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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]
Location of the pacemaker can also change its effect on the SA node and its rhythm. An ectopic pacemaker located in the atria is known as an atrial pacemaker and can cause the atrial contraction to be faster. [10] An ectopic pacemaker situated near the AV node and the septum is known as a junctional pacemaker. [11]
When the atrial rhythm is irregular (as in atrial fibrillation or sinus arrhythmia) the presence of bigeminy depends on the length of the P–P interval and happens more frequently with a longer interval. As with post PVC pauses, a longer P–P interval leads to a higher chance of re-entrant circuits and thus PVCs.
Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. [3] [12] It is a type of supraventricular tachycardia. [14] Atrial fibrillation frequently results from bursts of tachycardia that originate in muscle bundles extending from the atrium to the pulmonary veins. [15]
The types of SVT associated with TIC include atrial fibrillation, atrial flutter, incessant atrial tachycardia, permanent junctional reciprocating tachycardia, atrioventricular reciprocating tachycardia, and atrioventricular nodal reentry tachycardia. [1] Atrial fibrillation is the most common and well-studied etiology of TIC. [1] [5]
Wandering atrial pacemaker (WAP) is an atrial rhythm where the pacemaking activity of the heart originates from different locations within the atria. [1] This is different from normal pacemaking activity, where the sinoatrial node (SA node) is responsible for each heartbeat and keeps a steady rate and rhythm.
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