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1,2 – ventricles: impulse conducted via AV node with RBBB. A paced QRS morphology usually has a LBBB morphology when the lead is located in the RV. Configuration of RBBB in this case is a sign of native AV conduction with underlying RBBB. 3 – atria: premature beat Early appearance and different (from sinus rhythm) configuration of the 3 PQRST complex P-wave is characteristic of the atrial premature beat.

Answer to Quiz: Pacemaker on page 130 and case discussion