Agonal Rhythm: Not Always a Herald of Death! A Rare Presentation of Ebstein’s Anomaly

Abstract

An agonal rhythm is a variant of idioventricular rhythm often preceding asystole. It reflects significant myocardial or metabolic derangement and has a grave prognosis. Ebstein’s anomaly accounts for 0.3–0.7% of all cases of congenital heart diseases. The electrocardiogram in Ebstein’s is seldom normal across the spectrum and plays a major role in establishing diagnosis. This case report describes an electrocardiogram with extreme low voltage and bizarre complexes mimicking agonal rhythm in a patient having Ebstein’s anomaly, presenting with severe biventricular failure.