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Fast & Easy ECGs – A Self-Paced Learning Program
Junctional Dysrhythmias
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Junctional Dysrhythmias
• Originate in AV junction (area around AV node and bundle of His)
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Junctional Dysrhythmias
• Key characteristics – P’ waves may be inverted with a short P’R
interval, absent (as they are buried by the QRS complex), or follow QRS complexes
– QRS complexes usually normal unless there is an intraventricular conduction defect, aberrancy or preexcitation
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Premature Junctional Complex (PJC)
• Single early electrical impulse that arises from the AV junction
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Premature Junctional Complex
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Premature Junctional Complex
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Junctional Escape Rhythm • Arises from AV junction at rate of 40 to 60 BPM
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Junctional Escape Rhythm
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Junctional Escape Rhythm
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Accelerated Junctional Rhythm
• Arises from AV junction at rate of 60 to 100 BPM
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Accelerated Junctional Rhythm
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Accelerated Junctional Rhythm
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Junctional Tachycardia • Fast ectopic rhythm that arises from bundle of
His at rate of 100 to 180 BPM
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Junctional Tachycardia
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Junctional Tachycardia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Practice Makes Perfect • Determine the type of dysrhythmia
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Summary • Junctional rhythms originate in the AV junction.
• Impulses originating in the AV junction travel upward and cause backward or retrograde depolarization of the atria resulting in inverted P’ waves in lead II with a short P’R interval, absent P waves or P waves that follow the QRS complexes.
• With junctional dysrhythmias the QRS complexes are usually normal unless there is an intraventricular conduction defect, aberrancy or preexcitation.
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Summary • A premature junctional complex (PJC) is a single early
electrical impulse that arises from the AV junction.
• Junctional escape rhythm arises from the AV junction at a rate of 40 to 60 beats per minute.
• Accelerated junctional rhythm arises from the AV junction at a rate of 60 to 100 beats per minute.
• Junctional tachycardia is a fast ectopic rhythm that arises from the bundle of His at a rate of between 100 and 180 beats per minute.