USMLE Step 2 - Question 16

A 82 year old male with a history of benign prostatic hypertrophy and osteoarthritis presents to the emergency room with an episode of syncope while watching TV. He has felt generally weak for the past 5 days. He denies any chest pains, shortness of breath, or fevers. His medications include tamsulosin and celecoxib. His blood pressure is 115/65, heart rate 40, respirations 12, and he is afebrile. His physical examination reveals normal lung sounds, a regular, bradycardic rhythm with verying intensities of the S1 heart sound, and intermittent large cannon A waves in the jugular venous pulsation. His laboratory studies are normal. His ECG is below. What is the appropriate treatment?


A. No treatment needed

B. Discontinue tamsulosin

C. Permanent pacemaker implantation

D. Defibrillator implantation