Occurs when 3 or more sequential PJC's occur at a rate of 100 bpm or more Nonparoxysmal Junctional Tachycardia 101-140 bpm Paroxysmal Junctional Tachycardia starts and ends suddenly and is precipitated by a PJC If no P wave before QRS, no PR interval QRS of Accelerated Junction 0.11 seconds or less Junctional Tachycardia begins in pacemakers cells in Bundle of His Rate: 61-100 bpm P Wave of Accelerated Junction inverted-before or after QRSĪbsent (during QRS) PR Interval of Accelerated Junction If P wave before QRS- 0.12 seconds or less Withhold Digoxin if it is the cause Rhythm of Accelerated Junction regular
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Rheumatic Fever How to treat Accelerated Junctional Rhythms? usually asymptomatic If slow HR-pulse ox, oxygen, IV access, 12 lead EKG, Atropine Accelerated Junctional Rhythm AV junction speeds up and fires at rate of 61-100 bpmĬaused by enhanced automaticity of Bundle of His Causes of Accelerated Junctional Rhythms Acute MI If having symptoms (chest pain, weakness, syncope, LOC, hypotension) It refers to a rate slower than a normal for AV junction (40-60) Treatment of Junctional Escape Beats/Rhythm may be asymptomatic
considered Junctional bradycardia (escape rhythm) Rate usually normal, but check underlying P Wave of Junctional Escape Rhythm inverted-before or after QRSĪbsent (during QRS) PR Interval Junctional Escape Beat 0.12 seconds or less or none if P during QRS QRS in Junctional Escape Beat 0.11 seconds or less Junctional Escape Rhythm sequence of several junctional escape beats (40-60 bpm) If AV Junction paces heart at a rate slower than 40 bpm. Valvular Disease When do junctional escape beats happen? during episodes of sinus arrestĪfter pauses of PAC's Rhythm of Junctional Escape Beat regular with LATE beats If symptoms (feeling skipped beats, lightheaded) then withhold substances Junctional Escape Beat still begins in the AV junction but appears LATE after the next expected beat Causes of Junctional Escape Beats ACS (inferior MI) Must state underlying rhythm How to treat PJC's? if asymptomatic, no treatment QRS in PJC 0.11 seconds or less Is a PJC a rhythm? No, it is a BEAT
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