Clinical History 46

Fifty year old woman with a long-standing history of hypertension and morbid obesity who presented to the hospital with acute left-sided weakness. A computed tomography scan of the brain demonstrated findings consistent with an acute right middle cerebral artery cerebral vascular accident. Medications at the time of this electrocardiogram included aspirin, nifedipine, atenolol and clonidine.
Comment on this ECG ?