Junctional Rhythm Follow-up

Updated: Sep 22, 2016
  • Author: Sean C Beinart, MD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Follow-up

Further Outpatient Care

Most of the workup on an otherwise healthy patient can be completed in an outpatient setting. Documentation of the arrhythmia on a rhythm strip is essential to properly diagnose the rhythm and to help exclude other causes.

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Further Inpatient Care

AV nodal junctional rhythms generally are well tolerated; however, bradycardia for prolonged periods often causes symptoms such as dizziness and presyncope or, rarely, frank syncope in younger patients. Patients with coronary artery disease, those with significant comorbidities, or elderly patients may not tolerate a secondary junctional rhythm well and, in the acute setting, may require intervention such as a pacemaker.

Currently, the choices of treatment strategy include determination of the underlying cause and whether it is a normal physiologic response (ie, that observed in a young athlete) or due to a primary cardiac abnormality such as heart block.

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Complications

Complications are usually limited to symptoms such as dizziness, dyspnea, or presyncope.

Accidental injury may result from syncope if the arrhythmia is not tolerated well.

Exacerbation of cardiac comorbidities, such as congestive heart failure and rate-related cardiac ischemia, may occur.

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Prognosis

No evidence suggests increased mortality.

Prognosis is good.

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