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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]
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG [a]), a recording of the heart's electrical activity through repeated cardiac cycles. [4] It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart [ 5 ] using electrodes placed on the skin.
A junctional escape beat is a delayed heartbeat originating not from the atrium but from an ectopic focus somewhere in the atrioventricular junction. [1] It occurs when the rate of depolarization of the sinoatrial node falls below the rate of the atrioventricular node . [ 2 ]
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 ...
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 ]
Another heart rhythm similar to wandering atrial pacemaker is multifocal atrial tachycardia. Both arrhythmias have at least 3 different P-wave morphologies in a single ECG lead, but the heart rate is different. When the heart rate is lower than 100 beats per minute, the heart rhythm is considered wandering atrial pacemaker.
Junctional ectopic tachycardia (JET) is a rare tachycardia caused by increased automaticity of the AV node itself initiating frequent heartbeats. On the ECG, junctional tachycardia often presents with abnormal morphology P-waves that may fall anywhere in relation to a regular, narrow QRS complex. It is often due to drug toxicity. [22]
The ECG shows AV-junctional rhythm resulting in bradycardia at around 46 beats per minute. This ECG from the same patient shows atrial fibrillation at around 126 beats per minute. The most common complication of sinus node dysfunction is the development of tachycardia-bradycardia syndrome with abnormal atrial rhythms such as atrial tachycardia ...
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