Answer for January 22, 2013
An accelerated idioventricular rhythm. The QRS complexes are wide. There is no consistent P wave activity. Normal ventricular "escape" is around 20-30 beats per minute. Accelerated idioventricular rhythm may be seen with reperfusion (thrombolysis, for example), digoxin toxicity, and cardiomyopathies. It is generally a transient and not hemodynamically significant dysrhythmia. An alternative explanation would be a low atrial/high junctional rhythm with a pre-existing bundle branch block or IVCD, causing the wide QRS complex and no visible P wave.
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