ECG Junctional Rhythms

By behereaxum

Summary

You're watching the monitor, and something feels off. The P-waves look strange.

Chapters

  1. You're watching the monitor, and something (0s)
  2. Junctional rhythms start in the AV (6s)
  3. That's your biggest clue: the P-wave. (13s)
  4. Next, check the rate. A junctional (27s)
  5. Now look at the QRS. The (36s)
  6. So: a regular rhythm, a narrow (46s)
  7. Spot the P-wave, count the rate, (53s)

Transcript

You're watching the monitor, and something feels off. The P-waves look strange. Could this be a junctional rhythm? Junctional rhythms start in the AV node, not the SA node. So the atria fire late, or even backward. That's your biggest clue: the P-wave. It may be inverted, hidden inside the QRS, or appear right after it. Sometimes there's no visible P-wave at all. Look closely at every beat, and ask where that P-wave went. Next, check the rate. A junctional escape rhythm runs 40 to 60. Accelerated junctional climbs to 60 to 100. And junctional tachycardia races past 100. Now look at the QRS. The impulse still travels the normal path to the ventricles, so the complex stays narrow, usually under 0.12 seconds. So: a regular rhythm, a narrow QRS, and an absent, inverted, or retrograde P-wave. That's junctional. Spot the P-wave, count the rate, and you've got it.