A 65-year-old man with a history of obesity and severe chronic obstructive pulmonary disease presents to the emergency room with increasing shortness of breath and a productive cough. A chest x-ray shows changes of chronic obstructive pulmonary disease but no acute pathology. It is felt that he has a chronic obstructive pulmonary disease exacerbation and is begun on antibiotics, steroids, and albuterol inhalers. Several minutes after presenting, his heart rate is noted to increase and become irregular. An ECG is obtained.
What is the diagnosis?
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