A 70-year-old male patient with a history of recent aortic valve replacement for severe aortic stenosis, tricuspid annuloplasty for severe secondary tricuspid regurgitation (performed 3 days prior), paroxysmal atrial fibrillation, and ischemic stroke is admitted to the Cardiology Department due to repeated episodes of a wide QRS complex rhythm recorded by telemetry in the Post-Surgical Cardiac Surgery Unit. His ECG recorded at admittance to the Cardiology Department is presented in Fig. 1.