This is a series of recordings from an 80 year old man who had been treated with A/V nodal ablation and implantation of a ventricular pacemaker for persistent atrial flutter unresponsive to medication. He was totally dependent on the pacemaker. The first recording was more that a year before the last two, to which they can be compared. These recording where made after many hours of chest pain. The patient was in cardiogenic shock on arrival in the emergency room.