This document discusses junctional rhythms, which occur when the atrioventricular (AV) node acts as the backup pacemaker when the sinoatrial (SA) node fails. There are three types of junctional rhythm: junctional rhythm with a rate of 40-60 bpm; accelerated junctional rhythm with a rate of 61-100 bpm; and junctional tachycardia with a rate of 101-180 bpm. All junctional rhythms lack P waves or have inverted, buried, or retrograde P waves and a absent, short, or retrograde PR interval. Causes include SA node disease, increased vagal tone, digitalis use, and inferior wall myocardial infarction. Treatment options are

1. Junctional Arrhythmias
RAMI ALKHATIB

2. outlines
 Definition of junctional rhythm
 Causes of junctional rhythm
 Junctional rhythm ECG
 Accelerated junctional
 Junctional tachycardia
 Treatment
 complication

3. JunctionalRhythms
• The AV node can act as a backup pacemaker in the event of
failure of the SA node.
ECG features that are common to all junctional rhythms
include:
lack of P waves, or P waves that are inverted or buried within
the QRS complexes, or that come after
the QRS complex. The PR interval can be absent, short, or
retrograde.
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5. Causes:
Junctional Rhythm
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SA Node Disease
Increased Vagal Tone
Digitalis
Inferior Wall MI

6. JunctionalRhythm
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Rate: 40–60 bpm Rhythm: Regular
P Waves: Absent, inverted, buried, or retrograde
PR Interval: None, short, or QRS: Normal

7. ACCELERATED JUNCTIONAL
RHYTHM
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Rate: 61–100 bpm Rhythm: Regular
P Waves: Absent, inverted, buried, or retrograde
PR Interval: None, short, or retrograde
QRS: Normal

8. JUNCTIONALTACHYCARDIA
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Rate: 101–180 bpm Rhythm: Regular
P Waves: Absent, inverted, buried, or retrograde
PR Interval: None, short, or retrograde
QRS: Normal

9. References
 Huff, J. (2006). ECG workout: Exercises in arrhythmia interpretation.
Lippincott Williams & Wilkins.
 Hampton, J. R. (2013). 150 ECG problems. Elsevier Health Sciences.
 Khan, M. G. (2008). Rapid ECG interpretation. Springer Science & Business
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