This strip shows an underlying sinus bradycardia with a rate less than 40/min.  There is one "premature" beat, which can be considered to be ectopic, because it interrupts an otherwise regular rhythm.  The interesting thing is that the premature beat is not terribly early - it is about 740 ms from the previous beat.  If all the beats were spaced like this, the heart rate would be about 84/min.  There is probably an element of "escape" here, in that the ectopic beat is able to express itself due to the slow rate.  A faster sinus rate would override this ectopic focus.  So, we could view this early beat as a help, rather than a problem.  The most important consideration here is to address the cause of the bradycardia, and treat appropriately.