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A 66-year-old male presents in the urgent care, saying “it’s hard to breathe.” He’s had weakness and dyspnea for one day. The patient has a medical history of diabetes, hypertension, and heart failure. The patient has a pacemaker. An ECG is obtained.

View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page

ECG 1
Figure 1.
66-Year-Old With Weakness and Dyspnea