ECG of the Week – 28th August

The following ECG is from a 35-year-old man who has presented with exertional dyspnoea and presyncope. He has no chest pain. He has a history of congenital heart disease which was operatively repaired in childhood.

His GCS is 15, BP 135/78, RR 16, Sats 99% RA.

Describe and interpret his ECG.