ECG of the Month: The Path of Least Resistance (JACC: Case Reports)

Editor's Note: This ECG of the Month was adapted from a JACC: Case Reports ECG Challenge. You can access the original article here.

A 72-year-old man with a medical history of coronary artery disease, severe aortic stenosis with mechanical aortic valve replacement, paroxysmal atrial fibrillation, right bundle branch block (RBBB), hypertension, diabetes, obesity, and a recent hip arthroplasty complicated by osteomyelitis on outpatient vancomycin infusions became unresponsive before infusion and was found to be in ventricular fibrillation that required one shock.

An electrocardiogram was obtained (Figure 1)

Figure 1: 12-Lead Electrocardiogram Obtained During Hospitalization

Figure 1

Which of the following is the correct diagnosis?

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