A 19 year old male is brought in for evaluation by his mother after a syncopal episode. He was packing boxes getting ready to return to school after the long summer when he felt suddenly light-headed with associated palpitations.
His mother heard a “thump”and found him in his bedroom on the floor. By the time his mother got to his room he was awake but still lying on the floor. He was alert and oriented complaining only that he had “felt dizzy”and “must have passed-out.” He denied head, neck, back or chest pain. There was no reported seizure-like activity.
He has no significant PMHx. Takes no medications and denies tobacco, alcohol or other recreational drug use.
He has a normal cardiac exam without murmur. The rest of his physical exam is also unremarkable without signs of trauma or neurological deficit.
Temp: 98.1°F (36.7°C), HR: 82, RR: 16, BP: 118/74, Sat.99%
An ECG is performed.
1. What is your interpretation of this ECG?
2. What is the treatment?