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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]
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.
This is the property of the AV node that prevents rapid conduction to the ventricle in cases of rapid atrial rhythms, such as atrial fibrillation or atrial flutter. The AV node's normal intrinsic firing rate without stimulation (such as that from the SA node) is 40–60 times/minute. [ 13 ]
The Purkinje fibers, named for Jan Evangelista Purkyně, (English: / p ɜːr ˈ k ɪ n dʒ i / pur-KIN-jee; [1] Czech: [ˈpurkɪɲɛ] ⓘ; Purkinje tissue or subendocardial branches) are located in the inner ventricular walls of the heart, [2] just beneath the endocardium in a space called the subendocardium.
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.
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 ]
It is a region of cardiac muscle on the wall of the upper right atrium near to the superior vena cava entrance. The cells that make up the SA node are specialized cardiomyocytes known as pacemaker cells that can spontaneously generate cardiac action potentials. These signals are propagated through the heart's electrical conduction system.
The sinoatrial node (also known as the sinuatrial node, SA node or sinus node) is an oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of cells known as pacemaker cells. The sinus node is approximately 15 mm long, 3 mm wide, and 1 mm thick, located directly below and to the side of the superior vena ...