Peer Reviewed
ECG education
Is this a junctional tachycardia?
Abstract
An ECG showing a narrow-QRS suggests the presence of a junctional tachycardia.
Key Points
- Junctional tachycardias present with a rapid heart rate (usually between 140 and 250 bpm) and are due to an abnormal re-entrant circuit near the AV node and the bundle of His. Typically, the abnormal impulses are conducted retrogradely to the atria and anterogradely to the ventricles.
- Both AVJRT and accessory pathway-mediated tachycardias (such as Wolff–Parkinson–White syndrome) can typically be terminated using adenosine, and often respond to carotid massage or other forms of vagal stimulation.
- Atrial tachycardias and flutters are not usually terminated by adenosine or vagal manoeuvres, and continue with AV block and dissociation (especially after use of adenosine).
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