Which dysrhythmia does a compensatory pause commonly occur?

• A. Atrial fibrillation
• B. Premature ventricular complex
• C. Junctional escape rhythm
• D. Second-degree AV block, type II

Answer: (B)

A compensatory pause commonly occurs after a premature ventricular contraction. A PVC is an ectopic beat arising in the ventricles, not through the normal conduction pathway. After this early beat, the ventricles remain refractory and the sinus node keeps pacing, so the cycle is momentarily delayed before the next normal beat. This pause is longer than a typical RR interval and often amounts to about two normal intervals, effectively “compensating” for the premature beat and restoring regular timing. Other rhythms don’t show this classic pattern: atrial fibrillation has no regular compensatory pause, a junctional escape rhythm isn’t driven by a premature ventricular impulse, and second-degree AV block type II involves dropped beats from conduction failure rather than a compensatory pause after a PVC.