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The first finding is that junctional rhythms are regular rhythms. This means that the time interval between beats stays constant. The next normal finding is a normal QRS. Since the impulse still travels down the bundle of His, the QRS will not be wide. Junctional rhythms can present with either bradycardia, a normal heart rate, or tachycardia. [9]
Junctional tachycardia is a form of supraventricular tachycardia characterized by involvement of the AV node. [1] It can be contrasted to atrial tachycardia . It is a tachycardia associated with the generation of impulses in a focus in the region of the atrioventricular node due to an A-V disassociation. [ 2 ]
The AV node normally has the second fastest discharge rate. When the sinus rate falls below the discharge rate of the AV node, this becomes the dominant pacemaker, and the result is called a junctional escape beat. If the rate from both the SA and AV node fall below the discharge rate of ventricular pacemaker cells, a ventricular escape beat ...
Junctional rhythms (if a bradycardia) can cause decreased cardiac output. Therefore, the person may exhibit signs and symptoms similar to other bradycardia such as lightheadedness, dizziness, low blood pressure, and fainting. This rhythm can usually be tolerated if the rate is above 50 beats per minute. [citation needed]
"Junctional" is used as the abnormal tissue driving the ventricular rate is located close junction between the atria and ventricles, known as the AV node. Ectopic (from the Greek ektopos , meaning "out of place") refers to the fact that the ventricles are being triggered by tissue that is not the normal pacemaker tissue within the heart.
These "junctional" rhythms are characterized by a missing or inverted P wave. If both the SA node and the AV junction fail to initialize the electrical impulse, the ventricles can fire the electrical impulses themselves at a rate of 20 to 40 bpm and will have a QRS complex of greater than 120 ms.
Automatic junctional tachycardia is a type of tachyarrhythmia that originates in the atrioventricular node and His bundle area. It can be referred to as junctional tachycardia, focal junctional tachycardia, or Junctional Ectopic Tachycardia (JET). [10] Patients' heart rates are frequently between 200 and 250 beats per minute.
If more than two such beats are seen, then the condition is termed junctional rhythm. On the surface ECG, premature junctional contractions will appear as a normally shaped ventricular complex or QRS complex, not preceded by any atrial complex or P wave or preceded by an abnormal P wave with a shorter PR interval. Rarely, the abnormal P wave ...