ECG of the Month: 73-Year-Old Male Presents with Increased Frequency of Palpitations

A 73-year-old male presents with a history of hypertension and atrial fibrillation. Coronary artery bypass graft (CABG) was performed three years previously; recent coronary angiography showed all grafts to be patent. He is seen at this time due to an increased frequency of palpitations. An ECG is performed (Figure 1).

Figure 1

Figure 1

The ECG shows which of the following?

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