Junctional tachycardia: Difference between revisions
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**AV node | **AV node | ||
**Bundle of His | **Bundle of His | ||
*Also referred to as Junctional Ectopic Tachycardia | *Also referred to as Junctional Ectopic Tachycardia (JET) or Congenital Ectopic Tachycardia (CJET) if present at birth | ||
* Rate exceeds the upper limit seen in normal sinus rhythm | * Rate exceeds the upper limit seen in normal sinus rhythm | ||
**In adults, >100 bpm | **In adults, >100 bpm |
Revision as of 23:11, 21 December 2020
Background
- Rare
- Cardiac impulses originate at the AV junction
- AV node
- Bundle of His
- Also referred to as Junctional Ectopic Tachycardia (JET) or Congenital Ectopic Tachycardia (CJET) if present at birth
- Rate exceeds the upper limit seen in normal sinus rhythm
- In adults, >100 bpm
- In pediatric patients it varies by age until age 8 or 9 (see pediatric vital signs)
Clinical Features
- Clinical features vary widely, diagnosis usually made via ECG
- Past medical hx may include recent cardiovascular surgery
Differential Diagnosis
Narrow-complex tachycardia
- Regular
- AV Node Independent
- Sinus tachycardia
- Atrial tachycardia (uni-focal or multi-focal)
- Atrial fibrillation
- Atrial flutter
- Idiopathic fascicular left ventricular tachycardia
- AV Node Dependent
- AV Node Independent
- Irregular
- Multifocal atrial tachycardia (MAT)
- Sinus tachycardia with frequent PACs, PJCs, PVCs
- Atrial fibrillation
- Atrial flutter with variable conduction
- Digoxin Toxicity
Evaluation
- ECG findings
- P waves
- may be antegrade, retrograde, or absent depending on depolarization of the atrial relative to the ventricles
- QRS complexes
- Narrow in the absence of aberrancy
- P waves