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Table I-A.3. Electrocardiographic (ECG) Characteristics and Causes of Junctional Rhythms
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Name
ECG Characteristics
Common Causes
PT Considerations
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Junctional escape
Regular rhythm, rate 20-40;
Usual cause is physio
If occasional and intermittent during
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rhythm
inverted P wave before
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or
logic ro control the
bradycardia or chronic AF, usu
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after QRS complex; starts
ventricles in AV
ally insignificant and can treat
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with ectopic foci in AV juncblock, sinus brady
(with close watch of possible
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tion tissue
cardia, AF, sinoatrial
worsening condition via sympc
block, drug intoxicatoms and vital signs); if consistent
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tion
and present secondary to AV
block, acute myocardial infarco
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rion, or drug intoxication, can be
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symptomatic with CHE (See
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Table 1-21.)
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r
Junctional tachycar
Regular rhythm; rate 100-
Most common with
May produce or exacerbate sympi
dia
180; P wave as above
chronic AFj also with
[Oms of CHF or angina secondary
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coronary artery disto decreased cardiac output; PT
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ease, rheumatoid
treatment depends on patient tol
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heart disease, and
erance-if new, onset should wait
cardiomyopathy
for medical treatment.
AF = atrial fibrillation; AV = atrioventricular; CHF = congestive heart failure.
Sources: Data from 8 Aehlert. ACLS Quick Review Study Guide. St. LoUIS: Mosby, t 994; and EK Chung. Manual of Cardiac Arrhythmias.
Boston: Butterworth-Heinemann, t 986.