USMLE Step 3 - Question 28

A 56 year old male presents to the emergency department with chest pains, nausea and vomiting. His temperature is 37.2, blood pressure 110/70, heart rate 50, respirations 20, and oxygen saturation normal on room air. Physical examination reveals normal breath sounds, an S4 heart sound, and a regularly irregular rhythm. Laboratory studies reveal an elevated troponin I level and appropriate therapy for acute coronary syndrome is begun. His ECG is below. What is the treatment for his heart rhythm?


A. Atropine

B. Adenosine

C. Emergency pacemaker placement

D. Observation