In this chapter, we will look at how the AV nodal area functions as an escape pacemaker for the heart. The escape pacemaker can trigger off a single escape beat, if that is all that is needed; or it can trigger off an entire escape rhythm, essentially taking over if the sinoatrial (SA) node completely fails. The pacemaking function of the AV node is critical in maintaining a viable ventricular response in cases of sinus failure for whatever reason.