Float Nurse

It looks like there are dropped PACs that follow the complexes 1 - 5.  If you compare the T waves in complexes 1 - 5 with complexes 6 - 10, you can see that the T waves are flatter.   The T wave of the 5th complex looks split suggesting that there might be a dropped P wave. 

On this page there are a variety of complexes present.  The first complex shows a prolonged PR interval.  The 2nd and 3rd complexes are PVCs with P waves or fusion complexes.  On the 3rd complex there is a dropped P wave.  It can be seen in lead aVR and aVL.  This is followed by a short pause.  The 4th complex shows a prolonged PR interval and it is followed by another nonconducted P wave.  A short pause follows the nonconducted P wave, then sinus bradycardia with sinus arrhythmia follows.