On a January morning, an 87-year-old woman was found unresponsive in the fields. She had fixed pupils and a respiration rate of about 6 per minute. Rectal temperature was recorded as “< 80°F,” as no thermometer was available to read lower than 80°F. The electrocardiogram demonstrated atrial fibrillation with severe bradycardia and giant Osborn waves measuring up to 25 mm (2.5 mV) in amplitude and 160 ms in duration. In each lead, the axis and amplitude of the Osborn waves followed those of the QRS complexes.1 The patient was successfully rewarmed and survived!
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