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Introduction Part 1 - Junctional Rhythms


  • 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 retrodgrade p wave ekg

Authors and Sources

Authors and Reviewers


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