ECG of the Month: Near-Syncope Following TAVR

A 79-year-old woman with a history of severe aortic stenosis after transcatheter aortic valve replacement (TAVR), coronary artery disease with previous percutaneous coronary intervention (PCI), hypertension, dyslipidemia, and left bundle branch block (LBBB) presents to outpatient clinic with near syncope. One week prior to presentation she underwent uncomplicated TAVR with placement of a 26mm Edwards SAPIEN 3 balloon expandable valve. Her pre-TAVR ECG (ECG A) shows sinus rhythm with LBBB. A second ECG (ECG B) was performed at the time of her clinic visit:

Figure 1
Figure 2

ECG B shows which of the following:

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