Question

How is junctional rhythm characterized?

Answer 1

Junctional rhythm:

1. A junctional rhythm is where the heartbeat originates from the AV node (atrioventricular node) or His bundle.
2. Generally, in sinus rhythm, a heartbeat is originated at the SA node.
3. It is characterized by QRS complexes of morphology which is identical to that of the sinus rhythm without preceding the P waves.
4. Compared to the expected sinus rate, this rhythm is slower.
5. When this rhythm overtakes the heart’s action of the pacemaker completely, the retrograde P waves and the atrioventricular dissociation can be seen.
6. During cardiac surgery, the junctional rhythms are frequently the outcome of dissection/manipulation near the right atrium.
7. Generally, the central venous pressure contour depicts evident V waves (right atrial pressure wave at the end of systole) as a result of the loss of AV synchrony.
8. Lack of atrial contribution to the ventricular filling can cause a reduction in the systemic arterial blood pressure.