Clinical History  211

Sixty-eight year old gentleman status post recent coronary artery bypass graft surgery who returns for postoperative cardiac follow-up. His past cardiac history includes an anterior myocardial infarction one year prior to this electrocardiogram followed by a percutaneous transluminal coronary angioplasty of the left anterior descending coronary artery. His medications at the time of this tracing included metformin, diltiazem, procainamide, metoprolol and simvastatin.
Comment on this ECG ?