Atrioventricular junctional rhythm
Alerts and Notices
Synopsis

Terminology of the types of junctional rhythms depends on the rate. All rhythms will be regular and narrow-complex unless there is baseline intraventricular conduction delay.
- Junctional bradycardia: < 40 beats per minute
- Junctional escape rhythm: 40-60 beats per minute
- Accelerated junctional rhythm: 60-100 beats per minute
- Junctional tachycardia: > 100 beats per minute
Junctional rhythms are more common among those with sinus node dysfunction. Athletes and young children may also exhibit a junctional rhythm during sleep. Congenital ectopic junctional tachycardia is a rare disorder that is often refractory to medical therapy.
Codes
ICD10CM:I49.8 – Other specified cardiac arrhythmias
SNOMEDCT:
11849007 – AV junctional rhythm
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Second-degree AV block
- Complete heart block
- AV nodal reentry tachycardia
- AV reentry tachycardia
- Sinus tachycardia
- Atrial escape rhythm
- Sinus node dysfunction
- Sinus bradycardia
- Digoxin toxicity
- Lyme carditis (see Lyme disease)
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:07/01/2020
Last Updated:07/26/2020
Last Updated:07/26/2020