Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: vt and icd shocks major surgical or invasive procedure: electrophysiology study and vt ablation history of present illness: the patient is an 83 year old man with cad s/p cabg (23yrs ago), ischemic cardiomyopathy (ef 20-25%), hx of afib and sss, and vt s/p icd implantation presenting with syncope. the patient initially presented to on after 2 episodes of syncope. he has had pre-syncopal events that have been associated with a wave of dizziness often lasting seconds while standing. on the day of admission he was out to breakfast with a friend and while riding in the care he started to feel lightheaded and lost consciousness. per report of the friend, the patient was unconscious for ~3-5 seconds. about minutes later he had a second event. . on arrival to he was afebrile with stable vital signs. his ekg was v-paced. his initial ck was 86, tn <0.02, and serum potassium was 3.2. he was admitted to the telemetry floor. his icd was interrogated and per report multiple episodes of vt usually cycle lenghth of 2 different rates, multiple episodses at 150-160 bpm with termination by atp and muliple episodes at 190 bpm terminted by atp. vt episodes on the day of admission were sustained with rates of 197 bpm which failed to terminate with 3 cycles of atp and required 26 j shock. on the morning of he was found by the nurses nauseated, diaphoretic and telemetry reported showed vt that was treated by his icd. he was started on an amiodarone bolus then gtt (~930am) and transferred to . en route to he had 3 more events with subsequent icd discharges and restoration of sinus rhythm. . on review of symptoms, he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. he denies dysuria but has 1/night nocturia. he denies recent fevers, chills or rigors. he denies exertional buttock or calf pain. all of the other review of systems were negative. . *** cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema. past medical history: cad s/p mi and cabg (c. ) ischemic cardiomyopathy (ef 20-25%) atrial fibrillation sick sinus syndrome s/p ppm (guidant) vt s/p icd placement (guidant prism vr) hypertension peptic ulcer disease sleep apnea (home cpap = unknown cmh2o) social history: social history is significant for the absence of current tobacco use. there is no history of alcohol abuse. he was widowed last after his wife died of complications of ovarian cancer. he lives at home, and a son from is staying with him, his daughter is a pa and a second daughter lives in the same town. family history: there is no family history of premature coronary artery disease or sudden death physical exam: vs: t 98.7, bp 129/72, hr 60, rr 12, o2 95% on 4l gen: wdwn elderly male in nad, resp or otherwise. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with non elevated jvp. cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. chest: bilateral pacer pockets. no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. faint bibasilar crackles abd: no surgical scars. obese, soft, ntnd, no hsm or tenderness. no abdominal bruits. ext: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp left: carotid 2+ without bruit; femoral 2+ without bruit; 2+ dp neuro: mental status - cn ii-xii motor: moving all 4 extremities : light touch intact to fac/hands/feet pertinent results: 02:20pm wbc-8.9 rbc-4.20* hgb-14.1 hct-41.4 mcv-99* mch-33.7* mchc-34.1 rdw-14.0 02:20pm plt count-182 02:20pm pt-18.0* ptt-29.7 inr(pt)-1.6* 02:20pm glucose-125* urea n-26* creat-1.5* sodium-139 potassium-3.8 chloride-102 total co2-27 anion gap-14 cxr - there is substantial enlargement of the cardiac silhouette in a patient with multiple clips and midline sternal sutures from cabg. the defibrillator leads are seen extending to the general region of the right atrium and apex of the right ventricle. no definite pleural effusion, vascular congestion, or acute pneumonia, though the area behind the heart cannot be properly evaluated for possible atelectasis or consolidation. brief hospital course: 83 year old man with history of cad s/p cabg, ischemic cardiomyopathy (ef 20%), paroxysmal atrial fibrillation (on amiodarone and coumadin), s/p icd implantation and pacemaker, presenting with syncope, found to have multiple episodes of prolonged vt. now s/p vt ablation on showing inducible ventricular tachycardia on right side. . # rhythm: the patient has a known history of paf and vt. he presented to an outside hospital with episodes of vt with syncope and icd discharges. interrogation of icd showed multiple episodes of ventricular tachycardia cl 310 msec (all of which had a warm up phase - automatic or triggered), some requiring atp and requiring icd discharge. home dose of digoxin was discontinued on admission as it likely contributed to nsvt. amiodarone was discontinued as the patient's icd continued to discharde despite amiodarone bolus and drip. he was instead started on a lidocaine drip. as his telemetry remained without any further events other than occasional short runs of nsvt, his lidocaine drip was discontinued. an ep study on showed vt most inducible on r side near pacer wire; likely due to wires or old scar. ventricular ablation was stopped prematurely secondary to fluoroscopy failure. following the ventricular ablation the patient had occasional pvcs, and afib and was restarted on amiodarone for rhythm control. following the ep study, amiodarone was increased to 200mg daily to maintain nsr and prevent atrial fibrillation. the patient was transitioned to warfarin on a heparin bridge with a goal inr , currently 1.9. . # hematoma: the patient developed a large ecchymosis after sheath was pulled on right groin site, with extension to right scrotum and laterally to right hip. following sheath removal pressure was held for 30 minutes. pt continues to have good pulses with no bruit; hematoma has spread superficially but is not indurated. hematocrit remained stable. . # hypotension: pt developed hypotension with sbps in 70s following the vt ablation. this was presumed to be due to dehydration and not a bleed from the right groin catheter site as hematocrit was stable and the groin ecchymosis was superficial. it was not determined to be due to tamponade as no clinical signs or symptoms (no jvd, crisp heart sounds, pulsus 6, not tachycardic, good uo) were present. pt's blood pressure improved with fluids and oral intake. . # cad/ischemia: the pt has known disease and risk factors but there was no evidence of active ischemia on this admission. the patient was not on aspirin due to a history of pud but he was continued on atorvastatin, carvedilol and losartan. . # chf: pt was clinically euvolemic and sans evidence of decompensation on physical exam throughout this admission. he was continued on his home doses of carvedilol 6.25 and losartan 25mg qd. his lasix was continued at 20 mg qam and the evening lasix was discontinued. his home spironolactone 25mg daily was continued. . # sleep apnea: patient did well on home cpap machine. . # hypothyroidism: tsh was checked and was within normal limits. the patient was continued on home dose levothyroxine. . # anxiety/depression: the patient was continued on home dose paroxetine (confirmed). the patient also reported long-term use of librium (confirmed by pharmacy) for anxiety, which was continued. medications on admission: paxil 10 mg daily fosamax 70mg qweek cozaar 25 mg daily tricor 48 mg daily synthroid 100 mcg daily mag-oxide 400 mg tid aldactone 25 mg daily bentyl 10 mg tid zantac 150 mg coreg 6.25 mg amiodarone 200 mg daily lipitor 80 mg qhs librium 5 mg tid coumadin 2.5 qtwthsasu, 1.25 mg mofr lasix 20 mg qam, 10 mg qpm discharge medications: 1. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 2. librium 5 mg capsule sig: one (1) capsule po three times a day. 3. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). 4. alendronate 70 mg tablet sig: one (1) tablet po qsun (every sunday). 5. carvedilol 6.25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. amiodarone 200 mg tablet sig: 1.5 tablets po daily (daily). disp:*45 tablet(s)* refills:*2* 7. losartan 25 mg tablet sig: one (1) tablet po daily (daily). 8. tricor 48 mg tablet sig: one (1) tablet po once a day. 9. bentyl 10 mg capsule sig: one (1) capsule po four times a day. 10. warfarin 2 mg tablet sig: 1-2 tablets po at bedtime: please take two tablets tonight () and tomorrow the nurse at dr. clinic will tell you how many tablets to take. disp:*50 tablet(s)* refills:*2* 11. paxil 20 mg tablet sig: one (1) tablet po once a day. 12. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 13. uroxatral 10 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 14. aldactone 25 mg tablet sig: tablet po once a day. 15. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: vna discharge diagnosis: primary: ventricular tachycardia s/p icd placement and ablation . secondary: paroxysmal atrial fibrillation cad s/p mi and cabg (c. ) ischemic cardiomyopathy (ef 20-25%) sick sinus syndrome s/p pacemaker hypertension sleep apnea (home cpap = unknown cmh2o) hypothyroidism peptic ulcer disease discharge condition: stable discharge instructions: you presented with syncope and ventricular arrhythmia. you have undergone electrophysiology investigation of your heart. you have been treated for ventricular arrythmia. . please note the following changes to your medications: amiodarone was increased to 300 mg daily furosemide pm dose was discontinued; you will take 20 mg in am only warfarin was increased to 4 mg every night; your dose will be adjusted by at dr. office. please continue all other medications as prescribed. . please be sure to make it to all of your follow-up appointments. please get your inr checked on at 1:30pm at dr. office. your nurse will tell you what coumadin dose to take tomorrow. . if you develop any recurrent chest pain, shortness of breath, weakness, loss of consciousness of any other general worsening of condition, please call your pcp or come directly to the ed. followup instructions: primary care physician: grape md: phone: . at 4:45pm. inr checked at his office on . cardiology: md: (. date/time: at 2pm. procedure: excision or destruction of other lesion or tissue of heart, endovascular approach diagnoses: obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status hematoma complicating a procedure paroxysmal ventricular tachycardia other specified forms of chronic ischemic heart disease chronic systolic heart failure cardiac pacemaker in situ sinoatrial node dysfunction dehydration 

Answer: The patient is high likely exposed to