Clinical History 267

Forty-four year old gentleman who is status post radiofrequency ablation who returns with recurrent palpitations. An echocardiogram demonstrated mild to moderate left ventricular systolic dysfunction felt secondary to a tachycardia-induced cardiomyopathy. The patient underwent a successful repeat radiofrequency ablation of an ectopic atrial tachycardia site originating from the posterior right atrium.
Comment on this ECG ?