Cardiology In Critical Care
Impulses originate in a supraventricular pacemaker (above the bifurcation of the the common bundle) at a rate 150-250. P waves cannot be positively identified either because they merge with preceding T waves or because they are buried in QRS complexes so the the differentiation between atrial and junctional tachycardia is impossible. QRS complexes are less than 0.11 sec; occasionally QRS are wide and have RBBB configuration due to aberrancy. Vagal stimulation may have no effect or may terminate tachycardia abruptly.
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