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Dysrhythmia update: The effect of intermittent heart block on the central venous pressure trace.

A 75-year-old man developed heart block with intermittent conduction following mitral valve replacement. A simultaneously recorded central venous pressure (CVP) trace revealed evidence of the normal sequence of atrial and ventricular contraction, as well as episodes of ventricular contraction that preceded atrial contraction and episodes of simultaneous atrial and ventricular contraction. The dysrhythmia and CVP trace are analyzed and clinical implications relevant to this case history are discussed.