Junctional escape or junctional rhythm ! Let me explain

Junctional escape or junctional rhythm !

Let me explain these in more detail !!!!

So I know lots of confusion exists in the minds of Drs especially the very Jnr regarding some commonly heard terminologies & they always fumble when they come across any such tracings ! So the commonly heard terminologies are

1. junctional beat !

2. Junctional (escape) beat !

3. (Premature) junctional complex (PJC) /beat !!!!!!

So I will try to create a difference or differentiation among them

Some other terms which are used very frequently & mostly wrongly interchanged !

1. Ventricular escape beats

3. ventricular extra systoles

4. vs ventricular escape Rhythm

Ventricular escape beats may occur when there is a significant pause in the sinus and also total lack of junctional escape complexes!!!

Morphologically the complex’s will be quite variable depending on site of origin ! Usually QRS wide and bizarre, consistent with ventricular origin!!!!

As described V extra systole or PVC will not be preceded by a pause rather on the contrary they are often followed by a compensatory pause.

Ventricular escape rhythm

Succession of ventricular escape beats in absence of adequate SN function

a. Rate typically 30 to 40 bpm.

b. usually wide, complexes

ECG shown above Narrow complex QRS with no P waves,,rate is 44 BPM.inverted T waves in inf leads..this seems to be junctional escape rhythm.

Comments

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𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚 in Patient with AF and acute IS/TIA European Heart Association Guideline recommends: • 1 days after TIA • 3 days after mild stroke • 6 days after moderate stroke • 12 days after severe stroke Early anticoagulation can decrease a risk of recurrent stroke and embolic events but may increase a risk of secondary hemorrhagic transformation of brain infarcts. The 1-3-6-12-day rule is a known consensus with graded increase in delay of anticoagulation between 1 and 12 days after onset of ischemic stroke or transient ischemic attack(TIA), according to neurological severity based on European expert opinions. However, this rule might be somewhat later than currently used in a real-world practical setting.

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