Our latest cardiology case report from Brady Pregerson, MD, features a woman in her 60s with a history of sick sinus syndrome presenting with palpitations, SOB, and lightheadedness. Can you determine the correct diagnosis?
History:
A patient in their mid-60’s with a history of sick sinus syndrome diagnosed 3 years ago presents to the hospital with palpitations, shortness of breath and lightheadedness that started around 6 PM. She denies any chest pain, syncope or other complaints.
Exam:
Vital signs are normal except for a pulse in the 120’s. The physical exam is otherwise normal.
Other Info: Her cardiologist was contacted and found a normal echo and normal myocardial perfusion study in about 3-4 years ago.
What is the most likely rhythm in this patient?