Which feature is commonly seen in the EKG pattern of paroxysmal junctional tachycardia (PJT)?

Which feature is commonly seen in the EKG pattern of paroxysmal junctional tachycardia (PJT)?

• A. P waves that are identical
• B. A buried P wave within the QRS complex
• C. Two different QRS complexes
• D. Wide QRS complexes

Answer: (B)

In paroxysmal junctional tachycardia (PJT), the hallmark feature is often the presence of a buried P wave within the QRS complex. This occurs due to the electrical impulses originating from the junctional area, where there is a retrograde conduction of impulses to the atria. As a result, the P waves are not always distinctly visible on the EKG; they might be obscured or hidden within the QRS complex itself.

When an impulse arises from the junction, the ventricular depolarization proceeds rapidly and can mask the P wave in the EKG’s graphical representation. This characteristic makes it difficult to identify the P waves separately, which is a key diagnostic aspect of identifying PJT. Being aware of this feature helps clinicians interpret the EKG accurately and delineate PJT from other types of tachycardia.

The identification of identical P waves, variation in QRS complex morphology, or abnormal widths of QRS complexes are more characteristic of other arrhythmias and do not reflect the typical presentation seen in PJT effectively. This sets apart the characteristic feature of buried P waves as a definitive indicator of the condition.