A 68 year-old female with a history of diabetes, renal disease and pacemaker placement for heart block presents with 36 hours of weakness, near syncope and occasional vomiting. On exam she is afebrile with a pulse of 126 and a blood pressure of 81/53. She appears adequately hydrated and has clear lungs and a non-focal exam. Her labs are unremarkable except for a positive UA. Her EKG is shown below. How would you initiate treatment?

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