II. Causes
- Acute Coronary Syndrome
- Digoxin Toxicity (esp. with underlying Atrial Fibrillation)
- Beta Adrenergic Receptor Agonists
- Myocarditis
- Cardiac Procedures or Surgery
III. Findings: Junctional Rhythm
- Junctional Escape Rhythm
- Normal intrinsic junctional rate is 40-60 bpm
- Accelerated Junctional Rhythm (AJR)
- Rate 60-100 bpm (faster than intrinsic rate)
- Accelerated Junctional Tachycardia
- Rate >100 bpm
IV. Findings: P Waves
V. Types
-
AV Nodal Reentrant Tachycardia (AVNRT)
- Accessory pathway related re-entrant loop
- Automatic Junctional Rhythm
- Increased AV Node automaticity
VI. Management: Accelerated Junctional Tachycardia
- See Supraventricular Tachycardia Management
- Typically does not respond to Vagal Maneuvers
- Diltiazem or Metoprolol for rate control (may convert to sinus rhythm)
VII. Resources
- Burns (2021) Accelerated Junctional Rhythm, Life in the Fastlane
VIII. References
- Mattu (2018) Crit Dec Emerg Med 32(9): 12
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Related Studies
Definition (NCI) | An electrocardiographic finding of a junctional rhythm with a heart rate which is abnormally elevated. (CDISC) |
Definition (NCI_CDISC) | An electrocardiographic finding of a junctional rhythm with a heart rate which is abnormally elevated. |
Concepts | Finding (T033) |
English | Junctional Tachycardia by ECG Finding, Junctional Tachycardia, JUNCTIONAL TACHYCARDIA, Junctional tachycardia, Junctional Tachycardia by EKG Finding |