For the same previous 78-year-old lady, you decided to administer diltiazem to slow down the ventricular rate and also once slowed down carefully scrutinize atrial activity to determine if this truly was AF or atrial tachycardia/flutter with variable AV conduction. While preparing the drug, the monitor started alarming! You walked in along with the nurse. The patient was drowsy, but responsive. She was feeling dizzy and quite diaphoretic. The monitor was showing a rate of 28/min. The repeat 12-lead ECG showed the following:

Interpret the ECG. What is the explanation for the new rhythm abnormality?
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