Junctional Rhythms arise from the
AV Junction
AV junction
the tissue located between the right atrium and ventricle surrounding the AV node
Antigrade
Forward, towards the ventricle
Retrograde
Backwards, toward the atria
What regions can the AV junctional area be divided into?
High, Mid, low
High junctional Rythms
inverted p wave before qrs
Mid junctional Rhythms
No visible P waves
Low junctional Rhythms
inverted p waves following the qrs
Junctional Rhythms are seen ___ often than sinus or atrial rhythms.
Less
AV inherent rate
40 - 60 bpm
Treatment is aimed toward alleviating the _____ of the junctional rhthym
cause
For Junctional rythms More active treatment is not necessary unless ______ _______
Symptoms develop
For junctional Rhythms the goal of treatment is...
to return the sinus node to control or to return heart rate to more normal levels
QRS in junctional Rhythms can be...
both positive or negative
Premature Junctional Complexes (PJC)
Premature beats that originate in the AV junction before the next sinus beat is due
What is the cause of PJC?
Irritable tissue in the AV junction firing and usurping the sinus node for that beat
PJC rate
can occur at any rate
PJC regularity
Regular but interrupted
Pwave of PJC
inverted before or after the QRS or hidden inside the QRS
PR Interval of PJC
less than 0.12 if the P wave precedes the QRS
PJC effect
Usually no ill effects
Treatment PJC
usually none except for removal of the cause
Junctional Bradycardia
A junctional rhythm with a heart rate slower than usual
In a Junctional Bradycardia a _____ pacemaker has failed and the __ ______ has to escape to save patients life.
higher, AV junction
Junctional Bradycardia rate
less than 40
Junctional Bradycardia Regularity
Regular
Junctional Bradycardia P waves
inverted before or after the QRS or hidden inside the QRS
Causes of Junctional Bradycardia
vagal stimulation, hypoxia, ischemia of sinus node, heart disease
Effects of Junctional Brady
Decreased cardiac output
Junctional Rhythm Regularity
Regular
Treatment of Junctional Rhythm
Transcutaneous pacing, atropine, dopamine etc
The location of the P wave of Junctional rhythm is dependant on...
the region of the AV junction in which thr impulse originates
Accelerated Junctional Rhythm
can occur because of escape or usurpation.
Accelerated Junctional Rhythm Rate
60-100
Accelerated Junctional Rhythm Regularity
Regular
Cause of Accelerated Junctional Rhythm
Heart disease, stimulant drugs, caffiene
Accelerated Junctional Rhythm Effects
usually none
Junctional Tachycardia
An irritable spot in the AV junction has taken over as the pacemaker and the heart rate is very rapid. usually a result of usurpation
Junctional Tachycardia is best called ___ if there are no visible - ---- .
SVT, P waves
Junctional Tachycardia rate
greater than 100
Junctional Tachycardia REGULARITY
regular
Junctional Tachycardia cayses
digitalis toxicity, heart disease, stimulants, sympathetic nervous system stimulation
Junctional Tachycardia effects
decreased cardiac output
Junctional Tachycardia treatment
beta blockers, calcium channel blockers etc