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Atrial ectopics

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Atrial ectopics have the following characteristics on the ECG:

  • premature P waves
  • abnormal shaped P waves
  • incomplete compensatory pause before next sinus beat

Most atrial ectopic beats will be conducted through the AVN, hence the QRS complex is normal.

Ectopic P waves occurring early in the cardiac cycle may encounter components of the conducting system which are still refractory:

  • blocked atrial ectopic - the AVN is refractory
  • prolonged P-R interval - the AVN is partially refractory
  • phasic aberrant ventricular conduction - a bundle branch, usually the right, is refractory. The QRS may resemble that of a ventricular ectopic

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