ECG of the Month: Palpitation and Dyspnea

A 59-year-old woman with a history of CABG 10 years ago in the setting of hypertension, hyperlipidemia, and type 2 diabetes mellitus, presents with complaints of palpitations, dyspnea, and weakness. She has had paroxysmal atrial fibrillation for which she is receiving amiodarone. An ECG is performed.

Figure 1

The ECG shows which of the following:

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