A 45-year-old male was presented with palpitations. His medical history was otherwise uneventful and the family history revealed pacemaker implants in two of his father’s brothers in their fifties and in one of his brothers (mid-forties). His father was 74 years of age and without cardiac complaints. Physical examination revealed no abnormalities. His ECG was ordered (Fig-1). After an adequate period of anticoagulation therapy electrical cardioversion (ECV).

Figure 2 represents the ECG shortly after ECV. The patient was not on any therapy other than anticoagulants. What diagnosis can be inferred from his ECG findings? *This case is from Docplexus Editorial Team for educative purpose only.