62 year old male for DCCV

61 year old male arrives to your unit for an elective cardioversion (DCCV). His chart has not arrived yet but he tells you he has had palpitations on and off for years that have ended him up in the ED numerous times and he has had a device (pacemaker and/or defibrillator) inserted (his X-ray shows a single ventricular lead).
You take this ECG knowing that if he isn't in a cardiovertable rhythm, you need to discharge him.

Analyse this ECG.

What is the rhythm?

From his ECG findings, can you make an educated guess as to what device he has insitu and whether or not it is active on this ECG?

Can you guess what drug he may well be on for his atrial fibrillation to put him into this rhythm?

Are you going to discharge this man?

Answer to come!