48 yo with palpitations

A 48 yo male presents to the emergency department with a complaint of a rapid heart rate. He has been known to be in a rapid rate before(although he is not quite sure of what it is) and has been commenced on Sotalol. He sometimes neglects to take his medication and in this case has not taken it for two days. He has also been drinking heavily the night before. He states that at 7.15 that morning he felt his heart start to race suddenly.
His ECG is shown below.
​What is your diagnosis?

In looking at the diagnosis look at the p-wave axis.
What does the ECG show?
​What is your management?

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