ECG of the Week - 28th August 2017

This ECG is from an 86 yr old male referred by his General Practitioner with worsening renal failure. He has a history of atrial fibrillation with bradycardia for which he had a PPM inserted. His medications include metoprolol.

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Things to think about

• What are the key ECG features ?
• What are the potential causes of these features ?