This has a left bundle branch block pattern and is a good example of the AV dissociation that occurs. Now, look at the rhythm strip at the bottom in lead V1 to see the AV dissociation. This ECG ...
The second ECG strip below shows an ectopic atrial rhythm. Note that the P wave is ... dissociation is present (complete heart block or VT), as previously described, there may not be a P wave ...