A 55 year-old woman with atrial fibrillation, end-stage renal disease, and morbid obesity underwent coronary artery bypass and bioprosthetic mitral valve replacement. Following surgery, telemetry revealed atrial fibrillation with third degree atrioventricular block with a very slow escape, as well as ventricular asystole of up to seven seconds. There was nonsustained ventricular tachycardia (NSVT), and a postoperative echocardiogram showed a left ventricular ejection fraction of 35%.
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