Certified EKG Technician (CET) Practice Exam 2026 – Comprehensive Test Prep

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How can premature atrial contractions (PACs) be visually recognized on an EKG?

By absent P waves

By late QRS complexes

By early P waves that differ from normal

Premature atrial contractions (PACs) can indeed be visually recognized on an EKG by the presence of early P waves that differ from the normal sinus P waves. This occurs because PACs arise from ectopic foci within the atria that fire before the next sinus node impulse is due, leading to an earlier-than-expected P wave. The morphology of the P wave in a PAC is often distinct from the regular sinus P waves, which helps distinguish it during interpretation.

For instance, a PAC may exhibit a shape that differs from the regular P waves, indicating that it originates from an ectopic pacemaker in the atria, rather than the sinus node. These differences can be subtle but become apparent when comparing the premature P wave with the typical P waves that are fired from the sinus node. Recognizing these characteristics is essential for accurate EKG interpretation and understanding of atrial activity.

Other options do not accurately represent the hallmark features of PACs. The absence of P waves would suggest other arrhythmias or issues, late QRS complexes would indicate a different type of conduction issue, and elevated ST segments typically indicate ischemia or injury rather than PACs. Therefore, identifying the early, atypical P waves is crucial for recognizing PACs

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By elevated ST segments

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