A 63-year-old man with a history of chronic obstructive pulmonary disease and hypertension presented to the emergency department (ED) with stabbing left anterior chest pain while he was sitting on a bench. The episode lasted 5-10 seconds. The patient has a history of atypical chest pain; he is dependent on alcohol, is an active smoker and abused cocaine in the past. He has no other known cardiac risk factors except male sex and age. Medications: albuterol, tiotropium, and flunisolide. The patient's electrocardiogram (ECG), (Figure 1) in the ED was computer interpreted as showing "ectopic atrial bradycardia" (EAB). There were also peaked T waves and ST elevations in leads V2-V4. The rhythm on the patient's 13 ECGs between 2010 and 2017 was exclusively ectopic atrial bradycardia or ectopic atrial rhythm with rates ranging from 48 to 67/min with 1:1 atrioventricular conduction. Prominent T waves and ST elevations were also consistent in the precordial leads during these years. Except for one episode of syncope in 2010, the patient's history does not include dizziness, lightheadedness, or falls.