Exertional Shortness of Breath

The patient is a 70-year-old male with a history of diabetes mellitus type I, hypertension, hyperlipidemia, anemia, paroxysmal atrial fibrillation, and s/p atrial flutter ablation 6 months ago. He presents with dyspnea on exertion, pedal edema, and weight gain.

An electrocardiogram (ECG) (Figure 1) is performed.

Figure 1

Figure 1

The ECG shows which of the following?

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