ECG of the Month: 68-Year-Old Male with A Bioprosthetic AVR for AS Presents with Abnormal ECG

A 68-year-old man presents with a history of obstructive sleep apnea, pulmonary embolism, protein C deficiency, and bioprosthetic aortic valve replacement for aortic stenosis. He has been bothered by shortness of breath and palpitations for three days. An electrocardiogram (ECG) is performed (Figure 1).

Figure 1:

Figure 1

The ECG shows which of the following?

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