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: history of present illness: the patient is a 71 year old male with a history of hypertension, coronary vascular disease who presented from the operating room with bradycardia. the patient states he has been feeling weak and tired since he was started on metoprolol in . he is scheduled to have surgery for a urinary bladder incontinence on the day of admission. intraoperatively, he had a small dose of fentanyl. his heartrate went down to 8 beats/minute. he received atropine with heartrate going back to low 30s. he was hemodynamically stable and transferred to the emergency department for further evaluation. the patient states his symptoms began five to six months ago. he reports some fatigue, lower extremity edema, no paroxysmal nocturnal dyspnea, orthopnea, paroxysmal nocturnal dyspnea, orthopnea, chest pain, shortness of breath or dyspnea on exertion. his preoperative electrocardiogram was done on and showed junctional bradycardia, rate of 50. on the morning off admission he felt more tired and dizzy. he asked his wife to drive to the hospital. in the emergency room multiple short runs of atrial tachycardia with pauses of junctional bradycardia were noted on telemetry. the patient reported having dizziness times one during the eight second pause. past medical history: significant for prostate cancer, status post radical prostatectomy in , colon resection, transient ischemic attack, hypertension, appendectomy and urinary incontinence. allergies: he has no allergies. medications on admission: outpatient medications of lipitor, aspirin, plavix, lopressor, oxybutynin, prednisone forte and ultram. social history: lives in with his wife. reports heavy ethanol use three years ago and denies smoking tobacco. family history: non-contributory. physical examination: physical examination on admission revealed temperature 98.6, heartrate 58, blood pressure 112/77, respirations 18, oxygen saturation 99%, 2 liters of nasal cannula. general, pleasant elderly male in no acute distress, alert and oriented times three. head, eyes, ears, nose and throat, extraocular movements intact. oropharynx clear. pupils equal, round, and reactive to light and accommodation bilaterally. neck is full with palpable thyroid with jugulovenous distension 9 to 11 cm. pulmonary is clear to auscultation bilaterally. cardiovascular, regular rhythm and rate. no murmurs. persistent s2. abdomen is soft, nontender, nondistended, positive bowel sounds. no organomegaly. extremities, trace edema of the lower extremities bilaterally, 2+ pulses in all four extremities. neurologic examination is nonfocal. laboratory data: white cell count 4.0, hematocrit 36.8, platelets 110, sodium 146, potassium 4.3, chloride 109, pco2 27, bun 20, creatinine 1.0, glucose 87, creatinine kinase 224, troponin less than 0.3, mb 3. chest x-ray showed mild congestive heart failure. hospital course: interventional physiology, electrocardiac physiology was consulted and saw the patient in the emergency department. she was diagnosed with sinus node dysfunction, paroxysmal, nonsustained, atrial tachycardia, atrial fibrillation and no arteriovenous conduction disease. he was transferred to the ccu for observation over night. the next morning he was taken to the electrophysiology laboratory where ablation was attempted and temporary pacemaker was placed. urology was consulted the next day and recommended no surgery during this hospital admission. therefore, on , the patient was taken back to the electrophysiology laboratory and permanent ddd pacemaker was placed without any complications. over night the patient remained asymptomatic and afebrile. his pacemaker interrogation showed all parameters to be stable and his cardiac function improved. cardiac echo was done on and showed an ejection fraction more than 55% but the left atrium was moderately dilated. left ventricular cavity was mildly dilated with regional left ventricular wall motion being normal. the right atrium was moderately dilated with right ventricular cavity mildly dilated, aortic valve leaflets were mildly thickened and trace aortic regurgitation was seen as well as trivial mitral regurgitation. there was also mild pulmonary artery systolic hypertension. the patient remained stable prior to discharge. his pacemaker placement site showed no residual hematoma with moderate ecchymosis extending into the axilla without bleeding or oozing. the pressure dressing was removed on and the patient was placed on prophylactic antibiotics from until discharge, vancomycin 1 gm q. 12 hours. discharge medications: he was discharged to home on his home medications as well as keflex 500 mg q.i.d. for six days for prophylaxis. follow up: the patient was to schedule his own follow up appointment with his primary care physician. discharge diagnosis: 1. sinus node dysfunction, paroxysmal nonsustained atrial tachycardia, atrial fibrillation. condition on discharge: the patient was discharged to home in good condition on a regular diet. dr., 12-222 dictated by: medquist36 procedure: catheter based invasive electrophysiologic testing excision or destruction of other lesion or tissue of heart, endovascular approach initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle diagnoses: pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension cardiac complications, not elsewhere classified personal history of malignant neoplasm of prostate hematoma complicating a procedure sinoatrial node dysfunction surgical or other procedure not carried out because of contraindication stress incontinence, male 

Answer: The patient is high likely exposed to