When a there is a regular repetition of PJCs or junctional beats, the ECG/EKG is referred to as a “Junctional Rhythm”. The second and 7th QRS complexes are missing P-waves, and are PJCs. Note : This strip includes Normal rhythms and complexes, but include 2 PJCs. Here’s a picture of an ECG/EKG strip, showing 2 junctional beats. Typically there is either no p-wave because it’s hidden in the QRS complex, or the P-wave may be inverted and appear before the QRS complex. What is a Premature Junctional Contraction (PJC)?Ī PJC is a beat that originates from the AV node junction, before a sinus beat, thus disrupting the underlying rhythm. Let’s start with Premature Junctional Contractions, or PJC. Now, it should be noted that there a different types of junctional issues/rhythms. In many cases, particularly when the p-wave comes after the QRS complex, the p-wave may be hidden inside of the QRS complex, thus no distinguishable P-wave will be visible on the ECG/EKG. In cases where the P-wave is present, but inverted, the PR interval is typically shortened, less than the typical. Other times the P-wave may be present, but be inverted or come after the QRS complex. You guessed it, it’s not there!!!! Well…. So, if the impulse is originating from the AV node, what do you think happens to the P-wave? So, if you remember from our review of sinus rhythms, typically, when impulses originate from the primary pacemaker of the heart, the SA node, a P-wave will usually be present on the ECG. In the case of junctional rhythms, the impulses are originating from the Atrioventricular (AV) node junction, the junction in junctional rhythm. Let’s go!Įssentially, junctional rhythms are the result of electrical impulses, in the heart, that stem from somewhere other than the Sinoatrial (SA) Node that we talked about in sinus rhythms post. So, as always, we are going to keep this sweet and simple. Having a basic understanding of Junctional Rhythms gives you the ability to plan care for your patients, more effectively.Īn interesting thing about Junctional rhythms, is that they can be fairly easy to remember once you understand the definition of a junctional beat and rhythm. The thing is, Junctional Rhythms have popped up multiple times in my nursing career, while working on the floor and in the ICU. There isn’t a vast amount of epidemiological information on Junctional Rhythms, but we do know that they tend to be common in people suffering sick sinus syndrome and in young and athletic individuals ( Junctional Rhythms ). Why should you spend your time learning about Junctional Rhythms? Are they even that common? Well…. There may be affiliate links associated with some products but we promise that we will never recommend anything that we don’t use ourselves. Any use of the information given in this post series is at your own risk and should be verified prior to making it a part of your nursing practice. Junc in the trunk? Let’s talk about Junctional Rhythms and beats! Disclaimer: This material should be used to supplement your understanding of the cardiovascular system.
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