Junctional Rhythm - Course # 314-9

Junctional Rhythm

  • Rhythms are often named according to the origin of the electrical activity in the heart or the structure where the problem is occurring.
  • Junctional Rhythm aka Junctional “Escape” Rhythm is aptly named due to the electrical impulses causing the atrial activity are originating in the AV Junction.
  • The rate for this rhythm is the same as the AV Junction, 40 – 60 bpm.
  • The change in the locus of stimulation affects the morphology (inverted) and potential location of the P waves (before, during or after the QRS complex).
  • If the P wave occurs before the QRS, the PR interval will likely measure shorter than normal (0.12 second).
  • If the P wave is buried or occurs after the QRS, it cannot be measured.

Practice Strip

  • Analyze this tracing using the five steps of rhythm analysis.
  • T Compare your answers with the answers on the next slide.
junctional ecg image 8


  • Rhythm: Regular
  • Rate: 43
  • P wave: inverted
  • PR interval: 0.08 sec
  • QRS: 0.08 sec
  • Interpretation: Junctional Escape Rhythm
junctional ecg image 9

314 Junctional Rhythm - Course # 314-9