A 56-year-old woman with a history of pulmonary fibrosis and pulmonary artery hypertension who was receiving diuretic therapy for peripheral edema presents to the emergency department with complaints of palpitations associated with worsened shortness of breath and more significant peripheral edema. Her vital signs are stable, but her pulse is rapid. Her neck veins are markedly distended, and there is 3+ pitting edema of the knees. An ECG is obtained (ECG A).
She is admitted to the hospital and placed on telemetry. She is treated with intravenous diuretics. While on telemetry, her heart rate is noted to slow intermittently, and an ECG is repeated (ECG B).
What is the diagnosis?
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