The document discusses three types of atrial premature complexes: 1. Normally conducted complexes which have an early P wave that conducts normally with a PR interval that may be normal, increased, or decreased and a QRS similar to sinus rhythm. 2. Non-conducted complexes where an early P wave is not followed by a QRS and the P wave is often hidden in the T wave. 3. Complexes with aberrant conduction where the early P wave is followed by a QRS with an abnormal conduction pattern most commonly right bundle branch block but sometimes left bundle branch block.

1. Types of Atrial Premature Complexes
Dr Mohamed Salih Aziz

2. 1. Atrial premature complexes,normally
conducted
—suggested by the following:
■ Premature P wave in relation to normal sinus rhythm
■ P wave usually abnormal in configuration
■ PR interval may be normal,increased,or decreased
■ Post-extrasystolic pause is noncompensatory unless sinoatrial
entrance block is present and sinoatrial node is not reset, resulting
in either an interpolated beat or a full compensatory pause
■ QRS complex similar in morphology to the QRS complex present
during sinus rhythm

4. 2. Atrial premature complexes,nonconducted
■ Premature P waves that are abnormal in morphology but
not followed by QRS
■ P waves that are often hidden in T wave (look for
deformed T wave)
■ The sinus node is usually reset, resulting in RR interval
pauze

5. 3. Atrial premature complexes with aberrant
intraventricular conduction
■ P wave that occurs very early
■ RBBB pattern is most common, but LBBB
or even variable QRS morphology may
occur

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