ECG of the Week - 12th August 2013

I unfortunately have no clinical information on this ECG, but it looks interesting :-)

Click to enlarge

VAQ Corner

A 83 year old patient presents to your Emergency Department complaining of lethargy, nausea, and vomiting. There are on multiple medications but are unable to remember their names.
BP 105/64 RR 17 Temp 37.4 C

Describe and interpret their ECG (100%)