Which rhythm is characterized by an irregular pulse and may include a pulse deficit?

• A. Atrial Tachycardia
• B. Atrial Flutter
• C. Atrial Fibrillation
• D. Premature Junctional Complex

Answer: (C)

An irregularly irregular pulse with a possible pulse deficit points to atrial fibrillation. In AFib, chaotic atrial activity leads to unpredictable conduction through the AV node, so the ventricles fire at irregular intervals rather than a steady rhythm. That creates varying R-R intervals and often no distinct P waves on ECG. Because not every atrial impulse results in a strong, effective ventricular beat, some beats may not produce a palpable pulse, producing a pulse deficit.

The other rhythms don’t fit this pattern as well. Atrial tachycardia produces a rapid but typically regular rhythm with identifiable P waves from an atrial focus. Atrial flutter usually has a sawtooth pattern with a more regular ventricular response unless there’s varying block. Premature junctional complexes cause early beats within a largely regular rhythm and don’t produce a persistently irregular pulse.