A 64-year-old woman with a history of hypertension for which she is receiving therapy with a β-blocker and diltiazem (having been intolerant of an angiotensin-converting enzyme inhibitor and angiotensin receptor blocker) presents to her primary care physician for a routine physical examination. Her blood pressure is noted to be elevated (170/90 mm Hg); hence, the doses of β-blocker and diltiazem are increased. She presents for a follow-up 1 week later, and her pulse is noted to be slow. An ECG is obtained.
What is the diagnosis?
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