Question

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what is this rhythm?
what most likely would be the course of action?

Answer 1

The above ECG showing arrhythmia, In this ECG, it's very difficult to identify 'P' wave and there is irregular R-R interval so it's Arterial Fibrillation(AF).

There is also 'T' wave depression(Inversion), it suggests that there may be Myocardial ischemia,

If the condition is not treated then it can lead to the formation of blood clots due to arterial fibrillation, which can cause Coronary artery disease and stroke. it can also lead to cardiac arrest and death.