A 70 yr old male who is a known case of CLD with DCMP since 4-5 yrs with on/off Atrial Fibrillation presented with Giddiness and palpotations since 4 hrs....Vitals were BP-94/60mmHg PR-102/min spO2- 89%/....comment on this interesting ECG and approach to this pt



Chb with extensive cardiomyopathy pacemaker to be given treat as chf he has probably portal hypertension as well

Yes its a case of Chronic AF with Regularised Ventricular date due to CHB

Chronic af with ventricular rhythm with liver parenchymal disease..liver disease may be cardiac cirrhosis..viral markers, lft, rft, pt inr aptt, se electrolytes...liver biopsy can be thought about if needed..conservative mgmt with ace inhibitors, beta blockers, low dose diuretics...doses of all to be titrated carefully..treatment for liver disease of anything other than cardiac cirrhosis.

He is a known case of Alcoholic liver disease..not due to congestive hepatopathy

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Pt has slow AF, which is complete heart block. Check his electrolytes. If normal will need pacemaker support.Rule out sepsis also.

CHB needs TPM followed by PPM (DDDR ideally)

Is this patient really having heart rate 102/min as given in history???

CHB go for peacemaking


complete heart block needs pacemaker

Ventricular rhythm... LFT, PT INR MVR, TVR with Pacemaker placement....

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