An 86-year-old woman is evaluated for an abnormal electrocardiogram (ECG) during admission for hemoptysis (Figure 1-A). She denied any chest pain. Other medical problems include bronchiectasis, paroxysmal atrial fibrillation and sinus pause for which a dual-chamber pacemaker was implanted four years prior. Coronary angiogram performed two years prior for atypical chest pain showed mild disease in proximal left anterior descending artery. ECG one year prior is shown (Figure 1-B). What is the diagnosis?
