A premature atrial contraction (PAC) occurs when a focus in the atrium ... AV node recovering (the AV node is still refractory), a non-sinus P wave will be seen that is not followed by a QRS ...
When this occurs in a pattern of bigeminy, the interpreter may be fooled into thinking that sinus bradycardia is present, since every other beat is a non-conducted PAC and the QRS rate is quite slow.
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