Junctional Bradycardia

Created by team@ekgdx.com on Dec. 5, 2023

Let’s talk about junctional bradycardia.

Junctional bradycardia is a rhythm where the heart's impulse originates at the AV junction at the rate of <40 bpm.

Criteria

  • Regular R-R interval.
  • P wave can be before QRS (with PR <0.11 sec.), within QRS (hidden within QRS) or after QRS. 
  • QRS is usually narrow unless with BBB or aberrancy.
  • Rate <40 bpm.

There are several types of junctional rhythms:

  • Junctional Bradycardia: <40 bpm.
  • Junctional Escape Rhythm: 40-60 bpm.
  • Accelerated Junctional Rhythm: 60-100 bpm.
  • Junctional Tachycardia: >100 bpm.

NOTE: Clinical situations that may lead to junctional rhythm: Severe sinus bradycardia, sinus exit block, sinus arrest, third degree AV block, drug overdose (beta-blocker, calcium channel blocker, digitalis), others.

See an example below.

 

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Dr. Roig

Junctional Bradycardia