What typically does not occur with a PVC?

A regular P wave typically does not occur with a premature ventricular contraction (PVC) because PVCs originate in the ventricles and not from the atria, where P waves are generated. In a normal rhythm, each P wave is followed by a QRS complex, indicating that the atrial impulse is conducted through the AV node to the ventricles. However, with a PVC, there is often no preceding P wave since the ventricular contraction occurs independently of the atrial rhythm. This lack of a corresponding P wave is a key feature that distinguishes PVCs from normal heartbeats.

The other aspects, such as a compensatory pause following the PVC, a widened QRS complex due to the abnormal conduction through the ventricles, and irregularity in the ventricular rhythm, are characteristic of PVCs. The compensatory pause allows the heart to reset its rhythm after the early contraction, while the widened QRS complex indicates a delay in ventricular depolarization, and the irregularities expose the disruption in the normal rhythmic pattern caused by the premature beat.