Temporary pacemaker with left bundle branch block image in ECG

A 78-year-old man who had no history of dizziness and syncope was admitted to the emergency department of a public hospital with syncope. He had no angina. He had undergone multivessel coronary artery bypass surgery 6 years ago. His blood pressure was 70/40 mm Hg, and his pulse was 42 beats/ minute in the emergency department. Electrocardiography (ECG) revealed complete atrioventricular block and right bundle branch block (Fig. 1A).