Introduction Part 2 - Junctional Rhythms

P Wave & QRS Complex

• The coordination of the P wave and QRS complex is also affected by the increased conduction velocity of the electrical impulses in the ventricular myocardium.
• The inverted P wave may be seen before or after the QRS complex, or it may be buried within it.
• Refer to the image on the next slide to reinforce this concept.

Illustration

Intro to PJC

• PJC's can occur for a number of different reasons i.e., diet, fatigue, stress, disease, ischemia to name a few.
• Premature complexes frequently occur in bradycardic rhythms, but may occur almost any time.
• PJC's occur when an early electrical impulse occurs from a location in the atria other than the SA node.

Types

We will be discussing the following complexes and rhythms:

• Premature Junctional Complexes and Junctional
• Escape Beats
• Junctional Rhythm
• Accelerated Junctional Rhythm
• Junctional Tachycardia
• Although not specifically a Junctional rhythm, we include supraventricular tachycardia because it may originate above the ventricles (including the junction).