination was normal, including his observations and full neurological assessment.

The following ECG was obtained:

Fig.4 1