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Junctional Escape Beats example one



This strip begins with six sinus beats, a PAC follows, with its P-wave buried in the tail of the preceding T-wave, and then there is a pause.   The pause is ended by a junctional escape beat with a retrograde P-wave.  We know that the P-wave is retrograde because the P-R interval is too short (0.08 seconds) and that the beat is junctional because its QRS shape is no different than the sinus beats (the specialized conduction system, from the A-V junction downward, has functioned normally).  We call it an escape beat because the junction has acted as pacemaker, escaping from sinus arrest.  Another sinus pause follows, also ended by a junctional escape beat.   This JEB has no visible P-wave.  A short pause follows, and sinus rhythm resumes.