You have been asked to review an ECG for a 57 year old lady who has presented with chest heaviness and intermittent dizzy spells.

She has a background history of Aortic Regurgitation and Marfans. Her BP in both arms is 130/78, RR18, Sats 99% on air.

Her ECG is as below:

Interpret her ECG

Describe your further management.