Junctional Rhythm ECG Interpretation
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.
Show Answer
- Rhythm: Regular
- Rate: 43
- P wave: inverted
- PR interval: 0.08 sec
- QRS: 0.08 sec
- Interpretation: Junctional Escape Rhythm
Authors and Sources
Authors and Reviewers
- EKG heart rhythm modules: Thomas O'Brien.
- EKG monitor simulation developer: Steve Collmann
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12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language EKG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
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Heart sounds and mentorship: W. Proctor Harvey, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
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Last Update: 1/8/2023
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
Dale Dublin
Cover Publishing Company -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
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 - Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009) -
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
