Premature Junctional Complex (PJC) and Junctional Escape Beats ECG Interpretation
- 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
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
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