Premature Junctional Complex (PJC) and Junctional Esca.
- PJC’s and Escape Beats may occur for a number of different reasons i.e., diet, fatigue, stress, disease, ischemia
- Premature complexes and Escape Beats frequently occur in bradycardic rhythms, but may occur almost any time.
- Morphologically there is no difference between PJC’s and Escape Beats.
- After reviewing the previous slide you should note that the difference is that PJC’s occur early and disrupt the underlying rhythm.
- Escape beats typically occur when a cardiac rhythm is too slow and a backup pacemaker site initiates an electrical impulse.
- It is fairly common that a Junctional Escape Beat will occur as the first complex to terminate Sinus Arrest
- This early impulse causes an early cardiac complex which disrupts the underlying rhythm.
- The locus of stimulation being different, results in a change in the morphology of the P wave (inverted if it can be seen).
- PJC’s can occur occasionally or frequently.
- PJC’s can be observed with or without a pattern
- The P wave with PJC’s may occur before or after the QRS complex or be buried within the QRS.