inferior or posterior wall MI or ischemia.digoxin toxicity (most common cause), which can be enhanced by hypokalemia.Possible causes of junctional tachycardia include: Look for these distinguishing characteristics. This rhythm strip illustrates junctional tachycardia.
This rhythm strip illustrates accelerated junctional rhythm. Identifying accelerated junctional rhythm This arrhythmia is significant if the patient has symptoms of decreased cardiac output-hypotension, syncope, and decreased The accelerated rate is usually between 60 and 100 beats/minute.Ĭonditions that affect SA node or AV node automaticity can cause accelerated junctional rhythm. The atria are depolarized by means of retrograde conduction, and the ventricles are depolarized normally. Discontinue digoxin if indicated.Īn accelerated junctional rhythm is caused by an irritable focus in the AV junction that speeds up to take over as the heart’s pacemaker. If the patient is hypotensive, lower the head of his bed as far as he can tolerate it and keep atropine at the bedside. Nursing care includes monitoring the patient’s serum digoxin and electrolyte levels and watching for signs of decreased cardiac output, such as hypotension, syncope, or decreased urine output. Atropine may be given to increase the heart rate, or a temporary or permanent pacemaker may be inserted if the patient is symptomatic. Treatment for a junctional escape rhythm involves correcting the underlying cause for example, digoxin may be withheld. However, pulse rates less than 60 beats/minute may lead to inadequate cardiac output, causing hypotension, syncope, or decreased urine output. It may be slow, but at least it’s regularĪ patient with a junctional escape rhythm has a slow, regular pulse rate of 40 to 60 beats/minute. The rhythm is regular with a rate of 40 to 60 beats/minute. This rhythm strip illustrates junctional escape rhythm.
The rest of the ECG waveform-including the QRS complex, T wave, and QT interval-should appear normal because impulses through the ventricles are usually conducted normally. The PR interval is less than 0.12 second and is measurable only if the P wave comes before the QRS complex. The P waves occur before, after, or hidden within the QRS complex. Look for inverted P waves in leads II, III, and aV F. The less tolerant the heart is, the more significant the effects of the arrhythmia.Ī junctional escape rhythm shows a regular rhythm of 40 to 60 beats/minute on an ECG strip. Whether junctional escape rhythm harms the patient depends on how well the patient’s heart tolerates a decreased heart rate and decreased cardiac output. A junctional escape rhythm can be caused by any condition that disturbs SA node function or enhances AV junction automaticity.
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