A 70-year-old man with a history of chronic obstructive pulmonary disease treated with inhalers presents to his pulmonologist with increasing shortness of breath that he thinks may be related to chronic obstructive pulmonary disease. He has noted intermittent palpitations. His physician checks his blood pressure, which is 100/70 mm Hg, and also notes a rapid heart rate, prompting an ECG.
What is the diagnosis?
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