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No Junctional or Ventricular Beats


Safa mughal

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arrest-141E6AD129B2B8F916C.png
I am surprised that this EKG doesn't show any escape beats. I mean, 4 dropped beats? That should induce at least Junctional Escape Beats or PJCs and more likely Ventricular Escape Beats or PVCs.
So why are there no escape beats or premature beats in this sinus arrest? I also know that this EKG shows the first stage of a heart attack, the hyperacute phase where the only change is in the voltage and symmetry of the T wave(high voltage and symmetric vs normal low voltage and asymmetric).
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