ECG of the Month: An 82-Year-Old Man With Syncope

An 82-year-old male presents to the emergency room because of a syncopal episode after attending a funeral. He has a history of type II diabetes, hypertension, non-ischemic cardiomyopathy with a left ventricular ejection fraction of 25-30%, and atrial flutter ablation 5 years ago.

The following ECG is performed:

Figure 1

The ECG shows which of the following:

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