![]() Atrioventricular node: 40 to 60 beats per minute.Sinoatrial node: 60 to 100 beats per minute.Pacemaker sites and their depolarization rates are listed below: ![]() And the rate of a heartbeat depends upon the pacemaker site, and as we go down its conduction system, the rate of spontaneous depolarization at pacemaker sites decreases. PathophysiologyĪ heart has numerous pacemaker sites within its conduction system, which are independently able to keep the heart beating. Junctional rhythm is reported equally among males and females. Patients with sick sinus syndrome, young children, and athletes who have increased vagal tone may also intermittently exhibit junctional rhythm, especially during sleep. Junctional rhythm is typical among individuals who have a sinus node dysfunction (SND), and 1 in every 600 cardiac patients above the age of 65 within the United States has SND. Digoxin toxicity can also lead to an accelerated junctional rhythm. Other than the above-listed causes of severe SA node disease, which can result in junctional rhythm, a high-grade second-degree heart block and a third-degree heart block can also result in a junctional rhythm. Acute and chronic coronary artery disease.Vasovagal simulation (endotracheal suctioning).Some of these conditions and medications are listed below. Numerous conditions and medications can lead to a diseased SA node and lead to the AV node/His bundle taking over due to the higher automaticity of the ectopic pacemaker. When the electrical activity of the SA node is blocked or is less than the automaticity of the AV node/His bundle, a junctional rhythm originates. Junctional tachycardia: rate above 100 beats per minute. ![]()
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