AV Junctional Arrhythmias

Case 3 Answer

Junctional Tachycardia 1

History:
This ECG was recorded from a 88 year-old lady who was found to have a tachycardia on examination. She has no cardiac symptoms.

ECG shows:

  • 2 Rhythms:
        - beats 1-10 and 16-20, sinus tachycardia, 115/min
        - beats 11-14, paroxysmal junctional tachycardia, 150/min
        -Negative p waves in II (small arrow) due to retrograded stimulation of the atria by the AV node. These p waves have a temporal relationship with the preceding QRS complex.
  • Normal PR interval, QRS axis and duration, QT interval for rate.

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    Other variants of retrograde p wave produced by junctional rhythm:

    Before QRS, after QRS or hidden within QRS

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