Switching the QRS Complex

The patient is a 62-year-old man with a history of hypertension, coronary artery disease status/post stent placement, HIV, chronic obstructive pulmonary disease, and squamous cell carcinoma status/post chemoradiation and tracheostomy who presents for planned admission to undergo repair of persistent tracheostomy. A postprocedure cardiac monitor shows wide QRS rhythm with alternating narrow QRS. He denies any chest pain, palpitation, dizziness, lightheadedness, near-syncope, or syncope.

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

Figure 1

Figure 1

Which one of the following is the most appropriate next step?

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