ECG of the Week 25th January 2023

The following ECG was obtained from a 70 year old man with a history of chronic renal impairment, pre-dialysis. Relevant medications include verapamil 240mg daily. He presented to hospital complaining of palpitations. His blood pressure is 140/70 and his serum potassium is 5.2mmol/L. Please describe the ECG and the outline your management of the patient.