A 72-year-old diabetic and hypertensive patient with moderate renal insufficiency has been complaining for a year of episodes of palpitations lasting more than one hour, both during exercise and at rest. He also reports the occurrence a week ago and during exercise a presyncope.
The ECG performed during the consultation in our department shows, in addition to a first-degree atrioventricular block and an interatrial block (see figures).