What is the usual appearance of junctional rhythms on an EKG?

Junctional rhythms are characterized by their unique EKG features which distinguish them from other types of rhythms. The key aspect of junctional rhythms is the presence of inverted or absent P waves. This occurs because the electrical impulse originates from the atrioventricular (AV) junction rather than the sinoatrial (SA) node, causing the atria to depolarize differently compared to normal sinus rhythm.

In junctional rhythms, if P waves are present, they are often inverted (especially in lead II) or may be found in close proximity to the QRS complexes, leading to the absence of visible P waves altogether in some cases. This characteristic is combined with a regular ventricular rhythm, which means that the heart rate is usually stable, albeit generally slower than the normal sinus rate, often in the bradycardic range.

Since junctional rhythms do not exhibit the typical progression of P waves followed by QRS complexes seen in sinus rhythms, the combination of inverted or absent P waves and a regular rhythm clearly indicates the presence of a junctional rhythm. This is what makes the chosen answer accurate.