In a junctional rhythm viewed in lead ii, The P wave may come just before the QRS complex if the atria depolarized prior to the ventricles. It is usually inverted in Lead II due to backwards (retrograde) depolarization of the atria but does not have to be.
Therefore, It can fall before or after the QRS complex, or it can be hidden within the QRS compiled.
Junctional rhythm is a regular narrow QRS complex rhythm unless bundle branch block (BBB) is present. P waves may be absent, or retrograde P waves (inverted in leads II, III, and a VF) either precede the QRS with a PR of less than 0.12 seconds or follow the QRS complex.
Does the atria depolarize in a junctional rhythm?
When the sinus node does not depolarize the atrium for any reason.
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