The retrograde conduction occurs only when the ventricular complex appears in a certain relation to the preceding P wave — that is, in a certain phase of atrial diastole.

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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.

Results: Following AV node ablation, junctional escape rhythm decelerated into junctional bradycardia. After 3 weeks of AV block, 49.9 ± 13.1% of heartbeats were initiated by the device pacemaker.

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There is noted lead misplacement of V1 indicated by only positive deflection of QRS complexes not consistent with antecedent and subsequent studies. (C) Repeat EKG obtained 12-hours after atropine ...

With junctional escape rhythms, you notice that the rate is 40-60 bpm and regular. QRS will be narrow (less than 0.12 seconds), QT interval and T wave will be normal.

The rhythm may be irregular in patients with heart rates faster than 150 beats/min, and characterized by Wenckebach periodicity as a result of AV block.

Junctional rhythm is a type of irregular heart rhythm originating from the atrioventricular junction. Learn more about it, including its types, symptoms, causes, and more.