Junctional Rhythm Basics — ECG Academy Lesson

Understand the AV junction as a backup pacemaker, learn the three P wave positions in junctional rhythms, and recognize the hallmarks of junctional origin on the monitor.

Learning Objectives

• Explain why the AV junction functions as a backup pacemaker
• State the inherent firing rate of the AV junction (40-60 bpm)
• Describe the three possible P wave positions in junctional rhythms
• Explain why P waves appear inverted in leads II, III, and aVF during retrograde conduction
• Identify the QRS width expected in junctional rhythms and explain why it remains narrow