Junctional rhythm is an abnormal heart rhythm originating in the atrioventricular node. It can be a sign of an underlying condition and may require treatment such as a pacemaker or medication. Patients with no underlying heart problems may also have this rhythm.
Junctional rhythm is a heart rhythm that originates in the atrioventricular node of the heart, rather than the sinus node, the area normally responsible for regulating the heartbeat. It’s not necessarily dangerous, but it can be a sign of an underlying condition that needs treatment. An EKG will readily reveal the abnormal rhythm, and a doctor can use other diagnostic information to determine why the patient’s heart rate isn’t normal. This will be used to decide what treatment, if any, is needed.
The AV node sits between the atria and the ventricles, serving as a literal junction. In normal sinus rhythm, where the heart rate is regulated by impulses from the sinus node, the atria beat first, as expected. With a junctional rhythm, the atria still beat first, but the heart rhythm is abnormal. Some people have this type of heart rhythm with no underlying heart problems and can be perfectly healthy and active.
A junctional rhythm may be a response to a heart block, in which signals from the sinus modality are not transmitted and the atrioventricular node takes over. The patient may be at increased risk of heart failure and other problems if the blockage is not addressed, usually by using a mechanical pacemaker to regulate the heartbeat by relieving the AV node. Patients can also develop this type of rhythm when they experience bradycardia, in which the heartbeat is slower than usual, with this node compensating by increasing the heart rate.
People who have an adverse reaction to digitalis may also develop joint rhythm. These patients need medications to compensate for the digitalis and allow the sinus rhythm to take over. The cause of a joint rhythm is often evident from examining and talking to the patient, allowing the doctor to decide how to proceed with treatment. Typically a cardiologist supervises patient care.
In cases where the joint rhythm does not require treatment, it is noted in the patient record for future reference. Healthcare professionals who notice abnormal heart rhythms can rest assured that it has been identified and addressed by a previous doctor. If the heart rhythm changes again, more follow-ups will be needed to find out what is going on inside the heart and to see if interventions are needed to maintain the patient’s heart health. These can include medications and the use of a mechanical pacemaker, depending on the specifics of a patient’s case.
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