A 60 year old male, Rheumatic Heart Disease & Atrial Fibrillation, post PBMV ( 20 years ago), presented with extreme fatigue, dizziness and palpitations on and off over the last 6 months. He had frequent hospital admissions in the past with pulmonary oedema and had been on rate control, diuretics & anticoagulants. Presently, he reported with Bradycardia.
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