Junctional Rhythm

Hello All,

I had an appt. with my Cardio Dr. and Medtronics Tech today.
After having the PM for 18months for Bradycardia/ second degree block, I found out that I also have Junctional Rhythm.

I am now weraing a holter for 24 hours. Guess, I am a bit scared. I had been feeling weak and fatigued for a few months, but thought maybe that it was because they set my PM to 50 in Oct. I had been working abnormally long hours this past month and worked on call, and also had the flu a few weeks ago. I also feel a bit of heaviness in my chest.

Just worried.....

Thanks,
CJ

2 Comments

Just a guess

by BillMFl - 2009-02-25 11:02:43

Junctional rhythm is usually definded as retrograde conduction from the junction with the ventricle back to the atrium. The atrium is delayed and beats a little later than it should, so blood flow into the ventricle is not as efficient as it should be and can cause syymptoms like you describe. The holter moniter should show that the atrium is not firing as soon as it should and you will have an abnormal ekg. Your PM is supposed to sense when the atrium is late or not firing and pace you. However, with retrograde conduction you may be getting a second pulse coming back to your atrium from the junction. The Holter should show exactly what electrical activity you are having. Hang in there. An accurate dx is the first step in determining what treatment you may need or possible adjustments to your PM settings like voltage and delay.

It's No Fun...

by chip - 2009-02-26 10:02:50

I’ve been suffering from a junctional rhythm for some time now so I can empathize with your plight. It is no fun at all!

When you’re in a junctional rhythm you feel terrible and experience hypotension (at least I do) along with an overall tired “nasty” feeling. The fatigued feeling you describe fits right in.

My junctional rhythm was discovered when I began experiencing almost total cessation of any atrial activity. In my case the junctional rhythm was secondary to atrial failure, just my heart trying to keep going. My pacemaker would no longer pace the atrium either. Long story short – My EP corrected the problem using a new lead and placing it in the coronary sinus.

View the procedure here: http://wwwp.medtronic.com/newsroom/content/1213706985403.video.wmv

This is not saying that you will need surgery. A junctional rhythm can be controlled in many different ways they just didn’t work for me.

To put it simply (and to the best of my understanding) a junctional rhythm is defined as follows:
In a normal heart the sinoatrial node or SA node sets the pace for your heart beats acting as the hearts pacemaker. The beat starts in the SA node then causes the atrium to beat. It then passes from the atria through the AV bundle, traveling along fibers to the ventrical causing the ventricle to contract thus pumping blood to your body. This is the “sinus rhythm” in which the atria contract before the ventricles.

In a junctional rhythm the SA node does not control the heart's rhythm. The heart's atrioventricular node takes over. (natures backup system) With a junctional rhythm, the atria will sometimes actually contract with the ventricle and try to pump against the closed valve.

The electrical impulses start at the junction between the atrial and the ventricle areas of the heart thus the term junctional rhythm.

Stay on top of your doctors and don’t let them tell you that you have to learn to live with it because you don’t or that it’s no real big deal because it is! There is treatment out there you just have to seek it out.

Please drop a message back and let us know how things are going for you!

If you have anymore questions please don't be afraid to ask.

God Bless & Live Well

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