A 53-year-old man with a history of ischemic cardiomyopathy and an implanted defibrillator presents to the ICD clinic for routine follow-up. He complains of increased shortness of breath over the last few weeks: 

• Atrial tachycardia with 2:1 AV conduction 
• Non-specific intraventricular conduction block* 
• Left axis deviation – possible left anterior fascicular block, cannot rule out inferior myocardial infarction 
• Anterolateral myocardial infarction, age undetermined 

*Criteria for right bundle branch block is not met because there is no late delay (typically should have broad S wave) in lead I. S-wave exists in lead V6 but this is because of left axis deviation and low placement of lead V6.