Premature Junctional Complex (PJC) and Junctional Escape Beats - Junctional Rhythms
- PJC’s and Junctional Escape Beats may occur for a number of different reasons i.e., diet, fatigue, stress, disease, ischemia
- Premature complexes and Junctional 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.
- Junctional 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
PJC Rhythm ECGs
- 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 ECG’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.
Authors and Sources
Authors and Reviewers
- EKG heart rhythm modules: Thomas O'Brien.
- EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language EKG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Electrocardiography for Healthcare Professionals, 5th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
- Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH