ECG Case 323

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ECG from an 81-year-old female who presented with a 48 hour history of palpitations
ECG Case 323

This ECG is from an 81-year-old female who presented with a 48 hour history of palpitations. She underwent a cardioversion for an atrial arrhythmia 1 year ago. Her medications include metoprolol, digoxin and eliquis.

What’s the rhythm ?