Junctional Arrhythmias Flashcards
What’s going on with premature junctional beat?
Irritable focus in the AV junction spontaneously fires and stimulates the ventricles and sometimes the atria in a retrograde fashion
What does the EKG look like with PJB and retrograde fashion to the atria and forward impulse to the ventricles?
Because the impulse is moving in opposite directions, the p wave prior to the QRS is inverted or the P wave after is inverted.
What is junctional bigeminy and junctional trigeminy?
Premature junctional beat after two or three normal cycles/beats
What is the rate of paroxysmal junctional tachycardia?
150-250
What’s going on with the P wave in paroxysmal junctional tachycardia and why?
Inverted before each QRS, inverted after each QRS or buried in each QRS because of retrograde impulse conduction.
What does AVNRT look like on EKG?
No p waves, just R waves.
What is the overarching family of arrhythmias that PAT and PJT fall under?
Supraventricular tachycardia
Talk about whats going on with Atrial, junctional, and ventricular escape rhythms and what their rates would be.
If the SA node isn’t working, then the atria foci will inherently begin to pace at their inherent rate, which is 60-80. This pacing will be different in that the P wave will not be the same ones as the SA node pacing, but the P wave will be the new atria foci. If the junctional focus become the pacers, then there will be lone QRS complexes and t waves with no p waves at a 40-60 rate. If the ventricles take over, it will be 20-40 rate, with super wide QRS complexes.
What are the two things that will lead to the ventricles pacing?
A complete AV block or everything above the ventricles failing in the conduction system. If it is a complete AV block then there will be P waves and QRS but completely dissociated from one another.
