Patient Care Technician (PCT) AAH Practice Exam

In Accelerated Junctional Rhythm, how are the P waves commonly characterized?

1. They are always absent

2. They are inverted or occur around the QRS complex

3. They occur only after the QRS complex

4. They do not have a defined pattern

The correct answer is: They are inverted or occur around the QRS complex

In an Accelerated Junctional Rhythm, the P waves are commonly characterized as being inverted or occurring around the QRS complex. This occurs because the junctional nodal tissue, rather than the atria, is driving the heart rhythm. In these cases, the impulses can originate in the junctional area, which is located near the atrioventricular node. Due to this proximity, the electrical impulses may depolarize the atria in a retrograde manner (backward), leading to inverted P waves when viewing an ECG. Furthermore, the occurrence of P waves around the QRS complex suggests that they are frequently seen but not always in a typical relationship to the QRS complex, which adds to the complexity of identifying them. In many instances, the presence of inverted P waves indicates the junctional origin of the rhythm, which is a key characteristic to recognize when diagnosing this arrhythmia.