Junctional tachycardia electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Electrocardiography
A 12 lead EKG should be obtained to evaluate the rhythm. In so far as it may alter treatment, any co-existing rhythm disturbance that may have precipitated junctional tachycardia should be ascertained such as
- The rate is >60 beats per minute
- The rate is generally regular
- The QRS complex is narrow
- Retrograde p waves may be present due to retrograde conduction from the AV node. The p waves will be inverted in leads II and III.
- The p wave may be buried within the QRS complex and may not be discernable
- AV nodal reentry tachycardia (AVNRT) should be excluded.
EKG Examples
Shown below is an EKG depicting junctional tachycardia (rate about 115/min), dissociated from a slightly slower sinus tachycardia (rate about 107/min) producing one form of double tachycardia; pairs of ventricular capture (C) beats (5th, 6th, 19th, and 20th beats); see laddergram.
Image obtained courtesy of Jason E. Roediger, CCT,CRAT