An 84-year-old man with known hypertension and coronary artery disease and previous coronary artery bypass graft surgery presents to his cardiologist for a routine visit. His medications include a β-blocker, angiotensin-converting enzyme inhibitor, hydrochlorothiazide, and isosorbide mononitrate. He is feeling well. Physical examination is unremarkable, but his pulse is noted to be irregular. An ECG is obtained.
What is the diagnosis?
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