ECG of the Month: 48-Year-Old Man Presents with Fatigue, Dyspnea, and Palpitations

A 48-year-old man with a history of hypertension, diabetes mellitus (type 2), hypothyroidism, and left ventricular dysfunction presents with fatigue, dyspnea, and palpitations. The admission ECG is depicted below (Figure 1):

Figure 1

The ECG shows which of the following?

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