Jarisch-Bezold Reflex

Report:

Atrial fibrillation with slow response

Junctional escape beat(s)

Comment:

There is no observable atrial activity, but the patient had atrial fibrillation since admission. The strips could pass, electrocardiographically, for sinus arrest or atrial standstill.

Intense vagally-mediated slowing of AV conduction (or sinus impulse generation, when present) may be associated with both infarction and reperfusion of the basal region of the ventricles. The reflex was originally described by Bezold in 1867 and given its current meaning by Jarisch in 1937.

This patient was vomiting - another expression of the dominant vagal tone.

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