This ECG is from a 65 yo patient with h/o HTN c/o chest pain s/p intervention for a mid-LAD lesion.
Figure 1 - ECG case
Figure 2 - R2 and R8 are fusion beats
The first 9 beats are accelerated idioventricular beats/rhythm with beats #2 and 8 as fusion beats (F). There are inverted P waves after the beats due to ventriculoatrial conduction (retrograde conduction). After which sinus impulses (R10 - R13)were able to capture the ventricles. In this case, this could be a reperfusion rhythm.