ECG of the Week - 29th July 2013

This ECG is from a 49yr old who presented complaining of palpitations and feeling lightheaded.
On multiple medications including amiodarone, ACE-inhibitor, digoxin, and a beta-blocker.
Hx of cardiomyopathy with AICD in situ.

Click to enlarge

VAQ Corner

A 49 year old presents to your Emergency Department complaining of palpitations and feeling lightheaded.
Vital signs: BP 106/52, RR16, Sats 98% on room air, afebrile.
On multiple medications including amiodarone, ACE-inhibitor, digoxin, and a beta-blocker.
Hx of cardiomyopathy with AICD in situ.
An ECG is performed - see above

Describe and interpret the ECG (100%)