A 56-year-old man with a history of a reduced left ventricular ejection fraction (40%) due to a nonischemic cardiomyopathy presents to the emergency department with lightheadedness, shortness of breath, and palpitations. Physical examination is remarkable for a rapid heart rate, irregularS1 intensity, and irregular jugular pulsations with prominent cannon A waves. Bibasilar rales are present. An ECG is obtained.
Figure 1.