ECG Case #9 - Question #1

A 72 year old male with a history of chronic atrial fibrillation presents to the emergency room with a complaint of nausea, vomiting, generalized abdominal pain, and generalized weakness. No fevers or chills. No diarrhea, constipation, melena, or other signs of gastrointestinal bleeding. He does not know his medications. He states his vision has been slightly yellow tinged recently.

His temperature is 37.0, blood pressure 90/50, heart rate 55, respiratory rate is 16. No jugular venous distension is present, he is bradycardic and irregularly irregular on cardiac exam without any murmurs. His lungs are clear to auscultation. His abdominal exam is completely normal. The rest of his exam is normal. His ECG is below.

What are the ECG findings?