Progressive PR Prolongation in an Asymptomatic Man

Abstract

A man in his 70s attended his local medical center for an evaluation prior to travel. His medical history was remarkable only for recurrent deep vein thrombosis, for which he took rivaroxaban as the only medical treatment. He was completely asymptomatic. On clinical examination, he was found to be afebrile, with a respiratory rate of 16 breaths/min, oxygen saturation of 99% on room air, and a blood pressure of 145/75 mm Hg. His heart rate was 54 beats/min, prompting the recording of an electrocardiogram (ECG) (Figure). On retaking of the history, the patient was adamant that he had never experienced any dizziness, palpitations, or blackouts. Owing to the appearance of the ECG, the patient was referred for a cardiologic evaluation. Identify all potential conflicts of interest that might be relevant to your comment. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Err on the side of full disclosure. If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response. Not all submitted comments are published. Please see our commenting policy for details.