What does the P wave look like for accelerated junctional rhythm?

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Multiple Choice

What does the P wave look like for accelerated junctional rhythm?

P waves reflect atrial depolarization, and when the impulse starts in the AV junction, the atria are activated in a retrograde way. This makes the P waves polarity flip and often shift in timing relative to the QRS. In accelerated junctional rhythm, the junctional pacemaker fires faster, so you still see a P wave that is inverted and may appear after the QRS (or be hidden in it) rather than as a normal upright P wave before the QRS. So inverted or late P waves best indicate a junctional origin. Normal P waves imply sinus origin, absent P waves point to a ventricular rhythm or other scenarios, and a biphasic P wave is not typical for this rhythm.

P waves reflect atrial depolarization, and when the impulse starts in the AV junction, the atria are activated in a retrograde way. This makes the P waves polarity flip and often shift in timing relative to the QRS. In accelerated junctional rhythm, the junctional pacemaker fires faster, so you still see a P wave that is inverted and may appear after the QRS (or be hidden in it) rather than as a normal upright P wave before the QRS. So inverted or late P waves best indicate a junctional origin. Normal P waves imply sinus origin, absent P waves point to a ventricular rhythm or other scenarios, and a biphasic P wave is not typical for this rhythm.

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