Which rhythm is characterized by inverted or late P waves?

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Multiple Choice

Which rhythm is characterized by inverted or late P waves?

P waves reveal where atrial depolarization starts. When the impulse comes from the AV junction, atrial activation often occurs retrograde, so the P waves may appear inverted in inferior leads or occur after the QRS. That pattern—inverted or late P waves accompanying a tachycardic rhythm—points to a junctional origin. Sinus tachycardia has P waves before each QRS and upright in the standard leads, reflecting sinus node driving the rhythm. Atrial fibrillation lacks discrete P waves altogether. SVT can have rapid rates with P waves often hidden in or conflicting with the QRS, not the classic inverted/late P waves seen with junctional tachycardia.

P waves reveal where atrial depolarization starts. When the impulse comes from the AV junction, atrial activation often occurs retrograde, so the P waves may appear inverted in inferior leads or occur after the QRS. That pattern—inverted or late P waves accompanying a tachycardic rhythm—points to a junctional origin.

Sinus tachycardia has P waves before each QRS and upright in the standard leads, reflecting sinus node driving the rhythm. Atrial fibrillation lacks discrete P waves altogether. SVT can have rapid rates with P waves often hidden in or conflicting with the QRS, not the classic inverted/late P waves seen with junctional tachycardia.

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