2 yr old, postop. VSD. Returned from operating room 2 hrs ago.
What is the rhythm?
Where are the P waves?
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4V4b5MdTkZ4VUudEFFKAQNIvaGE1lQ-lveB2-ig0-68mx1DP9k0aP3DK6xjnem5eIFU0aBLe6yoj3jNdA9aCQudRquY9ARh2OtfbeNGjM94YybVdUmexC8DMkFa9oPkM0MhxuLw/s400/20101014JunctionalPostopSurf.jpg)
Just a little help to identify P waves: Atrial lead is connected in V1.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFAbv7wtFM0kIdDee_pzLlG5B6bSKDCh_uVawmlpOB6PwOa-9GTkclvhdVx3oWhc_FmIWfUgN2TwUFvpa-VvKVQkMjicrmCXqk1pWIyS4rJ7zF72UEhUBO798xtz_dTysamBgiyA/s400/20101014JunctionalPostopAtrialLead.jpg)
Atrial Lead is connected in V1, now recorded at 50 mm/sec paper speed - to help with identifying P waves:
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