Junctional Rythms

Question 1

What happens with a junctional rhythm?

Answer 1

AV node takes control for SA node, normal rate for this is between 50-70 bpm.

Question 2

What are the three waves a junctional rhythm can manifest?

Answer 2

AV node fires and retrograde conduction occurs in atria before moving to the ventricles (inverted P wave before normal QRS complex)

AV node conducts impulse that travels backwards to atria and forwards to ventricles at the same time (inverted P wave hidden in normal QRS) AV synchrony lost

Impulse travels to ventricles first before going backwards to atria (normal QRS with inverted P wave afterwards) AV synchrony lost

Question 3

Why would a junctional rhythm patient become symptomatic?

Answer 3

because of the slower heart rate

Question 4

What is a PJC?

Answer 4

ectopic impulse from the AV junction that occurs usually before the next sinus impulse.

Question 5

QRS with PJC?

Answer 5

normal <0.12, may be wide if conducted aberrantly

Question 6

P wave with PJC?

Answer 6

Inverted due to retrograde conduction

Question 7

Occurrence of PJC?

Answer 7

in healthy people or with same factors as PAC (stimulants, pharmacologic agents (digoxin)

Question 8

Can PJCs be a precursor for junctional rhythms if frequent? Do you treat PJCs?

Answer 8

YES they may be a precursor if frequent and no treatment is not necessary