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The morphology of the P wave will not be similar to the sinus P wave, which is normally upright in lead II and biphasic in lead V1. Often, the P wave is inverted in lead II, if it can be seen at all.
The diagnosis is normal sinus rhythm, complete heart block with junctional escape rhythm, retrograde P waves, and nonconducted premature atrial complexes. The rhythm is regular at a rate of 48 ...
The compensatory pause after the PVC is slightly longer than the junctional escape interval and allows the junctional rhythm to escape for 5 beats. During this period, the P waves from the sinus ...
Depending on the exact location of the pacemaker in a junctional rhythm, the P wave location may vary. If it occurs slightly above the AV node (low atrium), then the P wave will actually occur ...
However, the rhythm in the last strip is interesting. The first one is sinus, the second beat is premature QRS (probably originated from ventricle), and the third QRS is junctional escape beat.
The ECG follow-up revealed "normal sinus rhythm at a rate of 75 to 80 beats/min, regular PR interval of 200 milliseconds, and QTc of 410 milliseconds with disappearance of jugular cannon waves and ...
Twenty-four-hour Holter monitoring, performed twice consecutively, confirmed the total absence of P waves and the constant presence of a junctional rhythm alternating with an idioventricular rhythm .
Low atrial rhythm was defined as a P-wave frontal axis oriented in a superior direction. We defined the P-wave frontal axis to be horizontal when it was ∼ 0°, which is abnormal, although not a ...