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The most obvious abnormal finding will be abnormal P waves. One of three options can occur: [12] 1. There are no P waves. This is because of either failure of retrograde flow to the atria or the P wave is hidden in the QRS. If the P wave is hidden that implies the atria depolarize at the same time as the ventricles. 2.
Atrial escape (rate 60–80): originates within atria, not sinus node (normal P morphology is lost). Junctional escape (rate 40–60): originates near the AV node; a normal P wave is not seen, may occasionally see a retrograde P wave. Ventricular escape (rate 20–40): originates in ventricular conduction system; no P wave, wide, abnormal QRS.
Sinus bradycardia is a sinus rhythm with a reduced rate of electrical discharge from the sinoatrial node, resulting in a bradycardia, a heart rate that is lower than the normal range (60–100 beats per minute for adult humans).
For infants, bradycardia is defined as a heart rate less than 100 BPM (normal is around 120–160 BPM). Premature babies are more likely than full-term babies to have apnea and bradycardia spells; their cause is not clearly understood. The spells may be related to centers inside the brain that regulate breathing which may not be fully developed.
It is only when bradycardia presents with signs and symptoms of shock that it requires emergency treatment with transcutaneous pacing. False capture with visible phantom beats [3] Some common causes of hemodynamically significant bradycardia include myocardial infarction, sinus node dysfunction and complete heart block. [citation needed]
The P waves with a regular P-to-P interval (in other words, a sinus rhythm) represent the first rhythm. The QRS complexes with a regular R-to-R interval represent the second rhythm. The PR interval will be variable, as the hallmark of complete heart block is the lack of any apparent relationship between P waves and QRS complexes.
Junctional tachycardia is a form of supraventricular tachycardia characterized by involvement of the AV node. [1] It can be contrasted to atrial tachycardia.It is a tachycardia associated with the generation of impulses in a focus in the region of the atrioventricular node due to an A-V disassociation. [2]
On the surface ECG, premature junctional contractions will appear as a normally shaped ventricular complex or QRS complex, not preceded by any atrial complex or P wave or preceded by an abnormal P wave with a shorter PR interval. Rarely, the abnormal P wave can follow the QRS. [2]