Junctional rhythms originate in the
AV node
A junctional rhythm is identified by
Short PR intervals with aberrancy of the P wave
A junctional rhythm may have an
Absent P wave or one that occurs after the QRS complex
A premature junctional contraction can be distinguished from
- Premature beat with an aberrant P wave that is less than 0.12 seconds from the QRS complex
Etiology of PJCs
- Idiopathic and benign
- Anxiety
- Fatigue
- Drugs: nicotine, alcohol, caffeine, etc.
- Heart disease
- Electrolyte disorders
- Hypoxia
- Digitalis
- Sympathomimetics
A Junctional escape beat can be distinguished by
-A Junctional complex that occurs late
Etiology of a Junctional escape beat
1.INCREASED VAGAL TONE
2.PATHALOGICAL SLOW SA NODE
3.HEART BLOCK
Junctional escapes rhythms can be identified by
-A rate of 40-60
-Regular rhythm
-Short or absent PR interval
-Aberrant P waves
An accelerated junctional rhythm can be identified by
-A rate of 60-100
-Regular rhythm
-Short or absent PR interval
-Aberrant P waves
Junctional tachycardia can be identified by
-A rate of 100-130
-Regular rhythm
-Short or absent PR interval
-Aberrant P waves
Junctional rhythm etiology
- Primary SA node dysfunction
- AV dissociation
- Increased parasympathetic activity
- Drugs: digoxin, beta-blockers, calcium-channel blockers
- Myocardial ischemia 5. Myocardial ischemia
- Sick sinus syndrome
- Electrolyte disorders
- CNS events
- Idiopathic
If Junctional tachycardia has a rate of greater than 130 it is
AV nodal reentry Tachycardia
Junctional tachycardia etiology
- Ischemic heart disease, AMI
- Intracardiacsurgery
- Digitalis toxicity
- Myocarditis 4. Myocarditis
- Electrolyte disorders
AVNRT etiology
Idiopathic
Wolff-Parkinson-White is distinguished by
-Short PR interval
-Delta wave
-Wide QRS complex
