Sinus Rhythm with bigeminal pattern due to 3:2 conduction of the P waves (Second Degree AV Block), the non-conducted P wave is in the roof of the T wave
The PR Interval of the conducted P waves is the same and is accompanied by LBBB, so this AV Block is 3:2 Mobitz type II Second Degree AV Block (infranodal)
For this patient with this kind of AV Block a pacemaker is warranted
