A 76-year-old man with a history of hypertension being treated with a β-blocker and diltiazem, chronic obstructive pulmonary disease, and mild mitral regurgitation presents to his primary care physician with complaints of occasional palpitations that have been present for the past 3 weeks. Physical examination demonstrates a normal blood pressure, an irregular pulse, clear lungs, and a grade 2/6 murmur consistent with mitral regurgitation. As a result of the irregular pulse, an ECG is obtained.
What is the diagnosis?
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