STAT ECG Diagnoses: Post-cardiac arrest ECG with this pattern, what is the most likely cause of arrest and would you activate the cath lab?

An elderly male with no known past medical history is brought into the ED via EMS s/p cardiac arrest. He was found to be unresponsive with a weak pulse at 20 bpm prior to the arrest. He received chest compressions and 2 rounds of epinephrine before arrival. On arrival, a faint pulse is palpable and the following ECG is obtained: