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A 79-year-old male was admitted to our outpatient clinic with symptomatic heart failure (HF). The patient reported impaired exercise tolerance with increasing shortness of breath in the previous 4 weeks and a weight gain of 5 kg. The ECG showed new onset atrial fibrillation (AF) with rapid conduction and preexisting left bundle branch block ( fig. 1) . The patient had a history of coronary artery disease with successful PCI of the LCX after inferolateral myocardial infarction 15 monthsdoi:10.4414/cvm.2010.01470 fatcat:4roaiijzorhipp2nycmivor7v4