Atrial pacing
Also calledAtrial pace · Atrial paced beat · AAI pacing · AAIR pacing · Right atrial pacing
Definition
Pacing delivered to the atrium, seen on the ECG as a pacemaker stimulus (spike) followed, after a short latency, by a paced P wave. When AV conduction is intact, the impulse then reaches the ventricles through the patient's own AV conduction system, so the QRS keeps its native (non-paced) shape. Single-chamber atrial pacing is the AAI mode of the NASPE/BPEG generic pacemaker code (AAIR when rate modulation, the fourth code position, is on). The paced P wave's shape depends on the pacing site: pacing from the usual right atrial appendage site gives a P wave similar in morphology to sinus rhythm, whereas atrial septal pacing gives a short, sharp P wave whose polarity depends on whether the upper or lower septum is paced.
Sources
- Bernstein AD, Daubert JC, Fletcher RD, et al. The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. Pacing Clin Electrophysiol. 2002;25(2):260-264. doi.org/10.1046/j.1460-9592.2002.00260.x
- Das A. Electrocardiographic features: various atrial site pacing. Indian Heart J. 2017;69(5):675-680. doi.org/10.1016/j.ihj.2017.08.030
- Waqanivavalagi SWFR. Temporary pacing following cardiac surgery - a reference guide for surgical teams. J Cardiothorac Surg. 2024;19(1):115. doi.org/10.1186/s13019-024-02619-9
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.