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: codeine attending: chief complaint: dizziness major surgical or invasive procedure: pacemaker placement history of present illness: this is a 70 year old female with a history of paroxysmal atrial fibrillation and tachy-brady syndrome who was scheduled for elective pacemaker placement for symptomatic bradycardia on the week of presentation due to an outside holter monitor showing sinus pauses up to four seconds. this morning she presented to the ed and was noted to have sinus pauses up to 3 seconds, intermittently in a junctional escape at a rate of 30 maintaining adequate pressures. in the ed, initial vitals were 123/46 with hr 40. she received only aspirin, zofran and 1l of ns in the ed prior to admission to the ccu. temporary pacing wire was not placed in the ed. . she stopped taking amiodarone in after developing transaminitis. her last dose of coumadin was on in anticipation of the elective procedure scheduled for this week. . on review of systems, she 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. she denies recent fevers, chills or rigors. she 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, palpitations, syncope. past medical history: 1. cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: -cabg: none -percutaneous coronary interventions: s/p cath at without cad -pacing/icd: planned as per hpi 3. other past medical history: - paroxysmal atrial fibrillation s/p prior dccv - hyperlipidemia - mild asthma - gerd - s/p right laparoscopic oophrectomy - pulmonary nodules social history: the patient currently lives in , she is widowed. she was previously employed as a teacher, currnently retired. has several children. tobacco: none etoh: occasioanl social alcohol illicits: none family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death. mother: died of esophageal carcinoma in her 90s father: died of pancreatic carcinoma in his 70s physical exam: general appearance: well nourished eyes / conjunctiva: perrl cardiovascular: (s1: normal), (s2: normal), (murmur: systolic) peripheral vascular: (right radial pulse: present), (left radial pulse: present), (right dp pulse: present), (left dp pulse: present) respiratory / chest: (expansion: symmetric), (breath sounds: clear : ) abdominal: soft, non-tender extremities: right lower extremity edema: trace, left lower extremity edema: trace skin: not assessed neurologic: attentive, responds to: not assessed, movement: not assessed, tone: not assessed pertinent results: admission labs: 04:15am blood wbc-8.3 rbc-3.80* hgb-10.6* hct-32.8* mcv-86 mch-27.8 mchc-32.2 rdw-14.6 plt ct-371 04:15am blood glucose-87 urean-24* creat-1.1 na-140 k-4.2 cl-104 hco3-30 angap-10 04:15am blood tsh-6.1* 04:15am blood free t4-1.1 --------------- discharge labs: 07:20am blood wbc-7.9 rbc-3.55* hgb-9.9* hct-30.2* mcv-85 mch-27.8 mchc-32.7 rdw-14.5 plt ct-348 07:20am blood pt-14.0* ptt-26.6 inr(pt)-1.2* 07:20am blood glucose-82 urean-18 creat-1.0 na-133 k-4.4 cl-98 hco3-26 angap-13 07:20am blood calcium-9.0 phos-4.0 mg-2.0 --------------- ekg (): sinus bradycardia (hr35) with atrial premature beats and junctional beats. compared to the previous tracing of the rate is slower with appearance of junctional beats. --------------- studies: cxr (): the lungs are clear without focal opacity. the cardiomediastinal silhouette, hilar contours, and pulmonary vasculature are not significantly changed from prior. there is no overt pulmonary edema or evidence of chf. there is no pleural effusion or pneumothorax. there is slight elevation of the left hemidiaphragm. impression: no acute intrathoracic abnormality. . cxr (): prelim: pacemaker position appropriate. brief hospital course: 70f with paf, tachy/brady syndrome presents with symptomatic bradycardia with sinus pauses of up to 4 seconds. . # bradycardia ?????? symptomatic with sick sinus syndrome: patient with paf on diltiazem and flecanide & previously known tachy-brady syndrome with symptomatic sinus pauses presents with dizziness and is found to have intermittent sinus arrest with pauses up to 4 seconds. she was planned for a pacemaker placement later this week. initially her junctional escape was proven to be reliable and she did not require a temporary pacing wire. however, she then developed very frequent pauses up to 5 seconds in duration with symptomatic bradycardia. she was treated with dopamine which improved her heart rate to the 50s with symptom resolution. she had a pacemaker placed the next day without complication. of note, her tsh was elevated at 6.1, but her free t4 was normal. she should have a repeat tsh in a 4-6 weeks. . # dizziness / vertigo / lightheadedness: bradycardia, now resolved. . # fen: patient received cardiac healthy diet. she tolerated pos well. . # code status: full code medications on admission: alendronate - 70 mg tablet - 1 tablet(s) by mouth 1x week on tues diltiazem hcl - - 120 mg xr daily esomeprazole magnesium 40mg daily estradiol - 25 mcg tablet - 3x /week fexofenadine ] - 180 mg flecainide - 100 mg tablet - medroxyprogesterone - - 5 mg 4x /year sertraline - - 100 mg tablet daily simvastatin - - 20 mg tablet - daily warfarin - 2.5 daily, holding since zolpidem - 5 mg tablet - daily aspirin - 325 mg tablet - daily calcium with vit d discharge medications: 1. alendronate 70 mg tablet sig: one (1) tablet po qtues (every tuesday). 2. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 3. fexofenadine 180 mg tablet sig: one (1) tablet po once a day. 4. sertraline 100 mg tablet sig: one (1) tablet po once a day. 5. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 3 days. disp:*9 capsule(s)* refills:*0* 8. diltiazem hcl 120 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). 9. flecainide 100 mg tablet sig: one (1) tablet po twice a day. 10. vagifem 25 mcg tablet sig: one (1) tablet vaginal three times per week. 11. medroxyprogesterone 5 mg tablet sig: one (1) tablet po four times per year. 12. warfarin 2.5 mg tablet sig: one (1) tablet po once a day: start on . 13. outpatient lab work please check inr on and call results to dr. at 14. zolpidem 5 mg tablet sig: one (1) tablet po once a day. 15. calcium citrate + d 315-200 mg-unit tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: bradycardia paroxysmal atrial fibrillation discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you had a slow heart rate and required a pacemaker. a st. ddd pacemaker was inserted and there were no complications. you will need to take an antibiotic for 3 days to prevent an infection. no showers or baths for one week until after you are seen in the device clinic. no lifting your left arm over your head or lifting more than 5 pounds for 6 weeks. please see our instruction paper for further instructions. . medication changes: 1. start cephalexin for three days to prevent an infection at the pacer site 2. do not start taking your coumadin again until . please resume at 2.5 mg and check inr on . . please call np have any questions about your medicines or your hospital stay. followup instructions: electrophysiology: device clinic phone: date/time: 3:00 provider: , md phone: date/time: at 3:40pm. . cardiology: dr. phone: date/time: friday at 1pm. md, procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle other conversion of cardiac rhythm diagnoses: esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation asthma, unspecified type, unspecified other and unspecified hyperlipidemia long-term (current) use of anticoagulants other diseases of lung, not elsewhere classified sinoatrial node dysfunction nonspecific abnormal results of function study of thyroid 

Answer: The patient is high likely exposed to