Arrhythmia Recognition: The Art of Interpretation
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Practice Rhythm Strips

Practice Rhythm Strip 7
 
Rate:About 80 BPMPR intervals:Normal, except in event
Regularity:Regular with an eventQRS width:Normal
P waves:Present, except in eventGrouping:None
   Morphology:Normal, except in eventDropped Beats:Present
   Axis:Normal, except in eventRhythm:Sinus rhythm with a PJC
P:QRS ratio:1:1, except in event

This strip shows a nice sinus rhythm clipping along at 80 BPM. The cadence of the ventricular complexes is broken up by a premature complex that is narrow and similar in morphology to the rest of the complexes. This is obviously a PJC. The cadence of the atrial complexes, however, is not broken and persists right through the PJC making this a compensatory pause. Notice the buried upright P wave within the PJC (blue arrow). The fact the P wave is upright means that it did not come from the PJC.

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