It is likely that the P wave is buried in the QRS complex and the rhythm is junctional in origin. See the Junctional Rhythms Review below for more details on diagnosing a junctional rhythm.

A junctional rhythm occurs when the sinoatrial node (SA ... the P wave morphology (normally generated when the SA node fires causing atrial depolarizaion) will be altered since its origin is ...

Dr. Paban Saha, an Electrophysiologist with Prairie Cardiovascular, discusses atrial fibrillation. What is Atrial ...

The most frequent arrhythmias were isolated premature atrial contractions ... one patient had a persistent accelerated junctional rhythm associated with prolonged hypotension.