Clinical History 206

Seventy-two year old gentleman with a history of non-insulin requiring diabetes mellitus and a recent left circumflex coronary artery territory myocardial infarction who underwent this electrocardiogram prior to anticipated coronary artery bypass graft surgery. Medications at the time of this electrocardiogram included intravenous heparin, atenolol, ranitidine and intravenous nitroglycerin.
Comment on this ECG ?