junctional escape rhythm
A backup cardiac rhythm originating from the AV junction when higher pacemakers fail, typically presenting with narrow QRS complexes at 40-60 beats per minute.
Full Definition
Junctional escape rhythm occurs when the AV node assumes pacemaker function due to failure of higher automaticity centers, producing a narrow complex rhythm at 40-60 bpm with absent P waves or retrograde P waves. In emergency cardiology, this rhythm may develop during complete heart block, severe sinus bradycardia, or following cardiac arrest. While junctional escape provides hemodynamic support, the slow rate may cause symptoms requiring temporary pacing, and the underlying cause of sinus node dysfunction must be identified and addressed.
Usage
Usage note: Distinguish from accelerated junctional rhythm, which occurs at rates >60 bpm.
In Context
- "Following complete heart block, the patient developed a junctional escape rhythm at 45 bpm." — Telemetry monitoring report
- "The junctional escape rhythm provided adequate perfusion while awaiting pacemaker insertion." — Cardiology consultation