Certified Rhythm Analysis Technician (CRAT) 2025 – 400 Free Practice Questions to Pass the Exam

The atrial pacemaker rhythm is characterized by the presence of pacing spikes that occur before P waves. This indicates that the pacemaker is effectively stimulating the atria, which then contracts and generates the P wave on the electrocardiogram (ECG).

In this rhythm, the pacing spike is an indication that the artificial pacemaker is delivering electrical impulses specifically to the atria, prompting them to depolarize and produce a P wave. The placement of the pacemaker in the atria allows it to take over the pace of the heart when the natural sinus node is unable to function adequately.

In contrast, other rhythms such as the ventricular pacemaker rhythm show pacing spikes that occur before the QRS complexes rather than P waves, indicating that the pacemaker is stimulating the ventricles directly. The atrioventricular and atriobiventricular pacemaker rhythms involve pacing strategies that may affect both the atria and ventricles but typically do not exhibit spikes leading to P waves alone. This is why the atrial pacemaker rhythm is accurately associated with pacing spikes preceding P waves.