Case: A 71-year-old female patient presents to the outpatients clinic with an irregular heart rhythm. The complaints started a few weeks ago and seem to worsen. Her cardiac history reveals the use of digoxin prescribed by her general physician for an irregular, much faster, heart beat a few years ago. The present symptoms are different from those. Physical examination did not reveal any abnormalities except the irregular heart rhythm.

Additional cardiological examinations (X-ray, echo) were without abnormalities. Part of the ECG is shown in figure 1. Only the extremity leads are shown (standard calibration). What is the likely diagnosis of this case? Source: ECGpedia *This case is from Docplexus Editorial Team for educative purposes only