ECG of the Month: A 75-Year-Old Man Presents With Fatigue and Shortness of Breath

The patient is a 75-year-old man with a history of fatigue and shortness of breath due to paroxysmal atrial fibrillation. He was recently found to have esophageal carcinoma. During indwelling catheter placement for the delivery of chemotherapy, he developed bradycardia. His electrocardiogram (ECG) is shown in Figure 1.

Figure 1

Figure 1

The ECG shows which of the following?

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