00:01 Occasionally, beats will actually -- extra beats will actually develop in the AV node itself. 00:07 These are so-called 'nodal extra systoles'. They also have a narrow QRS but there's no abnormal P wave before the abnormal beat. 00:17 They originate in the upper AV nodal region. 00:20 They're not very common. Much more common are atrial premature beats. 00:24 And here we see some examples. 00:26 You'll notice that the first three marked with an arrow have no P waves before the extra systoles. 00:36 So, you'll notice first beat, there's no P wave in front of it. 00:39 Then when we have a normal beat. The second beat, P wave, QRS, and T. 00:43 There's another beat there, no P wave. Then the fourth beat, P wave, QRS, and T. 00:49 And there's another extra beat with no P wave and so forth. It continues through out. 00:54 So, these without a P wave are nodal extra systoles.
The lecture ECG of Nodale Extra Systoles by Joseph Alpert, MD is from the course Electrocardiogram (ECG) Interpretation.
Where do nodal extra systoles commonly originate?
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