Sign in or Join to use this FREE module.

Introduction Part 1 - Junctional Dysrhythmias.

Please sign in to use this FREE module.


  • Cardiac rhythms are typically named by the site of origin or heart structure where the problem is occurring
  • These junctional dysrhythmias primarily affect the P wave.
  • Electrical impulses formation and flow in a normal heart follow a forward or antegrade flow through the atria. This results in the upright P wave we see with Sinus rhythms.
  • With junctional rhythms, the impulse is initiated in the AV junction. This impulse point results in a backward or retrograde flow of electricity during atrial depolarization.
  • This change in the flow of electricity results in an inverted P wave. This morphologic feature is unique to Junctional complexes and rhythms.

Inverted P Wave

  • The result of this retrograde depolarization is the classic inverted P wave.
  • Because the electrical impulse causing atrial depolarization may come from anywhere in the AV junction. This can affect the location or coordination with the QRS complex.
junctional ecg image

Authors and Reviewers

Authored by Thomas O'Brien
Medically reviewed by Dr. Jonathan Keroes, MD, Cardiology
Last Update: 11/8/2020

An error has occurred. This application may no longer respond until reloaded. Reload 🗙