What does the P wave look like with a junctional rhythm?

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Multiple Choice

What does the P wave look like with a junctional rhythm?

Junctional rhythm starts in the AV junction, so the atria are activated in a retrograde fashion. This alters the P-wave appearance from the normal pattern. The atrial depolarization is often inverted in the standard limb leads (II, III, aVF) because the direction of atrial activation is opposite, and if the atrial impulse occurs after ventricular depolarization, the P wave can appear after the QRS (late P wave) or be buried in the QRS. So the P waves are typically inverted or late in this rhythm.

Junctional rhythm starts in the AV junction, so the atria are activated in a retrograde fashion. This alters the P-wave appearance from the normal pattern. The atrial depolarization is often inverted in the standard limb leads (II, III, aVF) because the direction of atrial activation is opposite, and if the atrial impulse occurs after ventricular depolarization, the P wave can appear after the QRS (late P wave) or be buried in the QRS. So the P waves are typically inverted or late in this rhythm.

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