ECG Case 218

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ECG Case 218

A 72-year-old male with nausea, lethargy, and anorexia the preceding week. Past medical history is positive for chronic renal failure, and ischaemic heart disease with previous 2 vessel PCI. Medications included frusemide, ACE-inhibitor, and a statin. Serum potassium levels were normal.

What do you see on this ECG ?